Emmanuel House Care Home

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

This service scored 68 (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.

Although care records contained guidance about people's preferences, routines and behavioural support needs, this was not always reflected in people's experiences. Care plans reviewed contained personalised information about people's likes, dislikes and preferred approaches to support, including guidance for people living with dementia, nutritional needs and daily routines. Some relatives raised concerns about a lack of meaningful stimulation and activities, and the activities coordinator post was vacant at the time of inspection. One person told us, “They (staff) don't always have time to say hello.” We also observed concerns regarding people's presentation, including soiled clothing, which did not always support person-centred care.

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.

Care records showed referrals and involvement from external professionals, including falls teams, dietitians, mental health services, social workers and GPs where people's needs had changed or increased. The service worked with families and professionals to review additional support arrangements, including requests for one-to-one support for people whose needs had changed. Staff described effective communication systems, including shift handovers and resident-focused updates to support continuity of care.

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

The provider gave people and those important to them information in a way that supported them to understand their care and make informed decisions. People and relatives had access to information about care and support, and relatives told us managers were approachable and responded when concerns were raised. Care records included information about care needs, risks, health conditions and future care arrangements. Electronic records were also used to share information and support communication.

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.

Records showed regular involvement of relatives in reviewing care arrangements and supporting people whose needs had changed. The service was working alongside families and professionals to explore additional support where required. Resident surveys had been undertaken and feedback was gathered from people and relatives about the service. However, resident and relative meetings had not taken place recently, which reduced formal opportunities for people and families to influence service development.

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

Care plans demonstrated consideration of people's diverse needs, including communication needs, mobility requirements, specialist diets, cultural dietary needs and health conditions. The service worked with external professionals to help people access specialist advice and support when required. One staff member told us, “There’s no favouritism, everyone is treated the same.”

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Although relatives spoke positively about the care provided, we received mixed feedback regarding people's experiences. Staffing pressures were raised by staff, relatives and people using the service and there was evidence this affected some people's experiences. Some relatives reported delays in support and concerns regarding stimulation, meaningful activity opportunities and the management of people living with dementia whose behaviour affected others.

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.

Care records contained information about future wishes and planning, including end of life preferences, legal arrangements and actions required when people's needs changed. Where risks increased or needs changed, referrals were made to health and social care professionals and support arrangements were reviewed. The service was working with professionals and families to secure additional support for people whose future care needs had changed.