North Hill 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 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 71 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care plans were not person centred and did not give staff clear guidance on how to meet people’s support needs. The provider used a digital care planning and recording system. Information taken from people’s care plan was used to develop a list of tasks for staff to complete. Staff then worked from this list, recording on the app when each task was completed.

However, we found care plans did not always provide staff with sufficient information and, in some instances, planned care had not been accurately converted into tasks. For example, one person’s care plan stated, “Mouth gel to be administered 3-4 times a day”. This had been inaccurately recorded on the digital app as a single event of oral care each day. Care records showed the person had not received the planned level of oral care. This exposed the person to risk of harm.

People’s care plans did not include sufficient guidance to enable staff to safely meet people’s more complex needs, including catheter and Percutaneous Endoscopy Gastronomy (PEG) care. This meant staff less familiar with people’s specific needs might not have access to the information they needed.

Following feedback at the end of the first day of the inspection, staff and managers had taken action to improve the accuracy and effectiveness of people’s care plans. Staff told us, “We have done a diabetes care plan and a Parkinson’s care plan after your last visit”.

Daily care records were focused on tasks and did not include information on the person’s mood, detail of how they had spent their time and what activities they had engaged with. Managers recognised these records did not provide an accurate picture of people’s experiences in the service.

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 service worked effectively with health system partners to ensure people’s needs were understood and met. Records showed prompt referrals to heath and social care professionals had been made and guidance provided was acted on.

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

Staff communicated with people effectively and staff varied how they presented information to help ensure people’s understanding and support their decision making.

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.

People and their relatives regularly spoke with the manager and told us the manager listened and acted on any issues raised. Relative comments included, “Communication is a lot better now, the staff all seem happy”, “Any issue you can raise with them and they are happy to talk to you” and “If we say something they sort it out straight away”. However, no recent surveys had been completed to provide people, relatives and staff with formal opportunities to give feedback on the service’s performance.

The manager had investigated and taken action to make changes to the service’s complaints procedure in response to learning identified during investigations.

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

Staff were attentive and responded quickly when people needed help. Relatives told us staff were welcoming and encouraged visits whenever possible. Relatives told us, “They make us welcome. There is nothing I am worried about. Nothing at all” and “I have turned up here in tears. The staff are great and provide us with reassurance and support. I was never worried about my relative”.

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 service employed a full-time activities coordinator and people were encouraged to participate in a range of activities both in communal spaces and their own rooms. People told us, “There is enough to do. I see [activities coordinator name] a bit”.

On the first day of our inspection people enjoyed a lunch club social activity in the dining room while on the second day a cupcake baking competition was organised. This had been designed to enable people who did not wish to leave their rooms to participate. People told us activities available included painting, ball darts and bingo. Relatives said there was a range of activities on offer. They told us, “They take people out on trips to the garden centre and the pub. There were barbeques in the summer.”

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.

People’s wishes and preferences in relation to support at the end of their lives had been recorded and were respected by staff. Where people had made decisions in relation to resuscitation, this information was readily available to emergency workers and the staff team.

Staff and the manager encouraged and supported relatives to spend time with people at the end of their lives. One relative told us, “When my [partner] was here, I was here every day and for their last month I slept here”.