Victoria Grand

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 as good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 62 (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 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 personalised care because staff were often too busy to spend time with them. Activities were organised for people in the communal lounge, but people who were unable or unwilling to go the lounge were disadvantaged. We spent time with 1 person who was having lunch in their room. They told us, “I don’t think much of the activities here. They give me piles of pens and colouring, but there’s nothing interesting or intellectual.” A relative was more positive and said, “It’s brilliant here”, and told us their loved one was engaging and interacting with others, and appeared happier, talkative and sociable. Activities were planned for the future, with a Valentine’s cream tea and dance. People could access the garden at the home.

Staff explained their understanding of person-centred care. One staff member said, “People are so different. You need to take time to get to know people.” The activities person was in the process of understanding and recording people’s life stories, with relatives adding information.

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.

The home worked with a range of health and social care professionals. With regard to people’s healthcare needs being met promptly, the staff had acted swiftly to have 1 person readmitted to hospital when they became unwell. A co-ordinated approach, working with a GP and district nurses, had ensured the person received urgent medical attention. An ‘alert’ card provided by the hospital provided advice and guidance for staff on symptoms to look out for after chemotherapy, and a number to call the hospital if the person became unwell following treatment, including possible side effects.

Where people’s religious beliefs precluded them from receiving certain medical interventions, this information was shared with hospital staff and paramedics.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was provided in an accessible format, and people’s communication needs were identified before they came to live at the home. There was information in an easy-read format for people, including information about safeguarding, Covid-19, and going to the GP. The activities staff were tasked with supporting people to understand this information, and to read it to them if needed. There were signs around the home to aid people to orientate themselves. People were supported to wear their glasses and, if needed, hearing aids. People had access to opticians to maintain their eye care and have their glasses changed if needed. One person had difficulty finding their bedroom, so arrow signs, with their name alongside, were displayed along the route.

Care plans contained communication plans. For example, 1 person who lived with Alzheimer’s disease, required care staff to be patient to enable them to communicate clearly. Staff had developed their own style of sign language and lip reading with another person.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. One person felt, “Staff are kind but too busy.” They had asked if their hot drinks could be prepared in a certain way, but their preference had not been listened to. They added that staff needed to face them when speaking, otherwise their hearing aid could not pick up what they were saying. They told us staff, “Just wander around the room talking to me, but I cannot hear them. I need them to face me. Then they wander off again, and they might as well be chatting to themselves, as I can’t hear them.” A relative was concerned about their loved one who did not want to get out of bed in the morning because they were cold. We checked the person’s bed. There was a pressure-relieving mattress with no cover, but a thin, discoloured sheet directly on the mattress. The sheet did not fit properly and ended just under the pillow, with the mattress exposed. On top of the sheet was a very thin blanket and what looked like an old duvet. The relative also noticed the poor quality of the bedlinen and agreed it was inadequate. Residents’ meetings took place and written notes recorded what had been discussed and the information that was shared with people. For example, a recent meeting had included information about building works, menus, and activities. People and their relatives were provided with a copy of the provider’s complaints procedure. Complaints were recorded together with the provider’s response, actions taken and outcomes.

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

The provider worked hard to ensure people received a reasonable standard of care. Some people had to wait before being assessed for specialist services. One person needed a mental health assessment and had been waiting for 3 or 4 months. Another person was on a waiting list for orthotics.

The home provided level access for people to mobilise and a lift between floors.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care and support in response to this.

Relatives felt communication between them and the staff was good. People’s protected characteristics were identified and recorded within their care plans, so staff knew people’s needs, preferences and wishes. For example, 1 person did not celebrate religious festivals or their birthday, and this was acknowledged by staff.

The provider’s equality and human rights policy was read and put into practice by staff.

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.

A relative told us they had been involved in completing a ReSPECT form. ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. The ReSPECT process creates a personalised recommendation for people’s clinical care in emergency situations where they are not able to make decisions or express their wishes. The form is designed to aid conversations between healthcare professionals, care staff, people and their relatives, about their wishes and preferences about their care at the end of their lives.

A couple of people were registered with the Echo service which provides advice and guidance for staff about people with life-limiting illnesses. Everyone had an end of life care plan which provided staff with information about people’s end of life wishes.