Elm Tree House

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 requires improvement. At this assessment the rating has changed to good.

This meant people’s needs were met through good organisation and delivery.

This service scored 79 (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 made 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’s care plans were now person-centred and included information about what was important to them. We found care was adapted to meet people’s specific health needs, such as modified diets (soft/ puree foods) and an epilepsy plan.

People told us they were supported to do the things they enjoyed doing, for example going shopping or go and play pool in their local pub.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Staff knew people well and demonstrated a good understanding of their individual needs, preferences and daily routines.

Effective communication between staff supported continuity of care. Staff used handovers, care records and ‘safety huddles’ to share important information and respond promptly to changes in people’s health and wellbeing. This helped ensure people received consistent support from staff who were aware of their current needs. The service worked closely with GPs, community teams and other healthcare professionals to coordinate care and support positive outcomes for people.

People also went out and about in their own community, and were regular visitors to local shops, café’s and the near-by pub.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People had their communication needs were clearly documented and understood by staff. For example, one person communicated using simple verbal language and was unable to understand written information, so staff used pictures to support their understanding. We observed staff adapting their communication approach to help a person understand information about their medicines during administration. Staff also supported another person to maintain contact with a relative through regular phone calls, ensuring the environment was quiet so the person could participate effectively in conversations. Staff told us one person had previously used signs and symbols to help them understand information and communicate with others. Staff explained the person now communicated verbally with them, which demonstrated progress in their communication skills. Information was available throughout the home in a range of accessible formats to help people understand information relevant to them and support their independence.

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.

We saw a ‘You Said, We Did’ board displayed in the home which showed how people’s feedback had been acted upon. For example, people had asked that the home be redecorated, and we saw a programme of redecoration was in place. People had also expressed a wish to go on holiday, and the manager showed us photographs of people enjoying holiday trips that had been arranged.

Leaders sought people’s views through regular engagement opportunities, including quarterly ‘Our Voice’ meetings. These meetings enabled people to meet with leaders and discuss their experiences, wishes and any changes they would like to see in relation to their support.

However, one relative told us they were unsure about how to make a complaint if they needed to. We shared this information with the provider.

The provider made sure that people could consistently access the care, support and treatment they needed when they needed it. Staff worked proactively with health care professionals to help people overcome barriers to accessing service and ensure their healthcare needs were met in a timely way.

Staff collaborated closely with GP’s and other healthcare professionals, including arranging home visits when this better met a person’s needs. For example, when one-person experienced anxiety about attending appointments at their GP surgery, staff worked with the GP to arrange home visits instead. Staff also supported another person to participate in gradual desensitisation programme to help build their confidence in attending appointments with a chiropodist. This person-centred approach helped people to receive appropriate health care in a way that was accessible and responsive to their individual circumstances. Through person- centred support, the service has helped one person reduce behaviours of distress, enabling greater access to community activities for example going swimming or out shopping.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. People’s care plans were person- centred and reflected their preferences, communication needs, cultural backgrounds and individual requirements. Staff had completed equality, diversity and inclusion training, which helped them to provide respectful and inclusive care.

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.

Personal preferences and choices were considered and respected. Person-centred information about end-of-life wishes was documented, and relatives had been involved in discussions and planning where appropriate. This helped ensure that people’s values, beliefs and preference were understood and reflected in their care.

Where appropriate, Recommended Summary Place for Emergency Care and Treatment (ReSPECT) forms and decisions about cardiopulmonary resuscitation (DNACPR) were in place. These had been developed in consultation with the person, their family and relevant health care professionals. This helped to ensure that emergency care and treatment decisions reflected people’s wishes and best interests.