The Gardens

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 outstanding.

This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (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 was exceptional at making 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.

The person was at centre of all the care they received. Care and the environment had been built around their individual needs. We saw the person was in control of their life and care was delivered around them.

Without exception, care plans and risk assessments were individualised and detailed. They were specific to the person’s needs, considered their history, preferences, likes and dislikes and ensured all aspects of care and support were considered. Records also reflected their aspirations and goals for the future. Care planning involved the person and those who were important to them and promoted their choices.

Staff worked with the person and their family in a person-centred way to ensure events were assessed, planned and individual. For example, the leadership team and staff were working with the family so that on overseas family holiday could take place. The person accessed community activities based on their likes and dislikes and chose what they wanted to do. The goals and aspirations this person had for the coming year reflected this. This included; maintaining swimming sessions, having their own vehicle to access the community, repeated holidays in the UK and a day trip to London.

The staff team had also developed [Person’s] story. This was a brief positive letter which staff read to the person each night as part of their daily routine. It focused on the positive achievements for the day and the steps made. Comments included, ‘Thank you for being the best today and the day was splendid today, although you had some low moods in the evening, you listened to staffs’ direction’.

Staff acted as advocates for the person and ensured they were involved with their care. They demonstrated a deep detailed understanding of the person. They could tell us their likes and dislikes, their preferred way of doing things and detail how they could express how they were feeling. This meant staff placed the person’s individual needs and wishes at the centre of everything they did.

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The person received support from professionals who understood their diverse health and care needs. Staff were able to give examples of how they worked with a variety of different professionals to develop individual plans of care for the person. These plans related to their health and emotional needs. They had access to the neurology team, the learning disabilities team, opticians, and the dental practice to meet the persons medical needs.

Continuity and consistency for the person had begun at the start of their transition into the home. The individual robust transition plan that had been developed and implemented for this person meant care was joined up, flexible and offered continuity. This level of care and support had then continued for this person into their everyday life.

The continuity the staff team provided had exceptional outcomes for the person, including positive health outcomes for the person, and reduce in periods of anxiety and emotional distress. The staff team, which had been recruited specifically for the individual had been supported by the provider to develop positive relationships with the person. Most staff had been present from day 1 of the transition of the person into the home. Without exception each member of the management team and staff team knew the person very well.

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual need.

Staff had worked creatively with the person to ensure they received information in a format they could understand. There were individual communication plans in place for the person which detailed the specifics of how they communicated.

Within the home there was an accessible communication reminder for the person, including communication boards which offered reassurance and prompts for the person. Pictures were an important part of how the person chose to communicate and were used when planning the day, activities and appointments. Staff spoke about the importance of this and the consistency it offered. One staff member said, “It’s not a reminder but a reassurance for [Person] so they can think about the now but the later also. It helps with the anxiety and limits expectations which makes the day more relaxed.”

The pictures were unique to the person and showed them participating in the activity. Staff worked closely with the person and professionals to develop this communication aid which was unique to them. Staff were continually reviewing and adapting the communication systems they used to ensure they were still relevant and effective.

There was a range of accessible information available for the person should they require it. This was in relation to their care and support, policies and procedures within the home and meetings they had participated in. All information was available in an easy read format for the person and freely available.

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.

Both the person and those important to them were at the centre of the care they received and without exception they were listened to. A relative confirmed this to us. Relatives, staff and professionals were given the opportunity to complete 6 monthly surveys about the care and support, to ensure their views were captured. All the information received was positive.

The person was really listened to, not just through their voice but through their interactions and actions. The home monitored how the person reacted and engaged with new activities, with health appointments, with changes to staff teams and to everyday tasks they completed in their home. This way they could capture the experiences of the person; they could review this information and make an evidence based informed decision about what was needed and if any changes were required to how care was delivered.

Staff communicated innovatively with the person to ensure they had the opportunity to express their individual needs and preferences. They empowered the person to express their individuality and have a voice. One staff member told us, “We make sure [Person] is always in charge of everything they do, no matter if that takes 5 minutes or a week to achieve.”

The person and those important to them were supported to raise concerns and share where improvements were needed. Staff regularly communicated with relatives.

The provider monitored compliments and complaints. There had been no recent complaints at the service. The registered manager was able to explain the action they would take if concerns were raised and told us this was in line with the complaints procedure that was in place. They told us how they would use this information as learning to the service and where possible make changes to the person’s care which would have a positive impact.

All policies had been adapted and presented in easy read formats so the person could access and view these if they wished.

The person had access to an advocate if needed. The service promoted advocacy and had easy read information available for the person. Staff were able to give examples of when the person may need advocacy services or support.

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

There were processes in place that the registered manager could consider if concerns arose. They had links with external agencies that they could engage with to raise concerns if needed.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Staff considered any inequalities that the person living in the home may face. They tailored the person’s care to consider barriers they may face to ensure positive outcomes.

Staff had received training and were able to demonstrate the action they would take if the person they supported experienced discrimination or inequalities. Staff felt confident to challenge such concerns. They understood the challenges the person may face and the importance of not always being accepting of such issues.

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.

The person being supported was not currently end of life. However, the staff team were aware of action to take if needed. The provider was aware of the action to take during this time and would adopt a multi-disciplinary approach when developing and introducing these plans.