Melbreck

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 75 (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.

People received person-centred care in line with their needs and preferences. One person said, “I'm happy here. They look after me well. All the staff are nice. They help me. They are well trained.”

People’s aspirations were identified and respected. People’s care and support plans were clear and included their biography, preferred activities and what made them happy and fulfilled. Care notes were completed appropriately and respectfully, and included details of any event, activities and interactions, and any healthcare concerns.

People had hospital passports in place. These detailed people’s preferences, things that were important to them and what staff needed to know to keep them safe from avoidable harm. This document was important should the person be admitted to hospital, to inform medical staff of the person’s needs.

We witnessed staff delivering person-centred support that met people’s needs. People appeared happy to engage with the staff in their own way, and staff understood them. A healthcare professional told us, “Currently I am finding the residents are all well-presented, clean, in clean clothes and with attention to personal grooming such as clean fingernails. The ladies have some lovely hairstyles like braids and clips.They look like time and pride has been given, getting them ready as the individuals they are.”

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 and relatives told us the service delivered good care that met people’s healthcare needs. Support plans detailed these needs and were personalised. There were clear instructions for staff to follow, so they understood each person’s condition and how it impacted on their daily lives.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The registered manager told us they recognised the importance of effective communication.

People’s communication needs were assessed during the pre-admission assessment so information could be made available to them in a format that suited them. People's care plans detailed their preferences and any aids they needed to support effective communication.

People were consulted and informed of all aspects of the service and its development. The registered manager told us, “We always discuss things with people. We tell them about people coming in to see them, who they are and what they are doing. We listen to them. They liked the Christmas lights, so we kept them. We ask people if they want to be involved in any activities, like cooking. If they don’t want to that is fine.”

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 and relatives were involved in the planning of their care and support. Care plans were reviewed regularly, and people and relatives were asked for their feedback about the care they received and anything they would like to change. The registered manager told us, “Some people join meetings, but we are mainly involved with relatives. They are forward in sharing their thoughts and concerns, and discussions about their loved ones.

The registered manager was keen to involve people and relatives in all aspects of their care. They told us, “We have done a lot of work with some of the parents. For example, [Person], who now goes to college. This happened because we worked together to make this happen. I try to be as responsive as possible, be honest and work with them.” A relative confirmed this and said, “They do consult me. They always call and ask things.”

The provider ensured people and relatives had the necessary information in relation to processes for sharing feedback or raising concerns. Records showed complaints received were addressed in accordance with the provider’s policies and procedures. Any learning from complaints and concerns was shared with staff to inform their future practice. A relative told us, “I'd certainly be OK to complain. In the first instance, I'd go to the manager. And certainly, higher if needed.”

Staff were encouraged to monitor people’s care to help identify issues before they could develop into complaints or concerns. There were regular meetings with people so they could raise concerns and make suggestions.

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

People told us they had access to the care and support they required and were happy with this. They felt their needs were met and the staff cared and supported them effectively. Records showed they were supported to attend appointments, and a range of healthcare professionals visited the home regularly. Records of visits were included in people’s care plans and the staff ensured they followed instructions.

People were supported to access the community for a number of activities. There were minibuses available and company employed drivers who were able to support people and staff with outings.

Care plans were regularly reviewed to identify any changes in a person’s care needs so the appropriate support could be found if needed. This included making appropriate referrals to external professionals as needed.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. People's care and treatment promoted equality and protected people's rights.

The provider had an equality and diversity policy in place and was committed to creating a welcoming and inclusive atmosphere for all people and staff, regardless of sexual orientation, gender identity, or gender expression.

People’s care plans indicated they or those who knew them well, had been consulted in decision making, including whether they preferred to receive care from a male or female care worker. Their care plans reflected people’s physical, mental, emotional and social needs.

People were supported to access the community and undertake activities of their choice. The registered manager told us, “At Melbreck we do daily activities both morning and afternoon, we do one active activity and one relaxed activity a day.” People’s activity plans evidenced this. For example, typical active activities included parachute games with music, intensive interaction and sensory cooking, whilst relaxing activities included, pamper sessions, feely bags (Fabric bags containing various objects, designed for people to identify, describe, and guess items by touch alone) and massage.

There was also a range of other activities organised, such as trips to the beach, cafes and garden centres, trips to the zoo and wine tasting days. External companies visited the service to provide a range of therapeutic activities such as art, animal farm, music therapy, music for health, reflexology and Indian head massage. There were also seasonal events such as the switching of Christmas lights, and pumpkin picking.

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. However, this was not always a subject people or their relatives were willing to discuss and this was approached sensitively by the management team and the care team.

Where people had end of life support plans in place, these detailed information about the person, important people in their life and how they wanted to be cared for at the end of their life. The registered manager told us, “We are currently doing an end-of-life plan for a person with the help of their relative.”

One person had been poorly and placed on end-of-life care as a result. They had been prescribed end-of-life medicines. However, with care and dedication from the staff, the person’s health had significantly improved, and they were no longer considered to be at this stage. The registered manager told us, “We supported [them] back to being healthy and [they are] now living a happy and fulfilling life with support from staff to participate in activities and go out into the community when possible.”

Some people had ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) forms in place. DNACPR is a documented medical decision that instructs healthcare teams not to attempt CPR if a patient’s heart or breathing stops. These were appropriately approved by relevant professionals.

Some people’s records containedRecommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms. A ReSPECT form isa personalized document that records preferences for treatment, including CPR, for those with complex needs or nearing end-of-life.

The registered manager told us they had reached out to the local hospice to discuss end of life care with the hope they may be able to provide some training for staff.