Harrier Grange

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 71 (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.

Staff had a good understanding of what person-centred care meant in practise. One staff member said, “Person-centred care is offering care to residents holistically. One resident’s preference is not the same as another’s. Each individual should be treated differently.”

Although some of the care plans we looked at were not reflective of people’s most up to date needs, this had no impact on people because staff were able to demonstrate to us that they knew people and their care and support needs and preferences well. When we fed back to the management team any inconsistencies in people’s care plans, these had been rectified by day 2 of the inspection.

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 told us they tended to work in the same areas of the service and that this meant they had got to know people well. They told us this also promoted continuity of care for people. The registered manager told us they were proud of the fact that no agency staff had been used for some years. The registered manager told us “I feel very confident of my staff, including out of hours. I know I have a good team.”

The service worked closely with people and healthcare partners to maintain continuity of care, including when people moved between different services. People told us they had access to health care professionals when required. The service was visited weekly by a local GP and staff told us how they were able to seek professional advice and support between those visits.

One health professional told us, “We are involved in [named process] for the residents. We are sent paperwork to sign after it has been agreed with the doctor and family members, and we also provide guidance for this, which is signed off by [named health professional.]”

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

People’s communication needs were assessed and when people experienced difficulties with hearing or speech for example, the care plans we looked at were generally informative and clear. Staff knew which people needed additional support with communication and were able to tell us how they met people’s communication needs, including for example, recognising facial expressions.

There was clear signage throughout the home which supported people to find their way around safely and independently.

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.

Annual resident and relative surveys took place alongside regular meetings held at the service. We saw minutes of these which showed good attendance, and ‘you said, we did’ newsletters showed that feedback was acted on. For example, people had asked for a history talk and visits from a local ukulele band which had taken place. Feedback was sought from people about meals. The chef told us “We have a resident and relative meeting so they can provide feedback on the menus. I also go round and ask residents for their feedback after meals. I find out about people’s likes and dislikes and will make something different for people if they don’t like what’s on the menu.”

Complaints were logged, investigated and responded to. The provider adhered to their duty of candour responsibilities. People and their relatives told us they knew how to raise concerns. One person’s relative said, “I do know how to make a complaint. I haven't complained as such, but I did bring up an issue, which was resolved.”

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

People’s needs were assessed before they moved to the service and when people’s needs changed, records showed staff had referred people for appropriate specialist support and advice.

The environment supported accessibility for people, with wide corridors fitted with handrails and adapted toilets and bathrooms. All areas within the service and the garden were wheelchair accessible.

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 received training in equity, diversity and human rights to help them understand equality and address discrimination. Care plans included information about what was important to people, such as family relationships, social interests, and cultural or spiritual needs. Staff used this information to provide care that was fair and personalised. We saw examples of how different cultures and religious festivals were explored and celebrated with activities, learning and food experiences.

People were not always 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.

At the time of our inspection, nobody was receiving end of life care. However, we did not see that advanced care plans were consistently in place which meant that there was not always a record of people’s choices and preferences for end-of-life care. This included those people who might have specific cultural or spiritual requests. We fed this back to the management team who told us they would review this with people and their families.

Despite this, staff told us they had completed end of life training. Nurses told us they had access to specialist palliative care support if needed. One staff member said, “We can directly request a review by the palliative care team if needed; they are really good and will review people’s medicines.”