YourLife (Shirley)

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• 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.

This is the first assessment for this service. This key question has been rated 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.

People received personalised care and support that reflected their individual needs, preferences and communication requirements. Care plans provided staff with guidance on how to support people and respond to changes in their health and wellbeing. For example, care records detailed how staff should monitor and respond to signs of illness, support a person with maintaining their glasses due to impaired sight, and how to provide reassurance to a person living with dementia.

However, we identified opportunities for the provider to strengthen their care plan and risk assessment guidance for staff on how support should be delivered for some people with more complex needs, including a person receiving care in bed.

The provider did not always ensure people experienced continuity of care. Some people were supported by a high number of different staff members, which reduced consistency in how care was delivered.

People did not always receive consistent support from a small group of familiar staff. Information reviewed as part of the inspection showed some people were supported by a high number of different care staff over a short period. Staff told us staffing levels could sometimes affect the timeliness and continuity of care, particularly where visits required two members of staff or took longer than expected. Managers recognised the challenges and were working to improve staffing arrangements and continuity of care.

However, people spoke positively about the staff and did not feel any impact from the different people who supported them. One person told us, “The girls have been wonderful, they have been by me, and they have helped me.”

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

People’s communication needs were assessed and clearly documented to help ensure information was provided in a way they could understand. Care plans contained personalised guidance for staff on how best to communicate with people, including any communication aids they used and specific preferences about how information should be shared. For example, one care plan instructed staff to “communicate directly with me,” while another stated staff should speak “loud and clear but not shouting, avoid jargon and position themselves facing the person.” Records also identified where family members supported people with maintaining communication aids, such as hearing aids, helping to ensure effective communication was maintained.

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 spoke positively about the support they received and felt listened to. They described having opportunities to provide feedback and raise concerns, with confidence these would be acted upon. One relative told us, “I’ve spoken to the manager about a few little things, I have popped into the office and they have got onto it. Never an issue after that.” A person using the service shared, “I would say if something went wrong, but I have never had to…” People were also encouraged to share their views through care reviews, surveys and feedback forms. One person commented, “You can’t improve on perfect. Any change to it would spoil it. I love being here.” The registered manager told us feedback was used to review and improve service delivery where needed.

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

People told us they were able to access support when required and felt well cared for by staff. One person said, “Review of care takes place, once a month and have a chat, queries, or I can phone them... They will come straight up to me if I need them. The duty manager will pop in once a day to visit. They bring my parcels in. That’s what I call being looked after.” Staff took steps to ensure people remained connected to their community and interests when circumstances limited their ability to access them directly. For example, staff supported people to use video calls, attend appointments remotely and participate in events within the facility. This helped to ensure people had equitable access to opportunities, social connections and support.

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.

One person living with dementia was reluctant to accept support with personal care due to a lack of confidence. In response, the service introduced a gradual familiarisation process, with a member of staff initially visiting for short wellbeing checks and conversations to build trust and confidence. A relative shared, “Overall it has been successful.” As confidence grew, the person began accepting support with showering and was later able to receive support from a second member of staff, demonstrating how care was tailored to achieve positive outcomes.

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.

Details of Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms, including where these could be located, were clearly documented to ensure staff could access them when needed. Staff told us they wanted to support people to remain in their homes for as long as possible and discussed future care needs with them where appropriate. One relative told us, “I know there will come a time where we have to discuss this, but currently we have not had much of a discussion about it.” While the registered manager described having conversations with people about their future wishes and preferences, these discussions were not consistently recorded on the electronic care planning system. However, the registered manager was able to provide a paper record which showed one person had been offered the opportunity to discuss their future wishes and had chosen not to do so.