EVHM LLP - 6 High Beech Close

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 newly registered service. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 82 (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 had person centred care plans that reflected them as individuals. Each person had tailored documentation to meet their needs and included their preferences about the way support was to be provided. Care plans recorded specific health and emotional needs that were individual to them. If people had a particular diagnosis or medical condition, there was information to make sure staff understood how to support the individual. Guidance from other health and social care professionals was incorporated into care plans and used to inform staff practice.

For people who experienced distress or anxiety, there were clear, personalised strategies in place to support their wellbeing and provide reassurance. During our visit, we observed staff who were patient, attentive and who interacted with people in a positive and respectful way. Daily records were used to describe people’s day and how they had been.

People’s relatives told us they were kept informed about changes to people’s needs and involved in decisions about their care and support. A relative told us, “The service feels like an extension of our family and if we all work together it works.”

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 were supported to be active, valued members of their community. For example, one person was taking part in a sponsored run/walk to raise money for charity. This meant additional exercise as part of the preparation for the event. The approach helped to promote health, build confidence, develop social connections and contribute positively to their local area.

A relative told us, “If [Person’s] keyworker is on leave, they arrange a step-in keyworker to take their place as this gives [Person] security that things will stay the same. All [Person’s] health appointments are covered, and I don’t have to worry about anything, I’m kept informed and I can pick up the phone to the [registered manager] or top management or send an email, and I will get a response asap.”

Staff worked closely with a range of professionals to ensure care was joined up. This included access to doctors and learning disability specialists. People’s choices were respected; one person did not always want to go out, so staff worked flexibly to support this. People knew what they wanted to do and their individual choices were respected.

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

People’s individual communication needs had been assessed and recorded within communication support plans. Staff understood how each communicated their needs and wishes. Information was provided to people in a way they could understand. When needed, staff used easy read formats, pictorial information and where appropriate social stories to support communication. Everyone had regular eye tests. People’s consent was gained to share information about them with other healthcare professionals. All information was stored securely.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

One person liked to attend a motivational therapy group that was run at another service. During a meeting with their keyworker the person raised that they found the course challenging in the environment it was being held. Staff explored why the environment was challenging and this related to the person’s sensory needs. There were building works ongoing at the time and the person found the noise too much. Staff supported the person to request that the group be held at 6 High Beech. This was agreed and everyone was happy with the changed venue. This proved extremely beneficial for the person who was proud that they had achieved the venue change. Staff told us they now made sure that all maintenance for High Beech Close was pre planned with the person’s needs in mind.

The registered manager told us about a time when following an incident in the home people were unsettled and not listening to each other in a house meeting. A staff member introduced a system whereby people had to hold a spoon if they wanted to speak. This meant people had to wait until their peer finished talking before speaking. This worked as a tool but was only needed for that meeting as people recognised the need to give each person the opportunity to have their say.

Following the annual survey, it was apparent that people had not fully understand the digital systems for care planning and why staff recorded their notes electronically. Easy read information was used to explain the new system for staff recording notes. People told us staff wrote their notes on their phones. Whilst people were fully involved in the preparation of their care plans, work was underway to ensure that people would be able to digitally sign their care plans.

People told us who they would speak with if they had any concerns or worries. They also knew that they could speak with staff during one-to-one meetings and said that they could also speak with the registered manager. Minutes of the house meetings showed that people were given a choice of activities and were encouraged and supported to make suggestions for things they would like to do. We saw that when people suggested activities, they were then arranged. For example, a bowling trip and a trip to the zoo. There had also been a discussion about people’s feelings and wishes in relation to various situations. Records demonstrated people felt respected and safe to speak openly and that they were all getting along well. People were supported to attend annual holidays.

People’s relatives told us they felt staff and management were approachable and they could raise any concerns or worries. No formal complaints had been raised withing the past year.

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

The service went above and beyond to ensure a consistent and proactive approach to enable people to have equitable access to healthcare and specialist support. Records showed timely referrals were made to health professionals, so care remained responsive to people’s changing needs.

When supporting a person staff noted a cause for concern. This was immediately referred to the person’s GP who arranged further tests and a subsequent hospital admission. The vigilance of the staff team ensured proactive treatment and better health outcomes for the person. Relatives gave positive feedback and told us the service supported their loved ones to access healthcare services without delay. This reflected a culture that prioritised people’s wellbeing and removed barriers to receiving the right support at the right time. A person’s relative told us, “[Person] had a serious health problem last year, staff were straight on it when they realised something was wrong, they kept us informed and supported her through treatment to the other side. It was not easy, but they did a super job.”

Another person had several medical conditions that meant their health needed to be monitored closely. Staff identified subtle signs that indicated the person’s health could be deteriorating. As a result of this, further investigations were being carried to assess the need for bringing forward a medical intervention. The person’s relative told us, “[Person] doesn’t always understand she can ask for pain relief, but staff remind her she can say yes to pain relief.” Staff told us that the medical conditions caused great anxiety for the person and they needed to give regular reassurance. We heard staff calmly reassuring the person when they felt unwell. We also noted that there were times staff had to assess if the concerns raised were anxiety or a deterioration in health. Staff managed this extremely well and took appropriate actions when needed.

Guidance from external professionals was clearly implemented into care plans. For example, there were guidelines written by the speech and language therapy team in relation to one person at risk of choking. One person had needed emergency treatment following a medical diagnosis and staff worked together to ensure they received the best care possible. A health professional told us that staff, “Seek to ensure they have all the required information and are happy to seek further advice or assistance in order to develop guidelines and ensure continuity of care.”

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.

There was a strong culture of inclusion across within the service. Staff demonstrated an in‑depth understanding of how people’s characteristics, backgrounds and health conditions shaped their experiences. This informed practice at every level, ensuring people had equal access to opportunities, meaningful activities, personalised support and the best health outcomes possible.

Staff made sure that whenever anyone needed medical attention at the hospital, they ensured the local learning disability nurse was made aware so that they could be involved as an additional advocate for the person.

The serviced used a variety of modes of transport to enable people to have access to activities. They walked where possible, caught buses, trains and used taxis. They knew that at times when people were anxious, they could draw attention to themselves, and they planned for these events so that this was not a barrier to the person getting to activities that were important to them.

One person had signed up for ‘race for life.’ They planned to do a 3k race/walk and were actively exercising as part of training for the event. They told us they were quite excited to take part.

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.

No one required end of life care at the time of this assessment. However, people understood what it was to lose family members and friends. One person told us that staff helped them when their [relative] died. Everyone’s wishes in the event of end-of-life care and death had been assessed and records demonstrated that a person-centred approach had been used to determine each person’s wishes on the subject. People’s relatives had also been involved in the process. We were told that each person’s wishes would be reviewed periodically as they may wish to change their wishes over time.