Herewards House

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 inspection we rated this key question good. At this assessment the rating has remained the same. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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 and the staff made sure people were at the centre of their care and treatment choices. They supported people to decide how to respond to any relevant changes in their needs. They worked together to ensure people could receive the most appropriate care and treatment for them as the service made reasonable adjustments where necessary. For example, when one person came to the service, they found it difficult to settle in. The provider worked closely with relevant professionals, including the psychiatrist and the community psychiatric nurse (CPN), to ensure person’s needs were appropriately assessed and managed. Staff were allocated to accompany the person once a week to engage in activities they enjoyed such as shopping, which helped promote their independence. Staff monitored and provided regular feedback to CPN enabling ongoing reviews of medicine. The provider also engaged with GP to review and ensure there were no underlying physical symptoms contributing to person’s anxiety and distress. As a result of this coordinated approach, the outcome had been very positive and the person settled well into the service and no longer expressed a desire to leave. The person told the staff they liked living at the service and were well orientated within the service. People remained in control of the care and support delivered to them and included their family as part of the process. People and the relatives told us they were happy with the quality of care they received. One relative said, “The staff are lovely and caring and to be honest, I have never seen my relative happier in their life.” Staff understood the importance of providing individual and co-ordinated care and support that would have positive effects for people. They used people’s plans of care and regular communication to support their physical, mental, emotional and social needs. One professional added, “[During the visit] staff were pleasant and had a good understanding of their residents and were really involved with the resident in a person-centred way.”

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 and staff understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.Staff kept daily notes for people to capture the support provided to keep everyone involved up to date. Staff also had handovers to discuss people’s needs, activities and any other matters to pick up and to keep everyone involved up to date.People and relatives were positive about receiving continued care based on their needs. They said some of the staff had worked at the service for a while which supported trust and consistency of care. This meant people received care and support that was co-ordinated, and everyone worked well together. People were in control of their care and support and were supported by the staff and provider. Staff responded to any changes to people’s care and treatment. One professional added, “[The provider] has upheld collaborative practices and has consistently demonstrated honesty and openness regarding suggestions and cooperation, ensuring that [people] remain the focal point of their efforts.” Relatives confirmed they were informed of people’s wellbeing or as changes happened.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.The registered manager was not fully aware of the Accessible Information Standard (AIS). Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the AIS. The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment or sensory loss and in some circumstances to their carers. We discussed this the standard with the registered manager to ensure they were meeting the standard when supporting people by assessing them and recording this in their care plan. Staff agreed they had access to all the information they needed to provide safe and effective care and support.We observed a number of staff and people interactions, and staff were aware how to help people communicate their wishes and feelings. People were listened to by staff and given time to respond or ask for the things they needed. Staff responded accordingly and helped with their requests respectfully and politely.

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.The provider and the staff made it easy for people and relatives to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people and relatives in decisions about their care and communicated regularly with them. People and relatives were able to contact the provider or staff to raise any concerns.The provider took feedback and any concerns seriously and would use this as an opportunity to review and improve the quality of the service. They encouraged everyone to come to them to ensure they were able to capture any issues in a timely way.Provider also carried out surveys for people, relatives, staff and professionals. Responses were analysed and some actions noted to address any specific requests or comments.The registered manager took complaints and concerns seriously. They recorded and responded to complaints in a timely way. People and relatives told us they would talk to senior staff if they had any issues or queries to raise. Staff felt confident the registered manager would address any issues should anyone raise a concern with them.

The provider and the staff made sure people could access the care, support and treatment they needed when they needed it. The provider communicated with different professionals as and when needed to oversee and manage people’s changing needs. The provider and the staff worked together to respond effectively. The registered manager said they had good network in the area, and they could approach different teams for support. They felt this helped the continuity of care for people to be maintained.Staff knew when to take action promptly and work with the provider so they could make referrals to other health and well-being professionals to address any issues with their health or changing needs. This helped the care for people's health and wellbeing be proactive and organised well.

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.The provider and the staff 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’s care, treatment and support were organised and managed in a way that promoted equality and ensured their rights were protected. For example, one person found it difficult with the transition from one service to come and live at Herewards House. During this period, staff, family members, and professionals provided significant reassurance to help the person feel more comfortable with the process. The provider worked closely with the Community Mental Health Team (CMHT), community psychiatric nurse (CPN), social worker, and the family to support the person, particularly as there was a language barrier that required additional communication support.CPN provided regular and frequent visits to support the person and provider. As the person settled, CPN visits became monthly to support the person with specific medicine. Staff also worked closely with the family and an interpreter to ensure the person’s wishes and preferences were fully understood and respected. The person also was supported to visit the town centre which had a positive impact to them. The person had settled well and continued receiving care from their circle of support.People and relatives were supported to give their views about their experience to ensure they had a positive experience while using the service. The provider was in regular communication with them to ensure any issues or queries were picked up and addressed without delay.

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.Provider noted they worked together with people and relatives to support them regarding any advance decisions made in relation to any specific wishes, treatment and support matters. If the person came with an advanced care plan to live in the service, the registered manager said they would follow that plan in place. Provider also planned end of life care plans when needed including any discussion with people, relatives and GP, to make sure specific care aspects were planned in advanced. People had reviews of support and plans of care with their family and the service. There was one person receiving end of life care and their relatives were happy with the support provided. They told us staff monitored the person constantly, addressed any discomfort and were really good.