The Old Rectory

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 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.

There were some minor discrepancies in people’s care plans and risk assessments which were responded to immediately, reviewed and had no impact on people’s safe outcomes. The management team were aware that there were still improvements to make, but they had only recently moved from paper care plans to a computer based system. They were still adjusting the system to ensure it was being used in the most beneficial way. It was also discussed that daily records were task based with minimal reflection of people’s moods and behaviours, and achievements. Staff were knowledgeable about people and did much more with people than they documented. This had been discussed and the peripatetic manager was already working with staff to improve their confidence and recording.

Care and support were provided in a person-centred way with people being at the centre of any decision making and their loved one’s views being asked for and listened to. People received the ‘right care’ with their rights, privacy and dignity being upheld at all times.

Care provision was tailored to meet people’s needs, and this was also reflected in care plans which described the person, any preferences they had for the way they were supported and then went on to describe the actual support required. The care plans detailed people’s specific health needs which were individual to that person. For example, there were people who lived with sensory impairments, and this was reflected within their care plan with directives for staff to follow to ensure their safety and well-being.

The activity programme was reviewed regularly to ensure people received opportunities to do the things they enjoyed. A staff member told us, “Everybody has a quite busy schedule, sometimes they might not want to do it, so we postpone or change until they are ready.” People told us of visits they had made, of shopping trips and walks in the countryside. A pub night had just been introduced. One person told us that Thursdays were bingo nights and this was something they looked forward to. There was a ‘you said’, ‘we did’ board which showed that people have lots of activities and there are ideas for future activities.

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. A relative told us they felt well informed and assured that if needed, specialist advice would be sought straight away. They told us, “Staff ensure we are involved in all decisions and updates, very pleased with the service.”
A health professional told us, “Staff contact us when needed and will always accompany the person for support.” Staff told us that they worked alongside families and always informed families of any appointments and kept a record of the appointment and advice given.
The peripatetic manager demonstrated an awareness of inequalities in accessing healthcare services and emphasised the importance of a holistic approach to care. They ensured that support was not narrowly focused on a single health condition. For example, when supporting individuals with a learning disability, staff did not assume all care and support needs were solely related to the learning disability. Instead, they considered the wider context of each person’s physical, emotional, and social needs.

Care plans were regularly reviewed and contained detailed information about people's care needs, including any health and medical needs. They also included evidence of regular partnership working with health professionals such as specialist nurses, and therapy teams. These records showed responsive co-ordinated care. Staff were able to discuss how they ensured people were treated equally and fairly no matter their age, sexuality or their health diagnosis. They told us of their knowledge of the Equality Act and how they used this in supporting people and decision making.

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

Most people living at the service were able to communicate well. For people that couldn’t, body language and certain noises aided staff to understand their needs well. Staff told us of different ways of communication that had been tried but had not been successful. We observed one person interacting with staff in a positive way, with the staff understanding them and their needs. Staff told us there was a range of different communication aids that could be used if appropriate but were not currently required.

Pictorial aids for managing pain were being considered for one person and would be included within the MAR charts for staff to refer to.

All care plans were written on the computer, and this enabled them to be printed off for family, hospital appointments and transfers. They could also be enlarged for those that had sight impairment.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people/families in decisions about their care and told them what had changed as a result.

Relative, resident and staff meetings took place and there were opportunities to feedback regularly. Feedback and actions proposed and taken were then discussed at the next meeting.
There was a complaints policy and procedure, and the management team kept a log that ensured the provider had an overview. Concerns raised had been responded to promptly and thoroughly.

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

People had access to health and social care professionals which meant that they received the most appropriate care and support when required. We spoke with professionals who said communication was good and that they were contacted for appointments, support and advice in a timely way that immediately addressed people’s needs.

A health professional told us, “The people I am involved with also have support from the learning disability team and we share outcomes.” Accurate records of appointments and interventions were kept as part of care plans which then provided a complete medical history for people for future reference.

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.

Activities were tailored to people’s likes and based on their interests. They were able to engage in 1 to 1 or group activities according to their wishes. Activity timetables were flexible depending on people’s presentation each day. People were supported to go out on trips and plan excursions or holidays. We were told by staff, “They have a lovely life, they go out on trips, take part in parties and celebrations and there is always something going on, gardening for some is important.”

People and families 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.

End of life wishes were considered for each person. Discussions took place with people and their families. Some people and families did not wish to discuss their preferences, and this was respected. However, the conversation remained open to ensure follow up discussions could take place when required.

Each person’s understanding and experience of death was considered when discussing end of life plans. People’s experience of bereavement and death was also used to develop conversations where appropriate. The peripatetic manager used readily available resources to support conversations with people.