Bishops Corner

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.

Whilst the provider made sure people were at the centre of their care and treatment choices, these were not always clearly documented.

Care plans contained plentiful information regarding living with Prader Willi syndrome, but it was generic information and not tailored to each person. All the people were very different in regard to their strengths and support needs. Some people’s health needs were not recorded, for example one person lived with Raynaud’s Disease, which is linked to their PWS and the temperature control in their hands and feet. This was known by staff but not linked to the care plan and risk assessment or reflected in monitoring their well-being. This was immediately actioned by the registered manager and a copy received by the inspector during the assessment process. Another person had swollen lower legs and should be wearing specified stockings and monitored. This was not recorded in the persons care plan and risk assessment. This has now been added and stockings ordered.

Care and support were provided in a person-centred way with people being at the centre of any decision making and their loved one’s views being asked for and listened to. People received the ‘right care’ with their rights, privacy and dignity being upheld at all times.

Bishops Corner consistently upheld the principles of person-centred care, and opportunities to tailor support around individual needs and preferences were taken to enhance positive outcomes for people. For example, enabling and encouraging people to be as independent as possible whilst keeping them safe.

The activity programme was being reviewed to ensure people received opportunities to do the things they enjoyed. Opportunities for people to work was encouraged, one person worked at a local horse riding stable one day a week and also had a riding lesson on another day. One person had a rabbit which they cared for themselves with support from staff in respect of the storage and management of feeding the rabbit. There was a home vehicle, and regular trips out were arranged and thoroughly enjoyed by people.

People told us, “I go home to see my family a lot, it’s really good, I used to go to work but I am not at the moment, but I do like going shopping,” and “I like living here, I can be independent and I go out regularly to see friends, I follow Prader Willi association and have been to meetings.”

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.

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. Relatives told us, “Health appointments are arranged in house and we get the date, we go if possible but if we can’t staff will go and tell us what happened,” and “The staff ensure health appointments are organised, and they consistently encourage my (loved one) to get out socially, trips out are important, shopping for things they want, all helps independence and self-worth.” Staff told us that they worked alongside families and always informed families of any appointments and kept a record of the appointment and advice given.
A health professional told us, “Staff been here a long time, know people well, always pick up on when people are not well, good teamwork.”
The management team demonstrated an awareness of inequalities in accessing healthcare services and emphasised the importance of a holistic approach to care. Staff ensured that support was not narrowly focused on a single health condition. For example, when supporting individuals with PWS, staff did not assume all care and support needs were solely related to PWS. Instead, they considered the wider context of each person’s physical, emotional, and social needs such as autism, and anxiety. However, despite staff knowing this, it was not always included in care plans or risk assessments or activities tailored to those changes.

Care plans included evidence of regular partnership working with health professionals such as specialist health care and therapy teams. These records showed responsive co-ordinated care. Staff were able to discuss how they ensured people were treated equally and fairly no matter their age, sexuality or their health diagnosis. They told us of their knowledge of the Equality Act and how they used this in supporting people and decision making

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

Most people living at the service were able to communicate well. For people that couldn’t, body language and certain noises aided staff to understand their needs well. Staff told us of different ways of communication that had been tried but not been successful. We observed the person interacting with staff in a positive way, with the staff understanding them and their needs. Staff told us there was a range of different communication aids that could be used if appropriate but were not currently in use.

Pictorial aids for managing pain were being considered for one person and will be included within the MAR charts for staff to refer to.

All care plans were electronic , and this enabled them to be printed off for family, hospital appointments and transfers. They could also be enlarged for those that have sight impairment.

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 all decisions about their support, as individuals and as groups at the home. There were regular house meetings where people were introduced to new staff, discussed what activities they would like to take part in and plan outings. People were supported by staff to ensure those less able to communicate verbally were able to express their ideas and choices.

Each person had been assigned a key worker who supported the person to live the life they wanted. They were also a point of contact with family, and other services. A formal way of setting and attaining personal achievements/goals was being discussed and will be introduced when all care plans and risk assessments were updated and reviewed.

People were involved in the day to day running of the home. Each person had a day set aside to attend to their laundry, to clean their rooms with support from their key worker. We were also told that people set the tables. This included laying the table at mealtimes and clearing up after the meals were finished.

People’s relatives told us they did not have any complaints or concerns. However, if they did, they would raise them with the registered manager or staff. They were confident that any issues would be addressed promptly. One relative said, “Any concerns we have raised they have always acted immediately. A health professional said, “I find I can raise any niggles, and they do act on it I have no hesitation in approaching staff.”

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

Any barriers encountered were discussed fully as a team with family and action taken to address. People had access to health and social care professionals which meant that the received the best and most appropriate care and support when required. We spoke with health professionals who confirmed that there were good lines of communication between them and the service and that they were contacted for appointments, support and advice in a timely way that immediately addressed people’s needs.

A health professional told us, “They are good at ensuring all medical appointments are attended and if there is a problem they let us know.” Another added, “They keep records of all health professionals involved in peoples care, this enables all of us to ensure they receive appropriate treatment in a timely way.” Records of appointments and interventions were kept as part of care plans which then provided a complete medical history for people for future reference.

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 ensured people were not subject to inequality or discrimination due to their PWS, learning disability or autism. They supported people to receive the appropriate care and support by involving their families and those who could support them to lead their best life. The staff team worked together, using innovative ideas, to ensure people were not prevented from doing what they wanted to do.

People were supported to go home for family time, and these visits were very important to people.

People were supported by staff to work in various venues, including stables. Staff identified that this person required their support whilst working to ensure their safety regarding access to food. Staff worked with the person, their family, employer and health care specialist to identify and mitigate risks. Another person had been working but at this time was taking a break.

Staff and relatives told us about opportunities their loved ones were given because they were not discriminated against due to their disability. This included, holidays, trips out and events in house. Pub nights were a particular favourite for people; they told us their favourite places and favourite drinks. Staff acknowledged that parties and celebrations were a challenge because of people’s relationship with food, however these were managed in house.

When people’s needs changed staff worked with them to identify why and how to provide support in a different way to ensure they could still enjoy the same opportunities as before.

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.

End of life wishes were considered for each person. Discussions took place with people, and their families. Some people and families did not wish to discuss their preferences, and this was respected. However, the registered manager told us, the conversation remained open to ensure follow up discussions could take place when the time was right.

Each person’s understanding and experience of death was taken into account when discussing end of life plans. Some people had lost friends and family, and their experience of bereavement and death was also used to develop conversations where appropriate. At this time, staff had not received end of life training, but this is something that was being addressed by the registered manager.