Tandridge Heights

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 Good. At this assessment the rating has remained Good. This meant people’s needs were met through good organisation and delivery.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Some people’s care plans lacked information which may support staff to ensure that person-centred care was consistently being provided.

People’s care plans contained contradictory information. This included 1 person’s communication care plan where it stated they liked to ‘socialise and chat with other residents and staff’ and yet, in their life enrichment care plan, it recorded they were a very quiet and gentle person who was private and liked to keep themselves to themselves. The service was currently using a large proportion of agency staff and as such people’s records needed to be accurate to ensure that people received care in line with their wishes and choices as they were using these to guide them.

We have reported elsewhere in this report on people not receiving person-centred care in relation to bathing and showering with 1 person’s care plan recording they should be offering a shower daily and another who was recorded as liking a bath twice a week. Neither of these were recorded as happening.

Staff told us it was difficult to find time to read people’s care plans. Although they had the electronic care planning system which gave a list of the tasks required on a daily basis, the real detail about how they could provide person-centred care in line with people’s wishes was not included in this information. A staff member told us, “We have these devices which are very good. But to get to know all people’s needs you have to read the care plans and we don’t have time to do that.” Another staff member told us they had not read people’s care plans saying, “If I want to know something I can ask a nurse.”

However, relatives were happy with the care their family member received with 1 relative telling us staff looked after their family member as they would like them to be looked after. Another relative told us staff strove to accommodate their family member’s, “Whims and ways.”

Staff understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

General feedback from staff was that they enjoyed working at the service and providing care to people living there. A staff member said, “I love working with people with dementia, getting to know their life stories.”

There was a diverse range of people living at Tandridge Heights which included some people living with dementia, others who had a physical disability and people who had complex health conditions. One person told us, “The staff are nice and they know me and how my condition now affects my memory at times.” A staff member said, “I have done training for equality. It’s important because you need to look at all service users the same way, despite age, background, ethnicity. They deserve the same quality of care.

Management could supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Senior management told us they had access to picture cards and links with the speech and language therapy team and alternate forms of communication could be developed if needed.

However, further consideration was needed on how people who were living with dementia were supported to make choices of their own, particularly at mealtimes as people were handed a menu with very small print. We did not observe any other formats for the menu to support them to make their choice, such as larger print or pictorial format.

Relatives told us information was shared with them promptly and appropriately. One relative told us, “They always contact me if there’s any minor issue, plus we get a weekly email about what’s going on in the home.” Another said, “They are very proactive. They’ll ring us if he’s unwell.”

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People were able to give their views and feedback through regular residents’ meetings and regular provider surveys known as, ‘Tell Barchester’. In addition, feedback books were in each dining area to enable people to comment on the food.

The minutes of the last resident meeting demonstrated people were involved in discussions about all aspects of the service.

We read people gave mixed views. People reported a lot of menu changes which they were not consulted on and the menus on the tables did not reflect what we are offered most days. They also said there were no hot plates and a lack of hot food. Other people said their rooms were cold and the heating was faulty. The outcome of discussions was recorded in an action plan. People had been given the opportunity to make suggestions on forthcoming outings and activities.

The service had a ‘Resident of the Day’ initiative where a care plan review took place. It was an opportunity for staff to celebrate the person and also for the person to give feedback on the care they were receiving.

People and relatives said they felt listened to and that they would feel comfortable raising concerns or a complaint. Relatives told us, “I do raise concerns if I’ve got a problem” and “I don’t need to worry that things wouldn’t be addressed.”

Staff made sure that people could access the care, support and treatment they needed when they needed it.

People were supported to access health care professional input and other services in a timely way ensuring any difficulties a person may encounter were removed. One person asked us to request a visit from their social worker and management confirmed this request was submitted immediately after us reporting this back to them. People were supported to access dental and audiology services when required. One person said, “I can ask anybody if I want to see the doctor and they will arrange it. The doctor seems to be here twice a week.” Another person told us they had seen a dentist in the home.

Staff were aware of people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider had an equality, diversity and inclusion policy and staff were trained in this respect. This helped ensure that people’s individual characteristics were recognised and respected.

The provider also ran a ‘Life Enrichment’ programme. This helped staff tailor activities to support people’s physical, mental, and emotional well-being. People were given the opportunity to make suggestions for activities and outings which helped to ensure these were aligned with how people wanted to spend their time. This included setting up a knitting club and a reading club.

During the morning when the knitting club was running, we saw people from all areas of the service in attendance which demonstrated an inclusive approach by staff.

The service had its own bus and external trips were organised. One person told us, “I have been out on a few trips. We even went for a pub lunch. The activities are good.” Another person said, “They have a lot of entertainment. Over Christmas it was lovely. I enjoy painting and sewing. There is plenty to do.”

Relative’s felt there was a good range of activities on offer for people. One told us, “Everyone gets a printout once a week of activities. There seems to be 3-4 things a day to keep them entertained. I get emailed a copy of these too. They do really encourage them to join in. They are keeping people busy and active in that way. They take them out a lot. They go in the van to the garden centre a lot. They work with us so he can come to ours for a family dinner too.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

We read people were asked about any specific end of life wishes when first moving into the service. Staff recorded where people had expressed their views or when people had chosen not to discuss this at the time.

A relative told us this area of their family member’s care was discussed with them. They said, “When he came into the home [registered manager] asked if we would like to continue with the (advanced plans) for dad and we did. We haven’t had any further discussions yet as we don’t feel dad’s at that point.”

Staff undertook end of life training to help support them with the skills necessary when providing care to a person at this time of their life. One staff member told us, “I’ve done end of life care training online and face to face as well.”