Eleanor Palmer Trust Home

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• 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 service met people’s needs.At our last inspection we rated this key question good.

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

This service scored 82 (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.

Staff worked with people to develop a personalised care plan with them which took into consideration their needs, risks and desired outcomes following an assessment.We found care plans were person-centred and delivered robust planning that supported people’s safety and dignity effectively. Care plans demonstrated detailed attention to people’s individual preferences. For example, in relation to their food preferences, clothing choices, gender specific care staff, religious and spiritual needs, as well as people’s nutrition and fluid requirements, skin integrity, and mobility needs. People’s views, opinions and choices were interpreted into plans for the future, so they were in control of their own lives.

Staff told us care plans helped them to reassure people and maintain their wellbeing. People were able to decorate their rooms with personal items and photographs. Their front door displayed their name amongst pictures or illustrations of things or people that were important to them, such as their favourite singers, places or hobbies. The management team and staff were exceptional at helping people maintain their links to the local community. They had an awareness of people's sense of place, their histories and past times and what was important to them. For example some people were supported to meet their relatives in the local area for catch ups in the cafe or attend annual sporting events with family members. Another person enjoyed attending friendship groups and visiting the local library because it was important for their well being and sense of belonging in their home town where they had previous strong connections. A relative said, "I’m extremely satisfied and impressed with the home's can-do ethos and the staff who are prepared to go the extra mile."

The staff worked with relatives to design a wishing tree which we saw in the home. People were invited to write down their wishes and the management team made efforts to fulfil as many of the wishes as possible. For example, a takeaway meal for everyone delivered in wrapped paper was arranged by staff in response to a person's wish. Another person was supported to learn to read by a member of staff after a need was identified. The staff made sure they dedicated time to help them when it was appropriate. These examples demonstrated how the provider could go 'above and beyond' as another relative described, to provide a personalised experience to people that meant something to them.

The management team involved people in the refurbishment of their rooms. The deputy manager told us they recently assisted a person choose colours for their new carpet and paint for their walls. People told us they were happy with the way care was provided. They and their relatives confirmed they had been able to develop and read their care plans. A relative said, “Yes. I have been involved and know about everything. They always phone me if [family member] had a UTI, what medication they’ve been given.” Another relative told us, “I am involved in reviews. I have an eye for detail so make loads of notes. The staff are in my [family member’s] corner and they are thriving here which is so good.”

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 and managers involved people and their families in their care and promoted choice and continuity. The provider was an established and well-known charity within the local community and ran a neighbouring sheltered housing service that some people in the home had moved from. This meant there was a chain of familiarity and continuity and people and relatives knew each other. The management team took steps to ensure that people received continuity of care to help them integrate into the home. People told us about how well they got on with staff. Staff communicated with relatives to inform them of how their loved one was and what they were doing.

People were supported to have access to a wide range of interests and integrate into the local community. The management team understood people’s health and care needs and communicated with professionals so people could have access to local health services.The home employed activity staff to arrange various activities for people to participate in. We observed people engaging positively in exercise sessions during the morning with staff encouraging their involvement. We saw that a hairdresser was in attendance who people looked forward to visiting. Planned activities included a sing along, bingo games, quizzes and crafts. A person told us, “We have singers and parties from time to time and people from the sheltered schemes can come and join in.”

People and relatives provided very positive comments about the activities. A relative told us, “People are encouraged to join in if they want to. [Family member] was delighted with the new garden as [family member] was an award-winning gardener.” Another relative said, “[Family member] enjoys all of the activities and the company. [Family member] never did drawing before but now loves to draw. They mentioned to [registered manager] that he used to grow runner beans when he was at home and she asked him if he’d like to have a go at growing some here. She got them the equipment and plants. She didn’t tell us and we were delighted when [family member] got their first crop of beans. [Registered manager] was overjoyed.” The registered manager showed us pictures of how the runner beans were growing. This showed how the provider was involving people in the day to day activities and entertainment in the home.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs were assessed and discussed during their initial assessment. This ensured staff knew how to communicate with people. The provider understood the requirements of the Accessible Information Standard which meant they were able to share and supply information in formats that were easy to understand. For example, easy read or large print versions of menu to promote independence and choice at meal times.

People’s preferred communication style was used so they could take part in reviews of their care. This enabled people to have their views, opinions and feedback captured and acted on. Communication tools were tailored to people and available to them to enable them to express their views, wishes and to make decisions.

Staff told us they knew how to communicate with people appropriately and respectfully and in accordance with their needs. Staff and managers made efforts to communicate with people in their preferred first language. For example, a language support chart for people who spoke a specific language was created which contained words and phrases to assist staff with communication. We learned that the deputy manager won an award for innovation, as they had learnt a person’s language in their spare time and developed communication cards for them. This helped the person communicate with staff on how they were feeling and express their choices and needs.

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 told us they felt free to raise any issues with their keyworker, or the manager. They felt confident they would be listened to and action would be taken to resolve any issues. A relative said, “Yes, you can ask to see the manager or deputy at any time and you can email the trustees.”

Complaints were handled appropriately and a relative was positive about the service and the level of communication and responding to concerns. Records showed that action was taken to address people’s concerns.

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

Staff and managers understood the needs of people with dementia or mental health needs. They worked hard to ensure that typical barriers faced by people were removed or mitigated against.Staff could reach managers for support outside office hours when needed, including emergencies. Referrals to specialist services were handled quickly if people’s needs changed, and connections with local GPs were strong.

Processes ensured equal access to healthcare like GP or dental registration, with regular health checks in place. The provider promoted human rights, anti-discrimination, and equity. Staff respected people’s traits such as gender and religious beliefs.

Staff and leaders listened to those most at risk of inequality and tailored care accordingly. Management assessed individuals before service use to identify and address diverse needs, including people's sexuality, spiritual or religious beliefs.

Reasonable adjustments were planned for external appointments, ensuring positive experiences and timely access to care despite disabilities or health conditions. Care plans detailed each person's needs and preferences. Management maintained awareness of groups facing inequalities and barriers in care.

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.

The provider ensured people’s wishes and care preferences, should they become seriously ill and require end of life care, were respected. Staff worked with people and their relatives to inform such planning. They were involved in decisions about their future care and support.End of life or palliative care was provided by the service and an end of life care policy was in place. People’s wishes and preferences for their funeral arrangements, for example, were recorded and respected. Their cultural and religious beliefs were also taken into account.

Comprehensive and detailed advance care plans were in place to address people’s end of life or palliative care needs. Staff demonstrated exceptional awareness of people’s palliative care status and needs. They maintained close communication with specialist teams to ensure their needs were met consistently and compassionately. For example, for there was a personalised approach focused on comfort, dignity, and proactive risk management. The provider had implemented the Gold Standard Framework (GSF) for end of life care and we saw how they demonstrated this. All people’s palliative care needs were assessed irrespective of whether they had reached this stage or not so a decision could be made as to whether they were required to be on a palliative care register. They were colour coded according to their needs according to the GSF proactive needs support plan. Staff sought advice from palliative care professionals and worked with them to help meet people's needs.

Relatives complimented the staff team on their end-of-life care and how they treated their family member. After their family member passed away, a relative had written, “We were comforted by the kindness and dignity with which you treated [family member]. It made a profound and lasting impression on us. We are especially grateful for the little things. Your gentle reassurance, the time you spent listening to them, and the thoughtful touches that brightened their days. These moments meant the world to [family member] and to us.” We noted how the provider had supported the person by providing them additional care staff who they were familiar with while they were in hospital in case they passed away alone, while their family were travelling to see them. This showed how the provider ensured people and relatives were supported with care, consideration and sensitivity at all times.

The management team told us how they were hoping to become accredited as a GSF organisation that provides a exceptional end of life care. Shortly after our inspection the provider informed us they received their award and accreditation.