Merecroft

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 71 (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 knew most people’s histories, preferences, lifestyles and interests. For a person, this understanding had developed over time as staff got to know them.

People had detailed support plans, including positive behaviour support (PBS) plans where appropriate. PBS is a person-centred approach that supports people with a learning disability or autism who may express distress in ways which could place themselves or others at risk. One-page profiles were in place and summarised key information, including what others liked and admired about each person, what was important to them and how best to support them.

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 care records described their healthcare needs and how staff should meet them. Staff worked with other health and social care professionals involved in people’s support, including consultants, psychiatrists, learning disability psychiatry services, behavioural nurse specialist and social workers.

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

Staff understood the Accessible Information Standard (AIS). People’s communication needs and preferences were assessed and recorded in their care plans to guide staff.Staff described how people who did not communicate verbally expressed their needs using key words, pointing, facial expressions and body language. They adapted their approach to each person’s level of understanding and allowed time for information to be processed. For example, staff reminded one person about the following day’s activities the night before, then prepared and presented a visual schedule the next morning. This helped the person process the information and supported them to have a more meaningful day. Information was available in easy read and pictorial formats. For example, safeguarding, compliments, comments and complaints.

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 day-to-day decisions such as with food and drink, activities, and were involved in decisions about their home environment and personal spaces. For example, plans were in place to redecorate people’s bedrooms. People, and their relatives where appropriate, will be involved to ensure bedrooms reflect individual’s preferences and choices.

Resident’s meetings were not held because staff found they were not the most meaningful or accessible way for people to participate. Instead, people were supported by key workers, and staff consulted with them individually about their wishes, choices and experiences in ways suited to their understanding and preferred communication methods. This enabled people to contribute without the pressure or sensory demands of a group setting, which some people found overwhelming and chose not to attend. An external professional said about one of the people living at the home, “I believe that [person] is listened to and responded to and their wishes and feelings are respected.”

A complaints process was in place, although relatives’ awareness of it varied. One relative said, “There’s no complaints process I’ve seen.” Another said, “I’m sure I do have a complaints process, but I’ve not made any complaints through the process. I’ve just rung up and they’ve dealt with it, and I can’t remember the last time. We communicate in an informal way because we talk face-to-face and it’s very good. They usually sort things out and sometimes you have to chase things up but it’s okay.” Feedback from families was shared with the registered manager. As a result, monthly relative’s meetings will be held which all families will be invited to attend.

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

Staff took steps to remove or reduce barriers to accessing care and support. This included ensuring people had advocates who could represent them where needed, making referrals to external professionals and supporting people to attend appointments. One relative said, “They’re excellent at contacting doctors and there’s a regular dentist.” However, the relative also said they were not always informed about appointments in advance and had asked staff to notify them of any relevant issues.

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.

Staff understood the people they supported and considered any barriers which may prevent them from taking part in activities, accessing services or achieving personal goals. Individual planning was used to identify the support people needed and the adjustments required to help them participate in opportunities which were important to them.

People were not always 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 had ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) forms in place to record their preferences for emergency care and treatment. However, end-of-life wishes were not documented in care records. Feedback from relatives indicated these discussions had not taken place. One relative said, “Future plans have not really even been brought up, but yes we could do that.” This feedback was shared with the registered manager, who told us end-of-life wishes would be discussed with people and their relatives during newly scheduled family meetings.