Hazel Garth

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
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’s health was not always effectively monitored for example, bowel health and weight loss. In 1 person’s records a health issue was identified but recordings to note any improvement or deterioration had not been completed for 2 weeks.
Care Plans and risk assessments were reviewed monthly and we saw evidence of care plans being updated when someone was discharged from hospital. However, people and their families could not remember if they were involved or if they had seen the care plans.

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.
Shortfalls in relation to recording and monitoring people’s health needs meant we could not be assured care was always joined up to support continuity and achieve positive outcomes for people.
However, health professionals told us that the provider was welcoming and “Staff have the information on hand, and are helpful and efficient,” and “Staff appear informed on people’s care and happy to liaise with [health] via phone and during face-to-face visits.”
 

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
There was minimal signage to support people living with dementia. Toilets were identifiable but there was no directional signage around the home to guide people. In addition, people had no way of locating their own room as no names or pictures were in place to support people, and we observed some people going in and out of rooms.

The provider assessed people’s individual communication needs and where needed ensured alternative formats were available, for example 1 person who could not communicate so picture cards were available to help them.

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.
The provider had a system in place to monitor complaints. Surveys to gather peoples feedback, as well as staff and partners were completed by the local authority with results shared with managers and staff.
Meetings were held with people. Meeting minutes showed people had enjoyed having the therapy dog to visit and a weekly exercise class.
People and their families told us that they felt comfortable to raise any issues with the management team and that they would be listened to. Comments included, “I think they are all amazing. If I had a problem I would speak to [name] but we haven’t needed to,” and “I can ask them all, I don’t have any grumbles.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.
Systems and processes were in place to support referrals to relevant health professionals, and staff supported people to attend healthcare appointments when required. However, improvements were needed to record keeping, as gaps in records meant we could not be assured that changes or deterioration in people’s health conditions would always be recognised and responded to appropriately. Where people required equipment to support their care and meet their needs, this was available.

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.
Shortfalls in record keeping meant people did not always receive care and support that was planned and delivered in line with their individual health needs. Systems to monitor and review people’s health and wellbeing were not always effective, which increased the risk that changes in their needs may not be identified and responded to promptly.
Opportunities for people to access the community were limited. One relative told us, “I have never known about any outings.” Staff also raised concerns about the lack of community access, telling us, “We have to get people out of the building more … there is not enough staff to do visits outside of the home,” and “People haven’t been out since March.” This meant people were not consistently supported to access activities and experiences outside the service in line with their preferences and interests.

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.
People’s wishes and preferences relating to end-of-life care were recognised and respected. The management team acknowledged that discussions about end-of-life care can be sensitive and may take time to explore. The registered manager told us these conversations were approached in a person-centred way, recognising that some people did not wish to discuss their preferences, while others were supported to consider and review their wishes over a longer period.
A relative confirmed they had been involved in discussions about future care wishes and told us, “They did ask and they know [person] has a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision in place.”