Hartley Locums

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• 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 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, but a more consistent approach to providing guidance to staff on how to do this was required. Staff told us people’s care plans, handover from other staff and working alongside staff who knew people provided them with the information they needed to understand people’s needs and preferences. However, we found staff would benefit from more consistent guidance within people’s care plans. This would help to ensure people consistently receive care based on their preferences. For example, in relation to people’s communication, management of their health conditions and social history and preferences. Without a consistent level of guidance for staff to follow, the risk people will not receive person-centred care is increased, especially when they are cared for by changing staff teams. The registered manager began to address this during our assessment, by introducing a “Comfort care plan”. Relatives told us their family members were positive about the care they received and how staff tailored the care they provided to meet people’s individual needs. Relatives were involved in care planning and reviews. One relative told us how close family members had worked with Hartley House staff to create a care plan to suit their initial needs. The relative said staff had put specific arrangements in place so they could continue to contribute to care planning reviews. The relative said, “Any changes are agreed over the ‘phone.” Another relative told us, “I would email or call and tell them what needed to change. I feel like I can just put across what I want. The partnership between us and staff helps [person’s name] to get the care they need.”

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. People and relatives told us there had recently been some changes in the staff providing care. Most people and relatives told us this had not adversely affected the care provided. One relative said because staff communicated so well with each other, “There was continuity of care, although there may have been different carers.” Relatives said their family members were supported to access other health and social care services and to integrate into the community. Hartley House staff worked flexibly to ensure their needs were met. Staff gave examples showing how they supported people so they would have access to the care and equipment they wanted from other organisations.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Relatives said their family member’s communication needs were being met. Relatives and staff told us people did not currently have any communication support needs. Staff we spoke with gave examples showing how they would appropriately support people, if their communication needs changed, so they would be able to continue to understand information in the future. One staff member explained how they had used large font and pictures to support people in the past. Processes were in place to assess people’s communication needs. The provider planned to further develop their approach to accessible information standards, to ensure people continued to understood information about their care, as their communication needs changed.

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 had opportunities to provide feedback on the care provided. People and relatives told us they would be comfortable to raise any concerns about their care. One relative said, “I do feel office staff would sort it out.” The relative said they had been listened to when they made a suggestion to improve matching of staff with their family member and this had been resolved to their satisfaction. Staff knew how to escalate any concerns, and how to support people if they wanted to make any complaints. Processes were in place to investigate and respond to any concerns or complaints received.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People’s protected characteristics were considered when their care was planned and delivered. Relatives were positive about the support their family members were given to access the service. Staff gave examples showing how they had promoted equal access to Hartley House’s services by supporting people with protected characteristics. This included people with long-term physical disabilities and mental wellbeing care needs. The service also worked with other organisations so they could provide care to people at risk of social marginalisation because of their support needs.

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. People told us they had improved physical and wellbeing outcomes because of the support staff had provided. This included prompt support which enabled them to avoid hospital admission. One relative told us their family member had been supported well to remain comfortable in between care calls, as their needs changed. The relative told us there had been a few occasions when their family member required extra support. The relative said, “I spoke with [senior staff]. They arranged for 2 staff to do a detour and make an extra call.” Another relative told us about the continued support staff provided to their family member and said, “They [staff] are fair to them.” Staff and relatives gave examples showing how people's recovery after illness had improved. For example, in relation to people’s mobility.

Further development of processes were required to ensure people were 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. Relatives told us they started discussions with staff at critical times in their family member’s lives, instead of in a planned way. The registered manager said they would begin to discuss future care with people and relatives. The registered manager began to put systems in place to develop end of life care plans for people. This will help to ensure people and relatives have the maximum opportunity to decide what future care was appropriate. However, a relative told us about the quality and compassion of the care provided to their family member at the end of their life. The relative said, “[Staff] had been amazing from the first moment we had them. The staff at Hartley [House], as soon as I said what was required, they sorted it out quickly. [Person’s name] end of life care made a big impact on them. Always [person’s name] would brighten up and smile when staff came in and staff would just chat, ask her how she was and she would engage with them.” The relative said staff had worked alongside other health professionals, so their family member’s wishes and care needs at the end of their life had been observed. Staff were supported to provide end of life care. One staff member said, “I did end of life training and we [staff] do support each other.”