Haddon House Nursing Home

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 changed to requires improvement. This meant people’s needs were not always met.

This service scored 57 (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 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.

People did not always receive support in line with their person-centred needs. For example, unclear guidance relating to repositioning, or modified diets. We observed one person who was provided with a meat option for lunch, despite their care plan stating they preferred a vegetarian option. Staff were unaware this was in the person’s care plan, and the inspection team had to ask leaders to contact family to confirm the person’s dietary preferences.

However, interactions with people were warm and staff offered people choices in aspects of their support needs. For example, choice of meals, or activities.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Some relatives were satisfied their loved ones received the support they were funded for. One relative shared, “[Person] receives the care they need. I'm very happy with what they get. I don't need to worry about them at all.” People who had one to one support in place received this in line with their assessed needs. However, we received feedback that communication with leaders required improvement and some families were not involved in decisions around funding arrangements and whether their loved one required nursing care. A relative shared, “[Staff] said they’d look into it and ring me back and I just can't get hold of [staff]. And the manager said they'd look into it, but again, no one's got back to me. It's very frustrating.” Another told us, “No one informed me that [person] had been funded by Continuing Healthcare. No one wrote to tell me. I didn't know that an assessment had taken place. There's a problem with communication.”

The provider had regard to the Accessible Information Standard (AIS). Information was supplied in appropriate formats that were tailored to individual needs. For example, pictorial aids were available. People’s communication needs were appropriately assessed, and guidance was clear to support staff in the best way to communicate with people so they could understand. For example, one person’s care plan referred to the importance of tone of voice. Staff were observed to communicate clearly, patiently, and in a way that did not overload people.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

There was a complaints policy in place, and people, relatives and staff understood the process to raise a formal complaint. However, we received feedback that communication with leaders when concerns were raised required improvement. One relative advised they had raised concerns about an incident but had not received a response and were not confident this had been managed. We fed this back to the provider, who confirmed this had not been escalated by previous management and agreed to investigate as a matter of urgency. Other feedback included, “Sometimes it's hard to get hold of management. There's been no communication.” And “They don't get back to me. I've tried head office and I can't get through.”

However, initiatives were in place to involve and engage with people and relatives. This included a forget me not dementia café. Relatives told us, “We do have regular relative’s meetings. I go, they discuss what activities are happening like meal plans, and they change the menu for the summer.” And “I go to the forget me not café on a Saturday morning sometimes and they have cakes and drinks and chats and informal events.”

Following our first site visit, the provider met with people, families and staff to share the feedback from our assessment. This demonstrated a proactive approach to communication and a willingness to involve people and staff in discussions about service improvement.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People did not always have equitable access to appropriate care and support because ineffective systems to oversee risks, meant concerns were not always identified, escalated or referred to relevant professionals. For example, during our assessment, the inspection team had to prompt staff to seek healthcare professional input for 2 people as this had not been considered, despite concerns about their health and wellbeing.

We observed some examples of accessible, dementia friendly support. This included modified equipment at lunch time, and reminiscence activities.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. As people, and their relatives, were not always involved in care planning this meant opportunities to empower people to understand their rights, or share their experiences to improve their care were missed. However, the provider confirmed they would be strengthening and embedding their resident of the day system which would ensure each individual had opportunities to be involved about their care and support. Staff had received training in equality and diversity and relevant policies were in place to protect people from discrimination.

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.

End of life care plans were in place and people’s preferences for how they wished to be cared for at the end of their lives were recorded. This included any decisions around resuscitation. Staff had received appropriate training, and a policy was in place to support end of life care.