Housing 21 - The Watermill

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.At our last assessment we rated this key question outstanding. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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.

People, and if required, their family members were involved in decisions about their care and support. Staff recognised the importance of treating people as individuals and supported them to make their own decisions. Where people’s care needs changed, staff and the management team discussed options with them and involved relevant external professionals as required.

People’s care plans contained guidance for staff about how to meet people’s current needs. Care plans were updated and any changes were shared with staff to ensure people received the care they needed. Staff shared examples with us of when they noticed a change in people’s needs, they documented this and shared it with the staff team and senior staff. One staff member said, “We document the diet throughout the shift, weights are also done regularly. Skin is checked regularly as you go along you would document any change. If someone is anxious, we write it on the significant sheet or behaviour monitoring.”

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 staff and management teams worked well with other agencies to ensure people’s needs were met. Care was planned in a coordinated way, and processes supported referrals being made to relevant professionals when required.

Information was shared appropriately within the staff team and people’s care and support remained consistent when their needs changed. Where healthcare professionals were involved in people’s care, we observed staff sharing relevant information about the person’s needs or health to ensure care they received was current and suitable for them.

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

People’s care plans contained information about their individual communication needs. Staff we spoke with were aware of this guidance and shared how they adapted their approach to people, considering their individual needs. Care plans offered staff guidance about how people’s mental capacity impacted their communication. For example, one care plan read, ‘[Person] wears glasses, uses hearing aids, and needs support to attend audiology appointments. They can become more confused in the event of an emergency.”

We observed staff supporting people and saw they took a different approach with each person. For some they spoke quietly and ensured they were at eye level for the person, and for others they used visual prompts to aid their understanding. One staff member shared with us, “For some people it’s about getting to know them, input from family with their life history and if they can’t express it is what you can see. I watch people’s facial expressions as this helps me understand what they like and don’t like.”

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 were involved in decisions about their care. One relative told us, “The management are fantastic. They keep us in the loop with everything. [Person] is included in all the meetings about his care.”

People and relatives felt able to share feedback about their experiences. One relative said, “We have never needed to make a complaint. The management are good. We get a newsletter. There’s a suggestion box.”Residents and families’ meetings were held regularly to give people and their relatives opportunities to share their experiences and raise any queries or concerns.

There was a system in place to ensure any concerns or complaints were managed effectively. We reviewed complaint records and found people’s concerns had been taken seriously and where things had fallen short of the standards expected of the home, this was acknowledged.

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

The management team ensured people had access to services such as dentists, opticians and specialist healthcare professionals, including community nurses and occupational therapists when needed. Adaptations and equipment were in place according to people’s individual needs and staff were aware of how to use these to support people.

People were supported to access care and support in an equitable way. The staff team ensured that individual needs and preferences were recognised and responded to. For example, dementia friendly signage supported people to understand and make their own choices.

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.

Staff had received training in respect and inclusion and were confident to advocate for people when required. They were considerate of how people’s protected characteristics, such as cultural or religious needs could impact on the care they provided and respected this.

Relatives and staff shared with us an example where a person’s individual preferences around personal care were not being met. After discussing this with senior staff, changes were made which meant support was changed so it was tailored to the person’s individual needs.

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.

Where people’s needs changed, the staff team worked with them and any relevant professionals to ensure care met their current needs. For people who accessed the home for short term stays, plans about a return home, or to alternative accommodation were discussed with them and documented.

Care plans were being improved for people with regards to their wishes for care at the end of their life. Basic guidance was in place which staff told us they used to ensure they provided end of life care in accordance with people’s needs and preferences.