Fort Horsted Care Home 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 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.

The provider did not consistently ensure care was personalised and responsive to people’s individual needs, and this limited people’s experience of person‑centred care.

There was inconsistent practice in care planning. While some people’s care plans were personalised and contained detail about their life history, care and social needs, and their preferences other people’s care plans lacked person-centred detail. Some care plans were inaccurate or incomplete and did not always reflect people’s current needs. The service used some agency staff and without adequate guidance this increased the risk that people would not consistently receive person-centred care. A relative said, “There are agency staff who come who may not know. But overall, they have done a good job at getting to know her.” The provider told us they had an action plan in place to ensure all care plans were equally as personalised and detailed to guide staff to provide person-centred care.

Staff were not always meeting people’s individual care needs for example people’s fluid targets or repositioning plans to maintain their skin integrity. Feedback from some people was that staff were not always responsive to their care needs in a timely manner.

Despite this, people and relatives felt staff knew them well and were mostly satisfied with the care they received. A healthcare professional told us, “Staff interactions with residents appear caring and respectful. They demonstrate an understanding of residents’ needs and aim to provide person-centred care."

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, or supportive of continuity.

The provider did not always ensure care was coordinated, safe and delivered consistently, to ensure people always had good outcomes. We found gaps in continuity and oversight of care. Some care plans for a person were not completed within expected timescales following admission. We also found inconsistencies between risk assessments, care plans, and daily records for some people. For example, repositioning, hydration, and bowel care were not always monitored or acted on in line with care plans for people’s assessed risks, increasing the risk of harm. We also identified missed opportunities to escalate concerns or review care promptly when risks increased.

However, people had access to a range of healthcare professionals, including GPs, community nurses, chiropodists, and dentists. A health and social care professional told us, “The service supports continuity of care by maintaining communication with relevant professionals and documenting care appropriately. Handover processes and follow-up of clinical advice are generally in place.” Relatives told us staff kept them informed about hospital visits and changes in health and worked with professionals to support people’s needs.

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

The provider made sure people and relatives received information in a way they could understand. Information about complaints and how to raise concerns was displayed within the service. The provider used large fonts to make text more accessible for people and utilised pictures for the daily menu to support people to understand and make choices about their meal preferences.

Staff adapted the way they communicated with people to support greater understanding. We observed staff approached people at their level and spoke clearly, using gestures and touch to support communication. A relative said, “They tell her what they are doing.” Another relative gave examples of how staff tailored their communication to meet a person’s individual communication need to ensure they were kept informed of the support they were receiving.

Relatives told us staff contacted them promptly when people were unwell or involved in incidents and explained what actions had been taken. People said communication was clear and reassuring, and relatives felt confident staff would contact them when needed. A relative told us, “They ring me and are very clear with what has happened."

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.

The provider had several mechanisms in place to support people to be able to give feedback. There were regular meetings and surveys on different aspects of care so that people and relatives could feedback about the service and improvements could be made. A person said, “The ask my feedback, you can talk to someone straight away at any time.” An action from feedback received was to introduce key workers for people which we saw the registered manager implementing at the time of the inspection. The registered manager had been working to improve the services engagement and relatives confirmed being involved in care planning and risk assessments.

The providers complaints process was displayed in the service, and the registered manager followed their complaints process. People and relatives told us they could speak to staff or managers at any time and felt concerns would be taken seriously. They gave examples of concerns or complaints raised and action taken including changes to equipment, cutlery and the environment following feedback. A relative told us, “Staff listened and sorted it” after a concern was raised. Another relative said, “Haven’t had any (complaints) they generally are very responsive, they are always on hand to discuss anything with you."

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

People and relatives felt the service met people’s needs. A relative said, “They support her personal care help with eating they have been helpful with food and have provided aids.”

People were supported to access activities, visits, and services where possible, and adjustments were made for people cared for in bed or with complex needs. For example, activities staff went round to get individual feedback monthly because not everyone could attend the resident meeting.

People also had access to external healthcare professionals and specialist support, including for sensory impairments, mobility, and long‑term conditions. Relatives told us staff worked with social services and external agencies to secure equipment and support, such as aids for vision and communication.

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 provider recognised and supported diverse needs, including communication, disability, and identity. For example, staff told us they had received additional communications training and support from external professionals to better enable them to meet the needs of people who had visual impairments. Relatives confirmed staff supported their loved one’s communication needs well. Another relative gave an example of feedback they suggested to help their loved one make informed choices about meals which was acted on. They relative said, “They listened to us regarding pictures of meals of what [relative’s name] likes and show [them]. We spoke about it on the Sunday evening, by Monday it was being done and they were in the process of researching and downloading pictures. They really do work with us.”

Staff were observed interacting warmly with people, supporting personal identity, and respecting privacy during the inspection. People had access to things they needed and liked. A relative said, “[Relative’s name] has everything in place that [they] need to help [them] and the care [relative’s name] gets is good."

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 appropriate, advance care planning, DNACPR decisions and discussions with families were in place to support people’s future planning. These records contained personal details about how to provide person-centred care at the end of people’s lives and took into account any spiritual requirements. Relatives told us staff discussed care plans and future needs with them and kept them informed about changes in health. Staff had received training in providing end of life care and staff understood the signs that a person’s health was deteriorating and they were reaching the end of their life. A staff member said, “We need to put constant checks hourly, hourly repositioning due to frail skin to prevent pressure sores, give mouth care we take very seriously. For those taking little food, we immediately give mouth care. The nurse notifies them and calls the family and if possible, make funeral arrangements. We help them to have person-centred care, manage their pain symptoms, and report to the nurse and support the family emotionally."