Red Oaks

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 that the provider met people’s needs.At our last assessment we rated this key question Outstanding. At this assessment the rating has remained the same. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 93 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received exceptional, highly personalised care which consistently reflected their individual histories, preferences, relationships, culture, faith, communication and changing needs. Care plans, risk assessments, ‘Getting to Know Me’ profiles and regular reviews gave staff detailed guidance about what mattered to each person and how to support them in ways that promoted comfort, identity and control. Records and conversations with staff showed this knowledge was translated into everyday practice, including preferred routines, food and drink, meaningful relationships, sensory needs and individually chosen activities. Feedback was unequivocally positive. One relative said, “You would not find anything to equal it,” while a person told us, “They are very responsive. They do whatever I ask them.”

The service used people’s lived experiences to create support that was responsive, creative and outcome focused. For example, the whole-home life-enrichment approach made meaningful engagement everyone’s responsibility. Staff used life histories and family knowledge to provide purposeful one-to-one and group opportunities, from music, sport and reminiscence to community outings and faith support. In addition, care was adapted promptly when people became frailer or preferred to remain in their rooms, so they continued to experience companionship, inclusion and enjoyment. One relative described this attention to detail: “They know she loves Lindt chocolate, so she gets offered those after her meal. Also, she loves mango juice – so she gets that – they know her favourite food – and if it is something she doesn’t like they will change it.” One staff member said, “We prioritise people's preferences.”

Specialist dementia practice was embedded and continually developed. Dementia Champions reviewed people’s experiences, care approaches, best practice tools such as DECIDE (an initiative designed to support family members, friends, and informal caregivers who are making complex choices for people living with dementia), supported staff reflection and helped colleagues understand behaviour as communication. Learning was being used to identify improvements. Positive-reframing guidance had strengthened staff language and practice from labelling behaviour to exploring distress, discomfort, anxiety or unmet need. This promoted dignity, reduced negative assumptions and enabled staff to respond with reassurance and individualised support. A professional said, “The management team lead by example and have created a culture where residents are clearly at the centre of everything they do. Staff know residents extremely well, understanding their personalities, preferences, likes and dislikes, which enables highly personalised care.”

Personalisation was sustained through strong oversight, family involvement and rapid adaptation. Monthly audits, resident-of-the-day reviews and governance monitoring checked whether care remained effective and reflected people’s wishes; where engagement reduced, leaders identified this quickly and provided additional support.

The provider understood the diverse health and care needs of people, so care was joined-up, flexible and supported choice and continuity. People’s care and treatment was delivered in a way that met their assessed needs.

Continuity of people’s care resulted from staff working consistently and meeting their assessed needs. Effective partnership working with external agencies meant that care was delivered effectively, and people’s health care needs were responded to. People were supported to access health care services as required. One staff member said, “We try and be as flexible as possible but also making sure that residents are safe and that's really important.”

Care was coordinated and delivered to those most at risk and considered the preferences and protected characteristics of people living at the home. Staff understood those people who were more at risk and monitoring tools and systems were in place to respond to any changes and seek further support if needed.

The provider identified and removed barriers to communication. Accessible information was provided and staff adapted communication around each person's abilities and preferences and reviewed whether those approaches were effective.

The provider had embedded the Accessible Information Standard by identifying, recording, flagging, sharing and regularly reviewing each person’s communication and information needs from pre-assessment onwards. Care plans described how people communicated, the time and support they required, and adjustments arising from dementia, aphasia, dysphasia, hearing loss, sight impairment or blindness. This enabled staff to provide consistent, personalised support.

Information was made accessible through large print, easy-read material, pictures, short written prompts, whiteboards, talking books, verbal explanation and demonstration. Staff introduced themselves, described surroundings, clothing and food, used show plates to support meal choices, and gave people time to process information and respond. Communication plans were available on staff handheld devices, supported by life-story information and communication profiles. Staff training and dementia champions strengthened practice in provision of those living with dementia, while referrals to audiology, optometry and speech and language therapy ensured specialist advice and equipment were obtained when required.

The service used technology creatively to remove barriers and maintain important relationships. Staff supported people to use tablets, video and voice calls, smart televisions and voice-activated speakers. For one person whose daughter lived abroad, staff established and supported twice-weekly WhatsApp calls, setting up the device and remaining available for reassurance. The calls became a valued part of the person’s routine, sustained a close family relationship and improved wellbeing, while reassuring their relative that distance would not prevent meaningful contact.

People also shaped how information was shared across the home. In response to feedback, the provider introduced a monthly residents’ newsletter with larger text, more photographs and shorter, clearer sections. Residents contributed through meetings and the resident ambassador programme. Feedback showed the newsletter helped people recognise familiar faces, recall recent events, participate more fully and feel connected to their community; the initiative also received external recognition through a provider newsletter competition. Accessible communication was proactive, personalised and continually improved. Residents’ meetings routinely shared updates checked whether communication methods were working and recorded actions, while survey findings were translated into named actions and communicated through meetings, individual discussions, update emails and “You said, we did” displays.

The provider had an exceptional, inclusive approach to listening to and involving people. People and those close to them had multiple accessible ways to share their experiences, including everyday conversations, monthly residents’ meetings, resident-of-the-day reviews, 6-monthly care reviews, surveys, complaints and 2 resident ambassadors. One person said, “They listen to any suggestions and deal with any problems.” Another person confirmed that matters raised at the previous residents’ meeting had been resolved.

The service actively sought out voices that could otherwise be less heard. Two resident ambassadors gathered views informally, represented people at meetings and raised concerns directly with leaders. One ambassador lived with dementia and also welcomed and supported new residents, helping the service understand experiences from their perspective. Staff adapted communication to people’s needs and involved relatives where appropriate, so dementia, sensory loss or difficulty communicating did not prevent people influencing their care or the wider service.

People’s involvement was continuous and meaningful. A relative described the monthly resident-of-the-day meeting as an opportunity to speak with the nurse and review everything affecting their loved one, alongside a fuller 6-monthly care-plan review. People and relatives said staff discussed changes with them between formal reviews and involved them in decisions. This ensured feedback influenced individual care promptly rather than waiting for scheduled meetings.

Leaders consistently converted feedback into improvements and communicated the impact. Residents’ meetings led to changes to menus, outings and entertainment, with actions shared through “You said, we did” information. Following feedback, the provider redesigned its newsletter using larger print, more photographs and shorter sections. This helped people recognise familiar faces, recall events, participate in discussions and remain connected to the life of the home. Survey findings were assigned to named actions and shared through meetings, individual discussions and updates.

The provider also treated concerns and complaints as opportunities to improve people’s experiences. Learning resulted in clearer discharge information, increased communication with families when needs changed, improved maintenance reporting and follow-up, enhanced weight monitoring for people staying for respite care, and more personalised activity support for people whose cognition was declining. Staff meeting records showed this learning was embedded in practice: staff received coaching where needed, and team discussions were expanded to include people’s life histories and lived experiences.

Staff went above and beyond to ensure that people could access care, treatment and support when they needed to and in a way that worked for them, which promoted equality, removed barriers or delays and protected their rights.

The provider had embedded an inclusive model which ensured disability, frailty, anxiety or a preference for privacy did not reduce people’s opportunities or control. The service therefore adapted around people, rather than expecting people to fit established routines. Staff routinely took music, animal visits, adapted exercise, interactive technology and individual activities to people in their rooms. A personalised cinema experience was created for one person who preferred to remain in her room, with her chosen film, refreshments, cinema-style tickets and family involvement. People were also supported to maintain identity, faith and important networks, including attending local churches and community groups.

The service consistently turned people’s wishes and life histories into highly personalised opportunities. When one person asked to hear live opera again, staff used community networks to find an opera singer and worked with her family to sustain her anticipation and involvement.

The service made sure that people could access the care, support and treatment they needed when they needed it.People received care that was timely and in line with best practice and quality standards. Consistent provision of staff training contributed towards this. The provider sought, through the assessment process to ensure that people received their care when they needed it and wanted it.

People were able to freely access care, treatment and support when needed. People were registered with GP surgeries and staff ensured that timely referrals were made for specialist support when required.

The provider was exceptional at promoting equity in people’s experiences and outcomes. Leaders and staff understood that some people were at greater risk of poorer experiences because of disability, sensory loss, dementia, communication needs or protected characteristics.

The provider proactively identified these barriers and made personalised adjustments so people could participate, communicate, maintain relationships and experience the same opportunities as others.

An example of this was ‘Operation Hearing’. The service worked with a healthcare professional to review people’s ear health, identify previously unrecognised hearing difficulties and arrange treatment. One professional said, “Together, we reviewed residents' ear health, identified those who may have been struggling with hearing due to excess ear wax, and carried out ear wax removal where needed. The difference this made was remarkable. Residents who had previously struggled to engage became more involved in conversations and activities. Communication improved, and there was noticeably greater interaction between residents, staff and family members. This was especially evident amongst some residents living with dementia, where improved hearing appeared to have a significant impact on their ability to connect with those around them and engage with daily life.” This demonstrated a clear link between identifying inequality, taking targeted action and achieving meaningful outcomes.

Leaders also anticipated and addressed the risk of discrimination. When supporting a person whose identity created a foreseeable risk of prejudice, they involved the person and their relative, prepared the staff team, answered questions openly and tailored personal care arrangements to protect the person’s dignity, identity and choices and matched the person with a keyworker who could provide informed support. This resulted in a positive transition and sustained outcome and showed active prevention of inequality and a sustained outcome, rather than compliance with equality duties alone. Across the service, people’s cultural, religious, sensory and communication needs were understood and acted on.

The service made a wide range of reasonable adjustments to remove barriers. Staff used large print, pictures, written prompts, whiteboards, show plates, technology and specialist referrals to support people’s communication and decision-making. Leaders monitored whether people had equitable experiences with activities, outings and one-to-one engagement. Where people could not, or did not wish to, join larger groups, staff adapted opportunities around them; people with mobility difficulties were supported to access gardens, community facilities and trips. People were not segregated according to diagnosis or ability; support was adapted around each person, so they remained included.

People received exceptional, personalised support to plan for the future and make informed end-of-life decisions.

Staff encouraged advance care planning while people had capacity, respected their choices and reviewed resuscitation decisions as needs changed. People’s wishes were consistently acted on, enabling them to remain in familiar surroundings. Leaders said people had not died in hospital for a long time because staff proactively supported their wish to return home. This promoted autonomy, comfort and continuity at the end of life. One relative whose loved one had been supported at the end of their life told us, “It’s brilliant. She was here for 10 years, and she was the happiest she’d ever been. They took such good care of her. They kept in touch with me if there were any issues.”

Staff had exceptional end-of-life skills. Two senior nurses were palliative care champions, all nurses had completed syringe-driver training, and staff received symptom-management training and shadowing through St Barnabas Hospice. Nurses worked proactively with GPs, the care home matron, ECHO and hospice specialists to secure anticipatory medicines and specialist support without delay. This reduced avoidable hospital admissions and enabled symptoms to be managed promptly, supporting peaceful and comfortable deaths.

Support for families was exceptional. Staff anticipated relatives’ emotional and practical needs. One relative stayed for 4 days and nights and was given a care basket, meals and support so they could remain with their family member. Families stayed for as long as they wished, while staff respected those who chose not to be present. This went beyond routine provision and reflected an embedded culture of compassion.

Staff went above and beyond to honour people’s identity, relationships and bereavement needs. They hosted wakes, attended funerals and followed people’s known wishes, including dressing one person in their favourite blue dress. When one loved one felt unable to attend his wife’s funeral, staff arranged for him to see the hearse leave the home, watch the recorded service remotely and attend the wake held at the service. Palliative care champions reviewed every death to identify learning. These sustained, creative and highly personalised practices demonstrated outstanding care across the service.