The Shrubbery

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

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 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 ensure 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. We saw that care plans and risk assessments were not always reviewed consistently to reflect changes to people’s needs. Routines put in place, such as getting people up early did not demonstrate that people were being offered a choice of when they woke. The mealtime environment was peaceful. However, we saw staff serving dessert to people before they had finished their main meal, this resulted in some people not finishing their main meal. Staff had not considered that certain people needed time to finish their main meal before being presented with their dessert. People told us that there was not enough activity on offer, and we observed a large amount of people sitting together for long periods of time in the lounge area. Although some activity was taking place (ball throwing), several people were disengaged from this activity.

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.

Staff shared information with external health professionals so people’s needs could be assessed to support them. One relative told us, “The staff are very supportive in making sure my relative attends their health appointments.’’ Staff had received specific training so they could meet the needs of people living with dementia. For example, we saw staff had completed dementia care training. People received support from a consistent staff team. Care records evidenced continued partnership working and referrals to other health professionals were made as and when required.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to people’s needs, such as larger print or Braille. Easy read information regarding safeguarding was available and accessible. Easy read is a method of presenting written information to make it easier to understand for people who struggle to read. Relatives told us they were kept updated with people’s health and wellbeing.One relative told us, “The staff inform me if I need to know anything or if there are any changes regarding my relative’s care.’’ The registered manager told us, “We have measures in place to help support people to understand information, for example Braille and different languages.’’ Care plans detailed people’s communication ability and recorded communication aids when required.

The provider made it easy for people to share feedback and ideas or raise complaints about their care and support. People told us they attended regular resident meetings where they could express their wishes. However, people told us, ‘’Feedback was not always acted upon.’’ We saw that people had taken part in monthly satisfactory questionnaires. This allowed people to voice their opinions and make recommendations. The registered manager told us, ‘’We ask visitors to leave feedback on our e-reception device. We do a monthly audit on complaints. If we have any negative feedback, we will speak to the person to resolve it.’’ Staff told us they listened to people and respected their choice and decisions. Although, they said they would like more time to spend talking to people. Staff told us people and relatives were attended meetings where they could express their views and make suggestions into the service.

The provider made sure that people could access the care, support and treatment they needed when they needed it. One relative told us, ‘’The staff support my family member to attend all their health appointments, such as doctors.” Another relative told us, ‘’The staff liaise with external agencies well.’’ Staff told us they supported people to access health and social care services. One staff member said, ‘’We monitor people, to make sure they are healthy and if we have concerns then we help them to attend the doctors or other services as and when required.” One professional told us the service works in partnership with them. They said, “We are always involved where necessary.’’ Care records confirmed people attended regular appointments with health professionals.

People’s care and treatment was not always tailored to suit their health needs and wellbeing to ensure they could access support when required. People told us there were limited opportunities to access and engage in stimulating activities and social events. We saw that an activities board was in place. One person told us, “Just because it’s on the activities board doesn’t mean it’s actually going to happen.” The registered manager told us, ‘’We have a resident who has specific communication need. We have a staff member who can communicate effectively with the person.’’ We observed people engaging in some activities. However, some people were sat for long periods without support to engage in activities of daily living. This meant people were not always supported to achieve goals and experience new activities.

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. Relatives told us about people's health care plans and how these were being met by the service. One staff member told us, “We will work with external professionals to ensure people are comfortable and respected towards their end-of-life stages. We will keep family informed and fully involved in this process.’’ On the day of our inspection there were no people in receipt of end-of-life care. However, staff told us about people’s current support requirements and goals.
People’s health goals were clearly documented in care plans. Where people were nearing the end of their life, people's care plans contained end- of- life wishes and choices. We saw how the home used Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms to gather peoples wishes for end-of-life treatments. A ReSPECT form isa document that outlines a person's preferences for their medical care in emergency situations where they may be unable to communicate their wishes.