Wharfdale Extra Care Scheme

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.

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 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people were at the centre of their care and treatment choices, and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People’s care plans did not fully reflect their physical, mental, emotional and social needs. Care plans lacked sufficient detail and often there was not enough information for staff to understand the tasks which they were being asked to complete. For example, in a person’s care plan it stated, “Prompt and support with personal care,” with no further detail. For the same person, it outlined how the person washed and showered independently but occasionally required prompting. There was no explanation as to why this may be the case, how to prompt and what indicators would suggest the person required prompting. Staff members required a more detailed description of what the task was specifically, to ensure it was person centred.

People’s care plans did not include any information regarding their goals or aspirations. This is important because it ensures care is genuinely person centred, not just task focused. It also guides care planning and daily support and supports independence and wellbeing.

People’s lifestyle and associated support needs were not always incorporated into their care plans.

Although people had one-page profiles in place, they did not provide sufficient detail to help staff quickly understand how to support the person in a way that respected their needs, preferences and wellbeing. Daily routines, cultural, religious needs, relationships, hobbies, and what made the person safe were not included. Practical guidance for staff including mobility, medication support and emotional support was not always provided.

The provider responded to our feedback and started to make changes to care records which had more of an emphasis on them being person centred.

External professionals and stakeholders told us the staff had a strong understanding of the people they supported and how some of the people viewed the staff as extensions of their family. One professional said, “Wharfdale clearly adopts a person-centred approach. Staff support individuals to maintain independence while respecting their preferences, routines, and interests. This is reflected in how individuals are encouraged to personalise their living spaces and engage in meaningful activities, such as joining social groups and going on outings.” Another professional stated, “Wharfdale provides a high-quality, person-centred service… it is a strong example of effective, compassionate, and person-centred care. I wish all the people I support could move here.”

People were supported to access meaningful activities which were person centred. Some people attended day centres, others attended homeless support charities and others had specific routines in the community including attending the gym. Some people were involved in the maintenance of the gardens around the location.

People’s apartments were personalised to their liking. A person we visited had a keen interest in a particular football team and had memorabilia including photographs and ornaments throughout their home.

Most people were also very happy with the staff approach. A person told us how staff had a good knowledge of their interests including rugby, they said, “Staff are interested. They know that I like going watching rugby and will chat to me about this sometimes,” whilst another person said, “They [staff] know me so well; they even know every item that I get from [local supermarket]. They really understand the relationship I had with my [spouse] and have helped me get through what has been a difficult time.”

The service worked closely with the housing provider to ensure people had activities they could access in the communal area of the location on most days of the week. The service ensured events such as Christmas, Halloween and VE day were marked and celebrated.

Staff said they enjoyed working at the service for a variety of reasons but the main theme which came up was they enjoyed working with the people they supported and felt they were making a difference. It was apparent the staff genuinely cared about the people, for example, one staff member said, “I love working here. I love working with the people who I support, and I enjoy seeing them making progress when they come here. I have an amazing relationship with everyone.”

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 they received the care and support which they were commissioned to have.

The service made timely referrals when people required additional support and had good links with local services.

Staff were promoting a safe, consistent and predictable atmosphere, which met the needs of autistic people and people with learning disabilities. However, people did not always receive continuity in terms of the staff attending to them. Some people were frustrated by this, as they felt certain staff knew them and their routines much better than others and felt having consistent carers may build more of a rapport.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s care records were not always detailed, and most did not contain details around people’s key risks. Some people’s hospital passports were also not up to date.

People’s communication preferences were not always considered and when they were, they lacked detail. A person with a diagnosis of a learning disability, had a communication plan which did not provide detail about their nonverbal communication, what they were able to understand and what they were not, and there were no considerations of information requiring to be adapted for them. A person’s care plan stated they had difficulty communicating with staff verbally and therefore were to write down what they wanted to express on a sheet of paper. However, the same person’s hospital passport mentioned they used to use a pictorial exchange communication system (PECS) and sign language but there was no mention of this.

A person indicated their specific needs for communication had not been met, as they required documents in a particular format, but this adjustment was not provided. The same person told us how they had found staff dismissive of their requests for support when completing an important application form.

Although the provider’s accessible information policy stated the service provided information in different formats such as easy read, we did not see these as working documents in people’s apartments who required them.

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 knew how to give feedback about their experiences of support including how to raise concerns or issues. Almost everyone we spoke with said they were confident leaders would take their concerns seriously.

Staff were aware of the complaints procedure and would escalate any complaints they could not manage immediately to their service lead.

People had access to residents’ meetings which were facilitated by the housing provider.

Most people who completed a recent survey said staff interaction with themselves and fellow residents was excellent or good. However, some people felt communication with some staff required improvement. A person explained never having any correspondence from staff including not being told when staff had left the service.

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

People said their calls were mainly on time and understood that if they were not, this was likely due to an emergency.

People were aware the service had a staff member on shift during the night who would support them if required. They were also aware the service had an on-call system which meant any serious concerns would be escalated.

People told us they had access to the community, if they wanted to. There were examples of people attending day care centres, the gym, rugby league games and the local supermarket.

Staff, leaders and people showed us how the building was accessible for people. The housing provider ensured apartments were adapted for people who required a wheelchair. For example, the door frames were wider, and counters were at an optimal height. Although there were some areas for further improvement, we acknowledged this was for the housing provider to review and manage.

Professionals and stakeholders told us the leaders were always responsive when they were contacted.

Records relating to risks were not fully completed. This meant the service could not be fully assured people would receive the support they needed in a timely manner.

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 and relatives told us there was no discrimination in the service from leaders. They explained how everyone was treated equally and fairly, regardless of protected characteristics such as gender, age and culture. People and relatives were confident leaders would respond promptly and effectively if there was any discrimination.

Leaders were aware of potential discrimination in relation to the people they were supporting. For example, a person’s care plan clearly indicated how a person had been subject to discriminatory abuse whilst residing at the location and therefore indicated staff should monitor and observe interactions held in the communal areas and report any discrimination when required.

People’s care records required more information regarding individual’s social, cultural and spiritual needs to ensure staff and leaders could support them even more in supporting them in experiencing positive outcomes.

The service provided some positive case studies which demonstrated good outcomes and experiences for several people, regardless of protected characteristics.

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.

Staff had ensured almost all the people at the service had been offered an advanced care plan and those who had agreed had theirs completed.

Staff demonstrated an understanding of what good end of life care was. A staff member told us a person who they had been supporting had made a huge amount of progress, despite being on end-of-life care.

The service had established a good working relationship with the local hospice who provided enhanced training and advice when it was required. The registered manager confirmed staff were provided with up to 12 weeks training from local hospice staff.

A professional from the local hospice stated, “Wharfdale have engaged with the hospice team from the day they opened. They send staff on training regularly and they phone for advice appropriately and send referrals in when they identify they need support. They really do work in partnership, and they never let things become a crisis.”