Weald Heights

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. This service is dual registered, and this is the first assessment for this service under its new registration. This key question has been rated Outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The home always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.Staff spoke about the people they were caring for in a dignified and compassionate way. People felt that staff listened to them and communicated with them appropriately, in a way they understood. People’s privacy and dignity was respected and always upheld.

People were treated with kindness and respect. Our conversations with people and their loved ones confirmed this. One person said, “They are lovely and yes, they know me. My favourite is (staff member), she is so nice and always happy.” One relative told us, “They are lovely, very friendly and kind. They would do anything for you. They all make sure that they know your name and always say hello.”

People and their relatives stated that carers knew them and their needs. Our conversations with people and staff confirmed this. One person said, “Most (staff) know me well. They certainly know what they are doing and are very friendly.”

The provider treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The provider took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. For example, Dementia Coaches used the Kitwood Flower of Need, the Person Observation Reflection Tool, all to ensure that each person living with dementia was treated as an individual and that unmet needs were addressed. Staff used exceptional case studies to tailor excellent individual support. Case studies are analyses of specific care situations which offer a detailed understanding of how care was delivered and received, allowing for exploration of successes and areas for improvement These drew on people’s strengths, abilities, aspirations, culture and unique backgrounds in order to understand their needs, anxieties and behaviours. For example, an office area was created in a designated corner of the home to support one person who had been a businessperson throughout their life. Using conversations with the person about their previous work approach, together with an analysis of their dementia, this was used to allow the person a greater control of their environment and feel a sense of control. One relative said, “They know (person) exceptionally well, understand what she needs and deliver this brilliantly.”

People told us that without any exceptions all staff treated them as individuals and said their care had been discussed with them and delivered in line with their preferences. Staff demonstrated a drive to supporting people as individuals. Staff used dementia tools and innovative tools to understand communication needs to that peoples’ experiences and outcomes were maximised. Cognitive Stimulation Therapy (CST) sessions were used to improve communication and cognition, with results showing improved communication between residents. CST is support for people with degrees of dementia to stimulate thinking, memory and social interaction. Following the use of a Pool Activity Level (PAL), which is a tool to assess one person’s level of individual cognitive and functional ability, it was found that their vision might be limited to particular range and identified that it was difficult for them to see staff as they approached her. Guidance was for staff to use verbal engagement before physical engaging with the person, allowing the person time to adjust.

Staff practice was focussed on individual person-centred support, and they promoted care and support to this. Staff promoted the Wishing Tree initiative which encouraged individuals to put forward their wishes that allowed them to reconnect with a past hobby or try something new. Memory boxes were compassionately put together and placed outside people’s rooms that reflected past events in their lives, people they loved. Care UK said, “Our vision at Care UK is to give residents fulfilling and active lives, and the Wishing Tree initiative is just one way we live that ethos.” We saw numerous examples of where people had been supported to relive positive events or memories in their past. There was an equal and embedded approach to promoting people’s independence. People we spoke to were unanimous in this approach. Comments we received were, “They ask me what I help I need and allow me to do things for myself”, They will always let me try to do things myself but will help if I need it”, and “They don’t just do things for me but always ask first if I need help.” One relative said, “Well they always encourage her to do things for herself. They never just do things for her."

The provider was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. People continued to be supported by an outstanding range of events, engagement in meaningful activities that were person centred, and which promoted and supported their independence, choice and wellbeing.

Staff and leadership went above and beyond to support people with their social needs, to develop and maintain relationships and to access their social networks and community. People’s wellbeing and engagement benefitted greatly from links, projects and partnerships that the leadership had forged with the local community.

For example, many people at the home served in the armed forces, and stories and histories were collected to tailor support and activities for them. Supported by accreditations in the veteran Friendly Framework, staff helped people address needs and combat social isolation. One person who flew in the armed forces was supported in their dream to fly again with professionals at their old base. Engagement for veterans at the home were supported with the organising of informative talks, visits from cadets and veteran tea parties. The registered manager said, “We have gone the extra mile to find out what residents have done in the past and evaluate whether we can accommodate activities and make that happen. Reasonable adjustments are made in innovative ways to encourage independence.”

Staff and leaders looked to extend the home’s approach to intergenerational therapy. Intergenerational therapy looks to improve the cognitive functioning, as well as the social and emotional wellbeing of older adults through engagement with younger generations. For example, people received visits from local nursery children and interacted with them for themed entertainment. The providers lifestyle team responded to a residents wish to visit their old school by arranging a personalised tour and interaction with students. The registered manager said, “This relationship has got stronger as we continue for the children to visit us and cement our intergenerational relationship with them.”

Feedback from people, their relative and professionals was unanimous for the home’s promotion of independence through engagement. One person said, “They keep promoting things and are always very busy. I’ve been to three music events. They are very good and well laid on. Staff come and help take me down. They are very thoughtful and always make sure that I sit at the front as my sight is not good.” One relative said, “They have a fantastic programme. There is so much going on, very varied, its impressive.” One professional commented, “There is an excellent activities programme that caters for the needs of all floors which includes visiting speakers and entertainers. The activities team liaise with me so that residents can have their physio and enjoy activities as well.”

The home went above and beyond to support people with their social needs, to develop and maintain relationships and to access their social networks and community. People could see their family and friends whenever they wished, and those people were encouraged to visit and made to always feel welcome. Staff used Relish, an application that supported them to plan personalised activities for people. This was also used to keep their relatives informed of their loved one’s activities. One relative had commented, “The weekly programme of planned events, coupled with the Relish app, has allowed us to maintain a remote overview of Dad’s activities in between visits.” One relative said, “They always have entertainment here. Mum and Dad went to a sing along the other day. They even celebrated Mum Dad’s anniversary. They celebrate everyone’s birthday. They did them a special anniversary lunch. They have trips out and I get in to see what she is doing.” One relative said, “They always encourage Mum to try and do things, but they are always there to help if she needs it. She wasn’t walking when she came in and they have helped her, and again after her fall.”

People were supported compassionately to have choice and control over their own support. For example, one person, living with dementia, aided the Lifestyle Team to arrange events and built all the home’s bird feeders, which were then decorated by other residents. Another person organised the home’s film nights at the home’s cinema and wakes up early to collect the homes daily delivery of newspapers.

Staff go to great lengths to make sure that people’s needs, views, wishes and comfort are their utmost priority. They go above and beyond to anticipate people’s needs and take steps to ensure preventable discomfort, concern or distress for people. They are able to anticipate when someone needs urgent care or support and offer this immediately, using the most up to date tools and technology as required.

People living with Dementia received outstanding support from staff. Advanced dementia training, Dementia champion leadership and use of reflective tools allowed staff to review the causes and background to distressed behaviours to prevent them. One person said, “I think they give the overall package. They do everything they can to make me comfortable and remove any potential problems. They are very good at this.”

The provider was exceptional in how they listened to and understood people’s needs, views and wishes. Staff anticipated and responded to people’s needs and acted to minimise any discomfort, concern or distress, especially for those living with Dementia. Staff were supported by Dementia Care Coaches in the use of VERA framework. VERA is a communication approach developed to improve interactions with people living with dementia. Staff delivered a person-centred approach, using positive communication approach that looked to find meaning in people’s actions and behaviours. Analysis of environmental factors, timings of when peoples showed anxieties were all reviewed to better understand and support people. As a result, analysis showed that the home had very low levels of distressed behaviours amongst people living at the home, with low usage of the medicines used to manage these. The registered manager said, “This is reflective of the high quality of interaction, communication and understanding of everyone by colleagues.”

The provider introduced Cognitive Stimulation Therapy which uses interventions or approaches to help people with dementia improve their memory and thinking skills to enable them to cope better with memory loss. Staff ran sessions that explored communication, consisting of physical games, music, childhood memories, food, current affairs, word association, orientation, number and word games and a team quiz. The registered manager said, “Already there are positive results, with residents saying they enjoy getting to know other people and that the sessions have brought everybody together. Residents who had previously been shy now feel confident, and stories are being shared which have not been before.”

Technology was used to anticipate people’s needs and reduce risks to people. Leaders utilized a Sensor falls reduction system to alert staff in potentially risky situations, as well as on overview to adjust treatment and care. Improvements in the system allowed for a personalised analysis of people’s rooms to improve safety. The system led to a reduction in call bell noise and usage, reduction in sensor mats supporting people’s wellbeing and providing a calmer environment. The registered manager said, “Its allowed faster attendance the at right time. We are able to monitor remotely without disturbing people or waking them up. It improves overall wellbeing.”

The provider always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care. Staff were highly valued by the management team who provided them with the resources and support to provide quality care.

Staff accessed established and proven support networks if they were struggling, so they had support immediately and the impact on the care they deliver to people remained positive. Mental Health first aider provided support to staff when they needed it while staff could access a wellbeing application for confidential guidance on a range of personal issues. Staff commended the leadership for their supportive approach, both professionally and personally. When team members disclosed health concerns that could affect their roles, leadership actively worked to accommodate their needs. One staff member said, "We have two mental health champions at all times. I turned to (senior staff member) quite a lot when I needed to. There is also a number downstairs in the staff room we can ring but didn't need to ring it, as I have all the support here."

People’s experience was driven by a culture that normalised good wellbeing through inclusivity, active listening, and open conversations. Staff have easy access to personalised support that recognises the diversity of a workforce with proactive and reactive measures. This enabled staff to do their job well and to be well. For example, staff wishing to practice their faith were supported with workplace and shift adjustments to pray and fast. Staff who required additional support with conditions that impacted how they processed written language were supported with specific bite size training. This had a positive impact on the care they delivered to people. One staff member described support from the leadership with a complex personal issue that was compassionate and understanding, while providing the flexibility to continue in their role. The staff member said, “The support that I've had from the home manager has been brilliant for that situation, which I didn't expect, to be honest.”

People were supported by staff who felt valued by their leaders and their colleagues. Some staff were recruited from overseas and the leadership took proactive steps to support them living in the area and support with accommodation, as well as buddying with existing staff. The registered manager said, “A colleague had developed a ‘Welcome to Weald Heights’ Induction document to help them settle in and learn about the role. It’s about stepping into that person’s shoes and make them feel welcome and getting them settled.”

People were supported by staff who felt valued by their leaders and their colleagues. The provider offered reward schemes, events, incentives and support networks to ensure that staff were rewarded and valued for their contribution. Colleague Appreciation Week was celebrated in April to show thanks to colleagues for all their hard work. Staff could access the Cycle to work scheme, refer a friend scheme, access Wisdom application to support areas of wellbeing and lifestyle guidance, gym membership and retail discounts.

People benefitted from staff who had regular opportunities to provide feedback, raise concerns and suggest ways to improve the home or staff experiences. Staff could access the Over to You survey to provide feedback, while the home had a regional representative to attend staff meetings to discuss how communication could be enhanced, review policies and suggest changes to care practices.