Prestbury Beaumont

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence the provider met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider was exceptional at making sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People received highly personalised care which reflected their individual goals, wishes and changing circumstances. Records, observations and feedback demonstrated a consistently person-centred culture where what matters to people shaped how their care was provided. Staff adapted the service around people rather than expecting people to fit established routines.

Staff understood that what was important to a person could change as their health changed. For example, as one person approached the end of their life, their support changed from focusing on usual nutritional goals to prioritising comfort, enjoyment and quality of life. Staff continued to offer foods and drinks the person enjoyed without placing pressure on them to eat. This meant the person's wishes and comfort continue to guide their care even as their health deteriorated.

We observed staff adapting everyday support around people's individual preferences. During an activity, one person did not want to participate directly but chose to remain with the group, watch what was happening, and enjoy a preferred drink. Staff respected this rather than encouraging the person to participate in a way they did not want to. That's enabled the person to remain included while retaining control over how they spent their time.

Staff had a strong understanding of what gave people purpose and meaning. They supported people to maintain interests and activities that had been important throughout their lives. Staff understood that people's interests, relationships and sense of purpose remained important regardless of their care needs. One person continued aspects of an occupation which remained important to them. Staff supported them to have the equipment and space they needed to continue this interest. This enabled the person to retain an important part of their identity, independence and sense of purpose while living at the service.

Relatives consistently described care being adapted around the individual. They said staff recognised subtle changes in people's needs and altered their approach, increasing or reducing support as people's circumstances changed. One relative described their support as “wraparound care.” Relatives described staff learning how best to approach people, including when to offer support again rather than insisting when someone initially declined. This was important for people living with cognitive impairment or communication difficulties as staff use their knowledge of the individual to provide support in ways people were comfortable accepting.

There was evidence that this personalised approach had a positive impact on people's well-being. Relatives describe people becoming more settled, engaged and confident as staff learned what mattered to them and adapted support accordingly. People continued to have meaningful experiences, relationships and a sense of purpose despite changes in their health or abilities.

One relative described staff across care, nursing, management, catering and the grounds team as consistently having people's best interests at heart and the service was "shaped around what people needed."

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People benefited from highly consistent and flexible care provided by a stable and experienced staff team. The service did not rely on agency staff, and many staff had worked there for several years, with some having very long service. This continuity enabled staff to develop trusting relationships and an exceptional understanding of people's needs, routines, communication and what was important to them. Relatives consistently described the difference this made to people, familiar staff, knew people well enough to recognise changes in their health, mood and behaviour and respond promptly. This was particularly important for people who could not always communicate their needs verbally. One relative said staff understood them their family members facial expressions and could recognise when they were uncomfortable or in pain. They described staff as knowing the person as well as our family. This meant continuity directly contributed to staff recognising and responding to people's needs.

One relative described the significant reassurance that came from the consistency and continuity of the staff team. They said familiar staff helped people feel safe, comfortable and that they belonged. Another relative described how staff adapted support sensitively as people’s needs changed, without losing the familiarity and continuity that was important to them. This demonstrated how stable staffing and strong relationships supported people to experience genuinely personalised and consistent care.

Detailed care records, handovers and daily communication supported this relational knowledge. Staff returning after some after time away used these systems to understand changes in people's needs, helping ensure care remain consistent between shifts and important information did not depend solely on individual staff members.

Continuity also extended to relationships with healthcare professionals. Staff maintained established links with GP’s and other professionals and followed through referrals, appointments and changes in treatment. This meant people benefited from healthcare professionals and staff who understood their history and could respond when their needs changed.

The service provided continuity during periods of respite. People and families returned to the service for further periods of support following illness, hospital treatment or surgery because they already knew the staff and environment. Familiar relationships reduced uncertainty at difficult times and enabled staff to build on their existing knowledge of the person rather than starting again with each period of care.

People developed a strong sense of belonging because of those relationships. One person described this by saying “That is now my house, and this is my home.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was tailored to people's individual communication needs, enabling them to remain involved in decisions about their care and support. Staff adapted how information was shared, using personalised approaches such as simple language, allowing time to respond and presenting information in manageable ways.

People's communication needs were regularly reviewed. Records provided practical guidance on adapting communication and supporting people to participate as fully as possible. Staff supporting one person with significant communication difficulties were guided to reduce background noise, speak clearly and position themselves within the person's visual field.

Relatives consistently described communication as regular, clear and responsive. They felt well informed about people's health and well-being and were actively involved in care reviews and decisions about changing needs. One relative told us they were kept informed, “Always, absolutely, every single day”, while another said they were kept informed ‘step by step’ during a significant event.

Relatives described staff and managers as approachable and accessible. One relative told us, “They always let me know what is going on”, while another described communication as “Excellent”, adding, “Any change, even small, is shared with me promptly and clearly.”

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support.

The provider placed people's voices at the centre of decisions about their care and the development of the service. People were not only encouraged to give feedback, but they were also supported to influence, lead and contribute directly to improvements. Staff and leaders listened to people's views, acted on them and demonstrated how their involvement resulted in changes to their everyday experiences and the service. Listening to people was embedded in everyday practice.

Regular residents and relatives, meetings, informal conversations and the providers 'You Said, We Did' approach provided different ways for people and those important to them to influence decisions. People's views shaped activity, social events, their environment and how information was provided.

There was evidence that people's involvement went beyond consultation. For example, one person identified that information held by the service about the local area was inaccurate. Leaders recognised the person's knowledge and supported them to become directly involved in improving this area, with the person taking a lead role within the relative quality improvement work. This gave the person genuine ownership of an improvement and enabled their knowledge and lived experience to benefit others using the service.

Other feedback resulted in visible changes to people's everyday experiences. A suggestion to replace artificial flowers in dining areas with fresh flowers grown in the services gardens was implemented, meaning people could see their ideas reflected in their surroundings separately in other persons. Feedback identified that information about Wi-Fi and devices could be improved and the service acted to make this information clearer. These examples demonstrated that people could see a direct connection between expressing a view and something changes.

People also influenced everyday decisions. During a meeting, we observed people were actively involved in planning two upcoming events, including deciding what food should be provided, competition categories and contributing ideas about the activities. Their involvement was practical and specific, rather than people simply being informed about plans which had already been made.

Relatives consistently felt listened to, valued and actively involved. They described a culture where feedback was welcomed and concerns were taken seriously. One relative described regular relatives' meetings as a place where, "The floor is yours," while another said they felt "very listened to." Another relative said issues they raised were never treated as trivial or unimportant. They were acted on promptly and where something should could not be resolved immediately, the family was kept updated. This gave relatives confidence that raising something would lead to consideration, action and communication rather than simply acknowledgement.

Listening was embedded beyond formal meetings or feedback systems. Leaders spent time with people, staff understood people's individual ways of communicating, and people's views were used to shape both their own lives and the wider service. People experience meaningful influence over everyday decisions and service development and were empowered to participate directly in leading improvement.

The provider made sure people could access the care, support and treatment they needed when they needed it regardless of disability, communication needs or changes in their health.

Potential barriers to accessing support were identified and addressed through personalised care planning. Staff had clear guidance on how to overcome these barriers and ensure people could access the support they needed.

Staff adapted communication to meet individual needs and reduce barriers to involvement. One person with very quiet speech was supported through extra time, observation of non-verbal communication and staff's detailed knowledge of their usual behaviours, helping ensure their views and preferences were understood.

Support was adapted as people's needs changed. When one person developed significant physical and communication difficulties, staff adapted how they communicated, provided assistance with eating and drinking, and introduced proactive welfare checks because the person could no longer reliably use their call system.

Staff supported people to access healthcare services, coordinating referrals, appointments and professional input to ensure timely and appropriate care and treatment.

Relatives said leaders worked proactively to overcome barriers to healthcare access. They described the registered manager as committed to finding solutions when challenges arose.

People with complex health needs continued to access healthcare services and community opportunities. One person with significant communication and physical needs was supported to attend specialist appointments and take part in community activities.

The environment was adapted to support access and participation. People with mobility needs were supported to enjoy the gardens and outdoor spaces, while alternative indoor areas ensured people could remain comfortable and included.

Staff and leaders were innovative in how they listened to information about people who were most likely to experience inequality in experience or outcomes. They actively used this information to provide exceptionally tailored care, support and treatment in response to this.

People experienced inclusive care regardless of their physical abilities, cognitive impairment, communication needs, or increasing dependency. Staff understood where people could be at risk of having fewer opportunities or poorer experiences and adapted support for their needs did not unnecessarily limit their choices, participation or quality of life. This was evident in everyday care. People who required modified diets received meals presented to the same high standard as other people's food. Staff were available to provide individual support so people could eat alongside others rather than having a different or less dignified experience because they needed assistance. This meant people with swallowing difficulties or higher support needs could experience the same dignity, choice and enjoyment at mealtimes as other people.

Staff did not make assumptions about what people could enjoy because of their age, disability or care needs. People with physical disabilities and cognitive impairment continued to have access to meaningful activities and social experiences, with support adapted to enable participation. For example, activities included opportunities to interact with a range of animals. One relative described how amazing it was to see older people confidently handling a large snake and enjoying the experience. This demonstrated that staff maintained high expectations about the experiences people could enjoy, rather than restricting opportunities because of age or dependency.

Where people could not have participated in activities in the same way as others, staff found different ways for them to remain involved. This included individual activities and experiences in people's rooms when needed. People were not excluded from meaningful experiences because they were unable to access group activities or communal areas.

Communication difficulties did not prevent people from having control over their lives. Staff understood people's individual ways of communicating, including verbal responses, facial expressions, gestures and behaviour. Relatives described staff knowing people sufficiently well to recognise what they wanted and identify changes in their comfort or well-being, even when they could not communicate these directly. This enabled people with significant communication difficulties to continue to have their preferences understood and acted upon.

Staff also respected people's cultural and spiritual needs and supported them to maintain their beliefs and practises according to their individual wishes. One community partner told us support was based on what matters to each person, rather than assumptions about their background or beliefs.

These adjustments had a clear impact on people's everyday lives. Relatives described people with increasing dependency continuing to experience meaningful relationships, outings, activities, and enjoyment because staff adapted opportunities as their abilities changed. Staff focused on what people could still do and enjoy rather than what they could no longer do. Increasing dependency did not result in lower expectations for people's quality of life or fewer opportunities for meaningful involvement.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

Future care planning was proactive and person-centred. People's wishes, priorities and goals shaped decisions about their future care and treatment, with those important to them and relevant professionals involved as appropriate. Plans were regularly reviewed to ensure they continued to reflect people's changing needs and preferences.

Advance care plans were detailed and reflected people's individual wishes and preferences. They included preferred place of care, treatment choices, resuscitation decisions, anticipatory medicines and circumstances where hospital treatment remained appropriate.

Future care planning reflected what mattered most to people, including their emotional, spiritual, cultural and religious wishes. One person's plan clearly recorded their wish to remain at the service wherever possible and receive care focused on comfort, dignity and freedom from pain as they approached the end of life.

There was evidence future planning translated into compassionate, person-centred care. One relative told us staff did ‘all they could and more’ to make a difficult situation easier to manage and supported their loved one to be ‘as happy as their circumstances allowed’. Care planning considered quality of life and emotional well-being alongside clinical needs.

Future planning extended beyond immediate care needs. Staff reviewed arrangements as circumstances changed and worked closely with professionals and families to ensure safe, coordinated transitions. Where people returned to the community, support was carefully planned to promote continuity, safety and positive outcomes.

Relatives consistently felt involved in planning for the future. Staff used their detailed understanding of people's needs, wishes and circumstances to anticipate change and initiate sensitive discussions at the right time. This included supporting families to consider future care options and treatment decisions as people's health needs evolved.