Carricks Brook

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 remained 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.

Staff showed a strong understanding of people, their preferences, routines, and communication styles. Care plans were detailed and reflected individual goals, including and personalised risk assessments. People were supported to make choices and develop and maintain their own independence. Staff knowledge of people meant they were able to recognise people’s abilities and skills and promote these. They actively supported people to identify new goals and learn new skills to achieve these goals. Staff supported people to take part in activities that were meaningful to each person. They used these activities to further promote and develop individual skills.

Relatives told us staff knew their loved ones very well. One relative told us about their experience when their loved one moved into the home. They said, “We were immediately struck by the great care taken in getting to know [name] and in planning for his admission. This has continued to be our experience in the [time] that he has resided at Carricks Brook.”

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.

People’s relatives told us their loved ones were referred to relevant health and social care professionals when required. One relative said staff were, “Any issues and [name] is referred.” Staff knew people well and understood their health and support needs. Staff were regularly updated about changes in people’s care and support needs, and information was available to share with relevant health and social care professionals. When people attended appointments, they were accompanied by staff to ensure people’s needs were clear and that people were involved in discussion and decisions about their support and treatment.

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

A number of people living at the home did not communicate verbally. There was information within their care plans about how they were able to communicate. This included the use of Makaton, Easy Read documents, pictorial support, electronic and other communication devices. Communication was person centred and reflected individual needs. We saw social stories had been developed, for example, when someone needed a medical procedure. Social stories are short descriptions of a particular situation, event or activity, which include specific information about what to expect in a given situation and why. They are presented in a format to meet each person’s individual needs. This included information and pictures adapted to reflect how each person needed the information presented.

One person had a social story that staff regularly referred to when the person was showing signs of distress. Staff told us by encouraging the person to review the social story with them the person was able to identify the possible reasons for their distress, actions they could take and potential outcomes. Staff told us how this information supported the person to make informed choices; this also improved their quality of life.

People’s relatives told us they were kept up to date about their loved one’s care and well-being. There were family meetings which enabled families to spend time with each other and be updated about changes at the home, discuss any concerns both as a group and as individuals. They told us they were involved in reviewing their loved one’s care plans and generally kept up to date. Relatives told us they were regularly updated with photos of what their loved ones were doing each day. One relative said, “Staff even send me photos of things he has made; it’s these little touches that make a difference. Staff had developed personalised care plans with each person. These were separate from the main care plans. They included photographs and pictures of the person, their likes and dislikes, activities they enjoyed and care 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 were involved in all decisions about their support, as individuals and as groups at the home. There were regular meetings where people were introduced to new staff, discussed what activities they would like to take part in and plan the menu for the coming months. People were supported by staff to ensure those less able to communicate verbally were able to express their ideas and choices.

Each person had been assigned a key worker who supported the person to set and achieve goals and promoting independence. They were also a point of contact with family, other services. People’s goals were specific to each individual, for example, one person’s goal may be to identify and try a new activity, others may be to attend a college course. These were reviewed and updated regularly.

People were involved in the day to day running of the home. Each person had a role at the home, specific to their own abilities and interests. This included laying the table at mealtimes and preparing the pictorial noticeboard to show which staff were on duty each shift. People who were able to demonstrated they were proud of their own role and understood how it worked for the benefit of the whole home. People took part in interviewing potential staff. Their feedback was an integral part of the recruitment process and fully taken into consideration before an offer of employment was made.

People’s relatives told us they did not have any complaints or concerns. However, if they did, they would raise them with the registered manager or staff. They were confident that any issues would be addressed promptly. One relative said, “Any concerns they act immediately. They bend over backwards to help.” Another relative told us that if they ever raised anything it had usually already been addressed. They said, “Staff are very vigilant with everything.”

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

Systems were in place to help ensure people were not prevented from receiving the care and support they needed due to their health or disability. Staff told us and records showed, they worked with external professionals to help ensure people received the relevant health and social care support they required. Staff told us how they had developed specific plans for individuals to help ensure their health needs were met. When people needed GP appointments, these were arranged so that people did not have to wait. We were told about specific dental arrangements where people could be seen, for simple appointments, in the car by the dentist. This helped ensure people’s health needs were managed and if further treatment was needed appropriate arrangements were made.

People had free access around the home and garden. The home had been adapted to ensure it met both general and individual people’s needs. Externally, there was a large secure garden. There were sensor lights outside and these had been added to when one person chose to use the garden at night. People’s security and safety was balanced with supporting their independence, for example, the use of door alarms. People’s own rooms had been designed and decorated, with each person, to meet their individual needs and reflect their preferences.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Staff were proactive in ensuring people were not subject to inequality or discrimination due to their learning disability or autism. They actively supported people to receive the appropriate care and support by building effective relationships with people, their families and those who could support them. The staff team worked together, using innovative ideas, to ensure people were not prevented from doing what they wanted to do.

One person expressed a wish to undertake further education. They had completed previous courses and now wished to attend a mainstream college course. Staff identified that this was something the person was really interested in and motivated to achieve. The college identified the risks related to the person joining the course which were acknowledged by staff. Staff worked with the person and the college to help the person understand what was required of them. This was achieved and the person was able to join the course of their choice.

Another person was supported by staff to work in a café. Staff identified that this person did not require their support whilst working. However, due to the person’s health needs their local authority stated it was too risky for the person to be left without staff support. Staff worked with the person, their family, employer and health care specialist to identify and mitigate risks. This was presented to the local authority to demonstrate the measures that were in place to maintain the person’s safety. This was agreed and the person now worked independently without staff support.

Relatives told us about opportunities their loved ones were given because they were not discriminated against due to their disability. We were told staff had introduced awareness / special days (such as chocolate day or epilepsy awareness day) as a way of promoting a different range of activity ideas. One relative told us about how this had resulted in a zoo trip. They said, “Although [name] would not understand the concept of the awareness day he was still included, he still enjoyed himself and had the same benefits as others.”

When people’s needs changed staff worked with them to identify why and how to provide support in a different way to ensure they could still enjoy the same opportunities as before.

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 wishes were considered for each person. Discussions took place with people and their families. Some families did not wish to discuss their preferences, and this was respected. However, the conversation remained open to ensure follow up discussions could take place.

Each persons understanding and experience of death was taken into account when discussing end of life plans. People’s experience of bereavement and death was also used to develop conversations where appropriate. The registered manager used readily available resources to support conversations with people.