Old Hastings 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.

This meant people’s needs were met through good organisation and delivery.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This service scored 64 (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. Most people were positive about the care they received and described it as person centred. Relatives told us the same with one saying, “Yes I think that’s the overriding thing at Old Hastings House they see (relative) first and the problems that they come with after.” Another added, “Yes they really make enormous effort to keep the care person centred, it’s really impressive.” A staff member said, “I am a key worker providing complete support for three people however we do look after everyone.” Care plans did contain personal histories and people’s life stories however these were in the process of being updated. Health and wellbeing care plans which gave details of what unique support needs people required were in place but again were being reviewed and updated. See our well-led section for more about documentation.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. The provider and registered manager had only been in place for a few days at the time of this assessment. They were in the process of reviewing care plans and getting to know people’s backgrounds and needs profiles. Some of the documentation they inherited was poor and incomplete and at this time they were not in a position to fully understand everyone’s support needs. The service had a lot of staff, including senior staff, who had been working at the service for several years. These staff knew people well and had built up professional relationships and connections with other professionals to ensure that needs were met. People and their relatives all told us that the support from outside of the service was positive with regular visits from District Nurses, GP’s and specialists for example podiatrists and occupational therapists. A person said, “I think I am well looked after, I see a chiropodist, and I go to the dentist, the doctor sees me when I need it.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (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. Staff responded to people’s communication needs. These were assessed and recorded within individual communication care plans. These included specific information on how people’s communication needs could be met and what aided their communication. For example, those who needed spectacles or hearing aids had specific care plans. Systems to support people to communicate with staff, relatives and friends had been assessed and promoted. For example, video calls were set up and staff supported people to phone their loved ones as necessary. There was a lack of portable communication aids used - such as pictorial aids-for those who struggle to understand words. There was signage on toilet doors and bathroom doors and on some people’s doors, however this was not consistent throughout the home. All care plans were on a computer and this enabled them to be printed off for family, hospital appointments and transfers. They could also be enlarged for those that have sight impairment. We were informed that all organisational documents could be provided in an alternative language if required. Relatives told us that they were provided with information in a timely way. One said, “There was a recent sickness bug at the home. They called that very morning and then kept me informed.” Some staff told us that they thought people would benefit from some dementia friendly aids that would help them to understand information, for example in finding their way around, or to choose their meals or activities.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. Several people and their relatives told us they felt they were not kept informed about the recent change in ownership of the service and the change in registered manager. A person told us, “Yes but I haven’t been impressed with the communication from the acquisition (incoming provider)” A relative added, “The sudden change of the acquisition was not communicated well, and I am still unsure of what is happening, we have had no opportunity to respond to this. The only communication we have had with new management was informing us of a fee increase. We have been given no reassurance around staffing.” However, people did say they were confident to speak up if they needed to, a relative saying, “Yes, they definitely have a voice.” Opportunities for more formal feedback and involvement were lacking. People told us there had been an annual questionnaire to ask their views, but this had not happened for a long time. Similarly, residents’ meetings were held but recently had been very infrequent. A complaints policy was in place and complaints had been recorded and responded to in a timely way. There was no apparent management oversight however of trends.

 

The provider made sure that people could access the care, support and treatment they needed when they needed it. The service had developed positive working relationships with other health and social care professionals which ensured people received any additional support they needed. People told us their needs were met in a timely way if for example, they needed a podiatrist, occupational therapist or a hairdresser. Professionals confirmed these arrangements and told us the working relationship with the service was good. A professional said, “We complete weekly telephone ward rounds with a face to face care home visits every week.The care homes also have access to an inbox which is monitored Monday to Friday up until 12:30pm and staff appear to maintain a good standard of contact with us.” These positive lines of communication were also confirmed by the GP’s surgery who carried out the four weekly visits.

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 were treated fairly and were all given the same opportunities to receive the care and support they needed and wanted. We observed multiple staff interactions and conversations with people and saw that people were treated fairly, kindly and with compassion. People were included in conversations and activities. People and relatives told us they had a variety of activities they could engage with including regular trips out in the service minibus and many group activities in the communal areas of the service. People were given choice, whether they wanted to take part or not and this included people who chose to spend time in their own rooms. One to one activity was offered and provided appropriately. People’s cultural and spiritual needs were supported and staff told us of recent celebrations for International Women’s Day and St. Patricks day. Those who wanted to attend church on a Sunday were given that opportunity.

People were not always 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. Not all staff had received training in end of life care and support. Staff knowledge of medicines appropriate for people towards the end of their lives was poor. Documentation relating to people’s choices about support at the end of their lives, do not attempt cardiopulmonary resuscitation (DNACPR) forms had been completed but it was not always clear where these documents were kept. Quick and easy access was important in the event of an emergency. Some people and their relatives said that they had had conversations with staff and had been given opportunities to make advanced decisions. Comments from relatives included, “Yes we had a very long and careful discussion with a senior carer” and “Yes my sister has been involved in this.”