Three Roses

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.

Care plans contained specific details about people, their needs and requirements. Additional care plans were put in place where people were at risk of social isolation and where people needed structured person-centred care and support.

People and their relatives mainly told us the care met their needs. However, we received comments about staff not being able to support some people with their specific dementia related needs. They felt staff needed more training in this area but also said the registered manager had been very supportive due to the complexities involved. The registered manager told us they had escalated the concerns externally and was waiting for support for staff in this area. They also told us they would look at what additional training they could provide to staff.

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 told us the provider had worked with other care providers and health services on their behalf. Leaders told us about the variety of professionals they worked with, and we saw evidence of this through communication and referrals.

Professionals provided positive feedback about the way the provider provided care, integration and continuity. For example, one comment included, “They actively seek all relevant information before commencing care to ensure they fully understand each person’s needs and can deliver appropriate, person-centred support.They promptly notify the relevant departments if a person’s needs increase or decrease and request reviews where appropriate. They consistently communicate changes in a timely manner, helping to ensure care remains appropriate and responsive to people’s changing needs.”

However, some people told us they did not always have continuity of care from the same carers and there were lots of different staff visiting. We saw evidence where some people who received 4 calls a day had several staff visiting them over a short period of time. Although people commented most staff were competent, they felt some of the newer and younger staff needed more development. The registered manager told us where people received support up to 4 times a day and these visits needed 2 members of staff; the work can be more intensive. Therefore, they adapted the rotas to ensure staff did not ‘burnout’.

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

People's individual communication needs were assessed and clearly documented within their care plans, enabling staff to adapt their approach and provide information in ways that met people's needs.

While some people highlighted occasional communication difficulties arising from language differences, we found the provider had recognised this and taken steps to support staff development. This included implementing initiatives and providing ongoing support to help staff improve their communication skills and understanding.

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 told us they felt able to provide feedback about the care they received and knew how to make a complaint if needed. They spoke positively about the registered manager and told us they felt supported when raising concerns. People were confident that issues would be taken seriously and addressed appropriately.

The provider had an effective complaints process, supported by a complaints policy and monitoring system. Records showed complaints and concerns were investigated, actions were identified, and learning was used to help improve the service and reduce the likelihood of similar issues occurring.

The registered manager and care coordinators regularly sought feedback from people and their relatives through review meetings and ongoing discussions. In addition, regular spot checks were carried out in people's homes to monitor staff practice, gather feedback and ensure care was being delivered in line with people's preferences and expectations.

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

People’s accessibility was considered as part of the initial assessment and added into care plans to allow staff to understand access requirements. We saw referrals to relevant agencies where people’s mobility needs had changed, for example, occupational therapists.

Professional provided positive feedback, comments included, “The service has always been highly accessible. I have never had trouble contacting them, including outside normal office hours. Calls are answered promptly, providing reassurance that support is available whenever required.”

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 were supported to access healthcare services and community resources when needed, helping to promote their health, wellbeing and independence. Care plans contained up-to-date information about people's preferences, including how their social, cultural and spiritual needs should be respected and supported.

Leaders and staff demonstrated an awareness of the impact that discrimination, exclusion or inequality could have on people's experiences and outcomes. They were proactive in identifying when additional support or adjustments were needed and made appropriate referrals to external agencies and professionals to help people access the services they required.

Staff had completed equality and diversity training and demonstrated a good understanding of the importance of valuing people's differences and respecting their rights.

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.

At the time of this assessment, the provider was not supporting anyone receiving end-of-life care. However, systems were in place to support people to plan for their future wishes and preferences where they had chosen to discuss these matters.

Care plans included information about people's future preferences and decisions relating to their care and support, where these had been explored and agreed with them. This helped to ensure people's wishes could be understood and respected as their needs changed over time.

Staff had completed training in palliative care, end-of-life care and bereavement support, which helped to develop their knowledge and understanding of how to support people and their families during difficult periods.