Sackville Gardens

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 outstanding. At this assessment the rating has remained outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (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 was exceptional at making 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.

People were exceptionally well supported as individuals by a dedicated staff team who aimed to deliver holistic, person-centred care to everyone, including accounting for protected characteristics. The service was shaped using the voices of everyone living and working there, with a clear philosophy that everyone mattered and all had an important part to play.

Staff and the management team knew people extremely well and this enabled care to be provided which consistently met their needs and ensured their aspirations were met. People’s views were central to the arrangement of their care, including staff promoting an open dialogue about risks. People’s risk assessment contained a specific section on what their views were. This enabled any differences to be explored and ensure the person’s voice was at the forefront of the delivery of care and support. The significant positive impact of this was demonstrated in improvement to people’s mental health, living skills and confidence, enabling them to move on to more independent living with positive outcomes.

Where people's conditions could limit them from participating in meaningful activities which were important to them, staff proactively looked at overcoming obstacles to promote and fulfil people's potential. This was done in collaboration with the person so a positive outcome could be achieved together, whilst allowing ideas that the person may not have thought of themselves to be considered. For example, one person experienced times of significant distress and the worse this became, the harder they found it to express their wishes. As a result, staff supported them to introduce a card communication system involving colours. Each colour represented a mood the person was experiencing and not only helped them express this, but it also enabled staff to gauge how much support that person needed or would be willing to accept. This was a less restrictive way to help the person direct staff into what intervention they needed and when. Following the implementation of this system, the incidents of distress significantly reduced, and the person said, “I have lived a lot of my life unable to express myself and set up to fail, but now able to express myself.”

The management team's primary focus was to develop people's skills and confidence and provide them with the tools needed to live more independently. We saw a vast variety of examples in which people’s lives had been significantly improved. There was a key working system in place to support care planning and encourage people to share their wishes, however, even when this didn’t work, staff and management showed flexibility in their approach. One person found the concept of key working and the method used overwhelming. They had expressed that the categories were not applicable to them. Instead, staff worked with the person to discuss the points that where important to the person, and over time a plan which was meaningful to them was developed. By removing the pressure of a more formal process and staff applying a wholly person-centred approach, they identified people’s achievements and acknowledged progress made. This supported the person to formulate a plan to move on, something which they had never considered before.

People had been able to make their living spaces their own. For example, a person had gym equipment in their room, something which was important to them. Staff had supported them to source this creatively as the person had struggled to do this themselves. One staff member told us, “It would be easy for us to think people are only here for a short period of time so why personalise it. But that’s not how we work. People are here because they need our support and in order for them to be comfortable and help them achieve goals, we get to know what they want. I spend as much time as I can with those I key work, that’s how you get those little ideas that wouldn’t be spoken about in more formal settings. I’ve learnt a lot, especially about different religions and cultures.”

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.

Each person had an allocated keyworker who worked alongside them to coordinate their care provision and coproduce their care plans and risk assessments. There was a strong emphasis on keyworkers acting as advocates for the person they were supporting, including when communicating with external professionals. This helped people’s needs be understood clearly, and information was shared promptly between everyone involved in their care.

External professional spoke positively about the support people received from staff and were often kept up to date with progress against personal goals. Staff met with the ‘keyperson’ regularly to ensure care plans were responsive to any changing needs and were still accurate for each person. People told us that they valued the consistency of having a regular keyworker, who they could build trust and a relationship with, making communication about care needs easier. For example, one person was often caused anxiety when having to attend appointments. The keyworker supported the person to prepare for these well ahead of time, even utilising an electronic mapping system to identify where they would be going. This helped the person manage their expectations of the situation and encouraged them to remain engaged with the care provision they required.

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff had an excellent understanding and knowledge on people’s communication needs and how to meet these effectively. Staff and people formed strong bonds through exceptional communication skills. A specific section of people’s Wellbeing Action Plan focused on communication, and details of people’s preferred methods were core to personalised care.

Staff utilised creative methods to achieve the best level of communication with the people they supported. This was not only to continually improve and expand their communication skills, but also other people who lived at the home. For example, one person was hard of hearing and as such staff introduced a ‘sign of the week’ initiative to promote learning of British Sign Language and aid communication between people. This had a significant impact on the person who was deaf as it helped foster a more inclusive environment. It also helped others learn a different skill and broke down barriers.

Professionals spoke highly of the incredibly proactive and flexible approach from staff in relation to meeting people’s communication needs. One professional said, “Our service worked alongside Sackville Gardens. The team have been proactive and forward planning when booking in interpreter sessions. Continuity in interpreter provision can be difficult to achieve but with staff planning in advance, liaising with the interpreter service and offering flexibility with when support sessions can take place, has worked really well to everyone’s benefit.”

Staff were creative in the use of technology to enable those they supported to maintain relationships that were important to them. One person experienced paranoia when it came to using technology. However, staff supported this person to increase their confidence using the tablet and computer provided by the service. This work enabled the person to contact family who lived thousands of miles away.People living at the service developed a welcome pack to give to new people, which was accessible in numerous different formats. There was a clear ethos of the service being as person led as possible and encouraging people to shape their own welcome pack ensured it was accessible for all.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

The management team and staff presented a number of different ways in which people could provide feedback about their care. People were also given regular opportunity to talk about what was important to them, especially when forming goals for moving forward. The provider had an innovate approach to ensure no one was missed when giving feedback, providing a variety of methods to gather feedback. These included focus groups, including people from other parts of the organisation, so people could have a safe space away from the home should they need. They undertook an annual client snapshot survey; this was available in different formats to support those who had specific communication needs. There was also the opportunity for people who used the service to sit on the board of the organisation to ensure their voices were heard from the top down.

People felt their voices were heard and commented on how the service was shaped around them, having a positive impact on their lives and outcomes. When the service was awarded some additional funding, they consulted with people on how they wanted this to be used and what was important to them. The agreement was to redesign the garden so people could use this space for improving their mental health. The garden was transformed using the ‘Twelve Principles of Permaculture’, a method which encourages sustainable living and has an ecological design. People were fully involved throughout the process and staff used a number of creative techniques to gain their views, for example, drawing pictures, using thought bubbles and allowing people time to come up with ideas. The garden was complete at the time of inspection and comprised an accessible space with sensory elements to support people’s wellbeing. We observed several people enjoying it throughout the day.

One person was supported to engage in activities meaningful to her and a staff member supported her to do yoga at the service. Other activities which had been facilitated following feedback included work as experts by experience in the local trust, attending the local Parkrun, arranging gym memberships and supporting people to enrol and attend college.

People were able to raise concerns or complain. For people who could not easily communicate, other methods such as sending emails or writing notes had been offered. Residents’ meetings were also held. One person said, “I appreciate the time staff take to really listen and validate how I am feeling. I’ve not had this in my life, [staff] are not trying to fix my behaviour, they just support me and treat me like an equal.”

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

People were supported to have equal access to healthcare and activities. This was inline with their preferences and personal choices including considerations to cultural or religious support needs they had.Staff worked flexibly and collaboratively with people to ensure they could participate in opportunities that were meaningful to them and reflected their individual values and beliefs. Care plans included information around people’s identity, detailing support they needed to ensure their individualities were promoted. People were enabled to maintain relationships which were important to them.

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.

The provider had a commitment to creating equal opportunities for people who often experienced marginalisation. Staff worked exceptionally hard to ensure people were empowered and supported to promote equality and protect their rights.

Staff ensured people’s disabilities were not a barrier to having a fulfilled life. Although the service offered short term support before people moved on, this did not deter staff from dedicating themselves to getting to know a person and working with them to identify and breakdown barriers. For example, one person was experiencing significant isolation due to being deaf and having severe anxieties. Staff worked closely alongside this person to establish what was important to them and researched local activities. Staff linked them in with monthly events in the community and support them to attend a church which was specifically for deaf people. Staff learnt British Sign Language (BSL) to ensure they could effectively support this person to minimise their isolation. As a result, this person’s social circle significantly increased, and they gained confidence in living life more independently. They said, “For the first time in my life I feel happy and stable. Staff at Sackville do it differently and genuinely care”.

Staff were passionate to learn about people’s differences and how to support them to celebrate these. Details of people’s needs and wishes were clearly documented in care plans and risk assessments. Another person was isolating themselves within the service due to their cultural needs, fearing that they would not be able to access communal areas, restricting interactions. This had become their norm however they were matched carefully with an individual staff member to shape a risk assessment and support this person to access communal areas. This would involve them checking the area first as to who was around and supporting the person to take the steps they needed to if they wanted to access the area. The person gradually felt more confident in coming out of their room and began to forge relationships.

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.

Those who had wished to discuss end of life planning, this was documented in their care plan. The home had a strong emphasis on supporting people to move forward in their lives and plan for their future to enable this. Care planning was inclusive and collaborative, and people were able to set goals to work towards to move to a more independent way of living for the future.