Crescent 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 services were organised so that they met people’s needs, listened to their preferences and supported good outcomes. At our last assessment this key question was rated 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.

The provider did not always ensure care and support were fully person-centred or consistently reviewed to reflect people’s changing needs and preferences.

Monitoring systems were not always individualised. Food and fluid charts were completed for all people, including where this was unnecessary. Many were incomplete, and several showed people not meeting fluid targets. Intake and output were not always looked at, increasing the risk that dehydration or infection could go unnoticed. This reduced the value of the records and did not reflect person-centred practice.

People and relatives told us staff knew them well and provided care that met their daily needs. One family member said, “She’s happy and well looked after,” and another told us, “What they’re doing suits her well.”

We observed that staff were caring and attentive, but care delivery was sometimes task-focused, particularly during busy periods such as mealtimes.

During our observation of a lunchtime meal, staff were organised and attentive to people’s physical needs, but the approach was functional rather than person-centred. A relative commented that their family member was, “Being left largely to her own devices at the moment.” The provider gave assurance that the mealtime experience would be reviewed and improved.

Staff understood people’s preferences and delivered kind, day-to-day care, but improvements were needed to ensure care plans and monitoring reflected a truly person-centred approach.

The provider worked with staff and external professionals to ensure people received consistent, coordinated care that met their needs.

People and relatives told us they received regular support from familiar staff who knew them well. Permanent staff were described as “Kind,” “gentle,” and “friendly,” and relatives said their family members were, “Well looked after.” This helped people feel comfortable and supported by staff who understood their preferences and routines.

Agency staff were used occasionally to maintain safe staffing levels. The provider tried to use the same agency carers wherever possible to support continuity and ensure people were cared for by familiar staff. Records showed that appropriate checks and inductions were completed before agency staff worked independently. This helped maintain consistency and reassurance for people using the service.

Staff communicated effectively with each other through daily handovers, which included updates on people’s health, appointments, and changes in care plans. Health and social care professionals such as GPs, district nurses, physiotherapists and dietitians were involved in supporting people’s care. Their recommendations were followed in practice, which promoted continuity and good outcomes.

People experienced continuity in their care and benefitted from good communication between staff, agency workers and external professionals, ensuring support was consistent and well-coordinated.

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

People’s communication needs were identified in their care plans, and staff supported them to understand daily routines and choices. People told us staff explained things clearly and were approachable if they had questions. Relatives said they felt informed about appointments or incidents, although some said they would appreciate more regular updates about reviews.

Information about the service, such as activities, safeguarding contacts and complaints procedures, was displayed in communal areas and accessible to people and visitors.

We noted that pictorial menus were available and used to support peoples’ understanding and choice during mealtimes. This demonstrated that the home-made efforts to present information in an accessible way, particularly for people living with dementia or communication difficulties. Staff were observed helping people use the pictures to make informed meal choices, showing a person-centred approach to providing information.

Information about the service was appropriate and up to date. The use of pictorial menus and accessible communication showed that staff adapted information to meet people’s individual needs.

The provider made it easy for people and relatives to share feedback, ideas or concerns about the care and support they received. Staff involved people in decisions about their care and shared updates on actions taken as a result.

People and relatives told us staff and management were approachable and willing to listen. One relative said, “If I ever have a concern, they sort it out quickly.” Another commented that staff were “always friendly and open to feedback.” People said they felt able to raise issues directly with carers or senior staff and were confident they would be addressed.

Records showed that people, relatives’, and staff meetings took place, giving people opportunities to share their views and contribute ideas about activities, meals and general improvements in the home. Meeting notes showed that suggestions were recorded, and actions agreed, helping ensure feedback led to change.

A complaints procedure was displayed clearly in communal areas, and people and relatives confirmed they knew how to raise a concern. Complaint records showed issues were acknowledged, investigated and responded to with appropriate outcomes.

While most people said they received feedback on the outcome of their concerns, a few staff and relatives told us communication about follow-up could be more consistent.

The provider maintained an open and responsive culture that encouraged people and families to share their views. Feedback was listened to and acted upon, helping to improve care and maintain trust in the service.

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

Pre-admission assessments were completed to ensure people’s needs were understood before moving into the service. This helped identify any equipment or adaptations required, such as mobility aids or pressure-relieving mattresses, so support could be arranged in advance.

The home environment, including the garden and communal areas, was accessible for people using wheelchairs or walking aids. Staff supported people to move around safely and encouraged them to maintain mobility and independence.

People had timely access to healthcare and specialist services. Staff worked closely with the discharge-to-assess and intermediate care teams to support hospital discharges and ensure continuity of care.

Relatives told us staff were quick to contact health professionals when there were changes in people’s health, and updates were shared appropriately. Staff also understood how to access emergency or out-of-hours medical advice when required.

People with communication or cognitive needs were supported to access information in ways that worked for them, including the use of pictorial menus and patient explanations to aid understanding.

People could access the care and treatment they needed promptly and without barriers, ensuring their health and wellbeing were effectively maintained.

The provider made sure that people experienced fair and consistent standards of care and support, and that their individual backgrounds, preferences and abilities were recognised and respected.

People told us they were treated equally and felt included. One relative said, “One of the things I like is that everyone is treated as an individual here.” Staff supported people to participate in activities that reflected their interests, such as group events in the lounge or one-to-one conversations for those who preferred quieter interaction. A relative told us, “She likes activities; she’s happy so all’s well.”

We saw staff encouraging people to join activities, spend time outdoors, and interact with others. The garden and communal areas were accessible and well used, providing opportunities for social contact and inclusion.

Staff were observed giving equal attention to people who spent time in their rooms, ensuring they were checked on regularly and offered refreshments and conversation.

Relatives and People said care was delivered with respect and fairness. Although busy periods sometimes limited the time available for social interaction, staff prioritised ensuring everyone’s essential needs were met.

People experienced positive outcomes and equitable care. The provider promoted inclusion and dignity, and staff supported people in ways that recognised their backgrounds, preferences and abilities.

People were supported to plan for important life changes, including the later stages of life, so they could make informed decisions about their future care and preferences.

At the time of the inspection, there was no one receiving end-of-life care, although some people were being supported with palliative care needs. Records relating to these individuals were comprehensive, up to date, and clearly reflected their care requirements and comfort measures. Care plans included details of people’s wishes and preferences, such as resuscitation decisions, hospital admission choices, and any cultural or spiritual considerations. These were discussed with people and, where appropriate, their relatives, and recorded in their care notes.

Staff worked closely with GPs, community nurses, and palliative care teams to ensure people’s needs were met with dignity, comfort, and respect. They demonstrated compassion and awareness when discussing how they supported people approaching the end of life.

Pre-admission assessments helped identify people’s long-term and potential palliative needs, ensuring appropriate equipment and support could be arranged in advance. While some relatives confirmed they were involved in reviews and discussions, others said they had not been included recently. This feedback was raised with the provider during the inspection, who acknowledged the concern and confirmed that family involvement in care reviews would be strengthened going forward.

Staff told us they felt confident in delivering palliative and end-of-life care and knew how to access guidance and support from external professionals when required. We observed a calm, respectful approach, with staff focused on maintaining comfort, privacy, and dignity.

The provider supported people to make informed choices about their future care and ensured that palliative and end-of-life wishes were recorded, respected, and delivered with compassion and sensitivity.