Evelyn Grace Ltd

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 good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.
 

This service scored 79 (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 was exceptional at making 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 using the service and relatives spoke about trusting the staff team. People and their relatives had no concerns, they liked the staff who visited them and felt their needs were understood. Comments included, “They don’t manage my life, but they so make a significant contribution. They give me a framework to my day” and “(Registered manager’s name) called in yesterday for a chat and to check that everything was still ok.” People and their relatives spoke of staff as being like family and they felt they were at the centre of the support that was provided to them.

An example of excellent care and support to people was each Christmas the registered managers found out if people would like a Christmas hamper with food and drink and a Christmas meal. This was offered free of charge and not just to people who might be on their own but if they had a relative staying with them extra food was included in the hamper. One relative confirmed this and said, “Did you know that (registered manager’s name) sends invites at Christmas to people who would not be able to have a traditional meal. They send a menu then they cook and deliver the dinners ready to reheat on Christmas Day.” This act of kindness made people feel thought of during a time which might, for some people, be lonely and difficult.

Staff received clear accurate details about the people they supported. One staff member said, “I receive call plans (which give staff information about the person and how to support them) for all clients prior to a new visit. I also receive updated care plans when client needs change.” All staff spoke very highly about the information they received about the people they were visiting. They also confirmed, if anything needed to be changed this was acted on quickly. This ensured people were supported by staff who were informed about their current needs.

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.

Once people met the registered managers and staff team, they accepted they needed support because they felt involved and included from the start of receiving the help. One relative said, “When it comes to (person using the service) care team, they’ll listen and work with them.” One person also confirmed they had not been so sure about having staff visit them. However, they told us, “I don’t regret it at all, and I agree they (relatives) were right that I needed support.”

Emergency information and care details were available to support safe transition, including unplanned hospital admissions.

We saw evidence of regular communication between professionals and relatives in order to meet people’s changing health needs. For example, an email from hospital staff informing the registered manager of a person’s medicines, the equipment they needed and the person’s abilities to mobilise safely helped the discharge from hospital. We saw from the email exchanges between the registered managers, people, their relatives and professionals meant people received appropriate support and joined up care.

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

People and their relatives confirmed the care staff understood the people they supported. One person’s partner confirmed, “They (person) has limited speech but still manages to communicate. They are happy and confident and trusts them all. The carers are marvellous.”

A professional fed back about one of the registered managers, stating, "I have seen evidence of [their] commitment to quality beyond care delivery, for example [their] involvement in developing the service’s website, with a clear focus on accessibility, inclusive language, and visibly representing a person‑centred ethos."

Information could be adapted for both staff and people using the service. For example, one person was provided with a copy of the staff rota in large print so they could easily see who would be visiting them. Another person used sounds and facial expressions to communicate their needs. The registered manager described how they took photos of various items such as, a table, commode, socks, and general things that would help communication with the person and ease their anxiety. The registered manager then made a laminated booklet using the photos for staff to use when communicating with the person.

Information was given to people and their family members to inform and empower them. For example, during a person’s initial assessment the registered manager identified a significant concern. The person had swollen legs with signs of cellulitis and infection requiring urgent medical attention, which the current care provider had failed to report. The registered manager provided clear, immediate information to the person and family regarding the risks of delaying treatment. This information enabled them to seek prompt medical intervention. This demonstrated how knowledge and information was used to promote safety and reduce the risk to the person.

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 relatives knew the two registered managers and felt they could share any concerns with them or the care team. No-one had a complaint but everyone we spoke with, said they would feel comfortable raising a complaint. People confirmed the registered managers regularly contacted them or visited them to review how they were doing and to answer any questions they might have.

People and their relatives confirmed they felt involved in how they were supported. Comments included, “My care plan gets tweaked when there’s a need but the way our relationship works is that it constantly shifts as and when things change” and “The beauty of having a small team is that there’s a close working relationship.” This demonstrated there was an inclusive approach where people’s voices and the voices of those important to them directly shaped care delivery.

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

Assessments considered people’s individual circumstances, communication needs and risks. Staff adapted their approach to make sure people were not excluded because of disability, health needs or anxiety. Managers arranged visit times, staffing and equipment to meet people’s needs and reduce barriers to accessing care and community activities.

The registered managers were visible and regularly made contact with people and their relatives so that if they needed help accessing any community resources then this was acted on. When people needed a staff member to be present when they were seeing a community health professional, then this was arranged. This benefitted the person by having the support but also the staff team who then knew what conversations had taken place. Having up to date advice and information would then be shared with the staff team so everyone knew of any changes.

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 ensured people had access to community professionals when they needed it. The quick response from the registered managers and staff team gave people positive outcomes. One relative described how the person using the service, once they had seen a community professional, their quality of life improved greatly. They said, “(Person using the service) had been saying that their feet and toes hurt. They had not complained but their nails were in a bad way. They (staff) recommended a podiatrist, and it was almost miraculous (the improvement with their nails).”

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.

Staff worked closely with people to identify meaningful outcomes and building confidence. Planning was flexible and responsive, allowing goals to evolve as people developed new skills and interests.

People’s end of life wishes, where known, were recorded, with one person telling us “We’ve completed a ‘dignity form’ and agreed the pathway.” The majority of the care records clearly documented if a person had a do not attempt resuscitation document in their home. For some people this sensitive topic had not yet been talked about. The registered managers knew the importance of knowing if this was in place so that staff could inform emergency services, if they were present during a critical event. They confirmed they would review people’s care documents to check everything was recorded.

The registered manager kept staff informed when people moved from their own homes into hospital due to a deterioration in their health. Where agreed, staff were encouraged, if possible, to visit people in hospital as often the person and their relatives were missing seeing the members of staff.

A staff member had direct experience of how the service supported their relative in the end of their life. They told us, “I couldn’t have asked for better support and advice from (the two registered managers). They were amazing, caring, compassionate and answered all of our questions that we threw at them (the registered managers), even late at night.” Another staff member said, “Aspects and principles of (end of life) were discussed in my induction. I also have previous experience of providing end of life care. Should this situation arise, I am confident that I would be well supported in this role.” This highlighted that people, their relatives and staff were supported during sensitive and emotional periods in their lives.