The Hurst Residential Home

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 Requires Improvement. At this assessment the rating has changed to 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 provider had not fully ensured people’s care was person-centred. People’s care plans were not sufficiently detailed to fully reflect changes to their health and well -being, what was important to them and plans for the future. Daily care records were task-focused and did not always demonstrate how people’s social and emotional support needs were being met. This was fully discussed with the provider, who was already taking action to improve the care plan system and had introduced training in documentation for staff.

Peoples’ health needs were not always planned for or included in their care plan or risk assessments. For example, there was no guidance for staff to follow regarding managing the risk to staff and people from newly arrived people who may display their anxiety in a harmful way. Staff were able to discuss how they would manage this, but it was not documented clearly yet. This was addressed immediately.

During the inspection, we found there was a lack of provision of personalised activities, and it was not clear how people were being engaged in meaningful activities which suited their individual preferences and met their expectations. This was an area identified by the registered manager and was being explored with people and staff. We are aware of an activity person being deployed for one day but not yet fully implemented on other days. There was confirmation by people that some of them got together to play darts, but not all people were interested in joining in. The registered manager discussed ideas he had for this to be taken forward positively and building on people’s involvement.

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.

Care plans were regularly reviewed, and contained updated information about their care needs, including any health and medical needs. We were told of community partnership working (working with other health professionals) but this was not always clear in peoples’ care plans or records.

Feedback from people was mostly positive. They told us, that staff were pro-active in understanding their care needs and assisted them in receiving support from health professionals. We also received positive feedback from health professionals, comments included, “Staff seem to be kind and considerate. When I visit, they are professional and polite. They know residents well; I have seen good results. I have no concerns at present.” Another comment was, “They have had training and appear knowledgeable and seem genuinely to want to help people.”

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

People received information about the service from the provider, which included a contract with terms of residency. Since the last inspection, the registered manager had had meetings with all the people that lived in the home regarding smoking, visitors and alcohol consumption. People had signed this agreement, and the home was much calmer. All care plans were held on a computer, and this enabled them to be printed off or sent, for hospital appointments and transfers, there were also paper copies that were used if needed immediately or at night. Care plans could also be enlarged for those that had sight impairment.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

To gain peoples’ feedback, the provider used annual surveys, house meetings, 1 to 1 meetings with people and staff. Minutes of the house meetings were taken, and actions recorded to address peoples’ views. Comments regarding activities and food were discussed and taken forward. One person told us that they felt their views were acknowledged.

The provider had a complaints policy which explained the ways in which concerns could be raised, the process for dealing with any concerns and further steps that could be taken if complainants were unhappy with the resolution. People regularly had reviews of their care plans, and whilst we were told people had the opportunity to be involved in these reviews if they chose to, this was not clear in the care records.

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

People told us that they felt supported by staff to access appropriate support and treatment. Some comments were not overly positive, but this was due to specific problems with the person not wanting certain guidance and treatment. Staff confirmed that people were able to access care, treatment and support when they needed to.

One health professional told us, “They treat people respectfully and I’ve never seen anyone treated unfairly. They discuss people in non-discriminatory way.” Another health professional said, “Staff are respectful and appear kind.”

Records showed staff had received training in Equality Diversity and they explained how they treated people equally, without discrimination and respected their individual needs, including any medical, religious or cultural needs. People’s care plans contained information about their wishes in relation to cultural and spiritual needs. This included care plans around sexuality, emotional support and daily lifestyle.

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 had been supported to achieve good outcomes and have positive experiences. However, these whilst shared with external agencies, were not always documented in people care plans. Staff told us of one person who was managing their alcohol intake well, but did have days where they drank. Whilst staff could discuss this, there were no supportive plans to manage this. This was acknowledged by staff and documentation changed to reflect this. The staff team had worked to recognise and respond to potential inequalities people may experience. Staff were supportive in helping people develop strategies to overcome some obstacles people experienced due to their mental health diagnosis.

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 the provider planned to introduce.

Some care plans contained information and guidance in respect of peoples' religious and resuscitation wishes. ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment and ensured their personal wishes are followed.