Help at Home (Danbury Gardens)

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.

People were fully involved in the development and review of their care, which they signed. A copy of their care and support needs, along with a daily record detailing the care and support provided was kept in the person’s home. A person told us, “I’m happy with my care plan, every person has a binder, which includes a report book, when a carer is with me, they record it in the book. I sign my care plan on a ‘tablet’.

People, and in some instances family members were involved in establishing a plan for care and support to maintain safety and well-being. A family member told us, “My [relative] received an injury as a young person, so they have always had extra care needs. Following an incident, they were placed at Danbury Gardens, in what is a secure and caring community.”

The service was responsive to requests to change care call times. A family member told us, “If we need to change any of the care calls, or add an additional call, we can do that with notice. They will always do their best to accommodate, even if it is shorter notice than normal.”

The annual review of people’s needs included a representative from the funding local authority and in some instances a family member. Family members told us how the registered manager and staff were instrumental in ensuring people’s needs were met. A family member told us, “The carers understand my [relative’s] aim is to stay as independent as possible but did intervene when Adult Social Care visited recently and wanted to take away the lunch care call. When staff pointed out how [relative] was struggling because of the fall and the resulting pain, they got the care call reinstated immediately.”

People’s care records were developed and written to support person-centred care. They emphasised what was important to the person and the role of staff in the delivery of care in line with people’s expectations and needs. Any changes in people’s needs were documented within their daily records and escalated to the registered manager.

Staff were knowledgeable as to people’s needs, and the importance of providing care with consideration to people’s cultural and religious needs. A member of staff told us, “There are staff who speak Punjabi, Gujarati and Hindi, which means we can communicate effectively with the people we support.”

The registered manager liaised with the local authority who funded people’s care to seek agreement to changes in the duration or number of support and care calls a person received.

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 told us staff, in some circumstances, staff supported them to liaise, make and attend health care appointments. A person told us, “If I need a G.P. then the staff will contact the doctors on my behalf. The doctor won’t visit me here, so staff help me with telephone appointments.”

People and family members told us they were supported by staff who knew them well, which facilitated consistent care. A person told us, “I am grateful that I don’t have to tell them [staff] what needs to be done. If they are newer, they just refer to the care plan.”

The registered manager and staff worked well with healthcare professionals, and others involved in people’s care, to ensure people received continuity of care from everyone involved. A family member told us, “Staff liaise with the occupational therapist and physio visits and seem to work well together. From what I have seen, there is mutual respect.” Another family member spoke of the involvement of health care professionals in the management of their relative’s catheter.

Positive and supportive relationships developed between staff and the people they cared for facilitated the provision of good quality care and outcomes, this in part was achieved as the people received care from a consistent team of staff who know them well. A member of staff told us, “I mainly support the same people as part of my everyday role. I think this helps them trust us because we go to them regularly and they trust us to care for their needs. This helps me work and gives me confidence knowing that I know people very well.”

The registered manager confirmed in the event a person was admitted to hospital, staff from the service kept in contact with the hospital for any updates, and to support a planned discharge to ensure a smooth transition to return home.

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

People and family members spoke of effective communication, both in terms of staff being able to converse in their preferred language, but also with regards to good communication with office-based staff, including the registered manager. A family member told us, “The manager is aware of everything that is happening with [relative], and I can go to speak with them anytime.” Another family member said, “You can call them in the office anything, there is always someone who knows what they are doing.”

The provider was aware of the Accessible Information Standard and where required was able to provide information in a format which considered people’s communication needs. The provider upon request, was able to provide key information, such as the service user guide and quality assurance feedback surveys in several languages as well as in easy read for those with a learning disability.

People received a copy of the service user guide, which provided key information about the services provided by Help at Home (Danbury Gardens). For example, the referral and assessment process, aims and objective of the service, how to raise concerns including contact information and how the service was developed and shaped based on people’s feedback.

Care professional team meeting minutes included information and discussions of the importance of keeping information secure with consideration to paper and electronic based records, and social media and the action to take should a suspected data breach occur.

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 were confident in raising any concerns or issues, they told us they would either speak with staff who provided their care and support or with the registered manager who was based in an office within Danbury Gardens. A person told us, “I’ve never had to complain, but I would speak to [registered manager].” A family member told us, “The manager is very transparent and will do whatever they can to support.”

People’s views about the service were regularly sought through one-to-one discussions and surveys. A family member told us, “My [relative] received a survey form, and I do see the newsletters they put through their letter box.” An analysis of people’s views was undertaken quarterly, and a voice of the customer improvement plan developed in response. Results of surveys evidenced high levels of satisfaction amongst people, with individual members of staff being commended. The action plan referred to the celebration of success being shared with the staff team.

Records evidenced concerns and complaints were recorded, acknowledged, investigated and responded to in writing, in line with the provider’s complaint policy and procedure. Where complaints involved staff, the provider’s policies relating to human resources were considered. For example, the provider’s capability process. The outcome of complaints was used to continually develop the service. For example, where appropriate staff were provided with additional training or had their competency in specific areas reassessed.

The registered manager informed us complaints investigations were reviewed by senior management and the compliance team, for any further suggestions or preventative actions. Where investigations indicated misconduct by an employee, disciplinary procedures would be considered. The complainant would be informed in writing of the outcome of the investigation and given the opportunity to appeal if they disagreed with the outcome.

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

People and family members spoke of the reliability of the service, and of the services ability to be flexible where required. A person told us, “If the time of a care call isn’t convenient, then I will speak to the staff in the office. They’re pretty good at making requested changes.” A family member spoke of the flexible approach and the impact on their relative. They told us, “My [relative’s] mood has certainly improved since they started the extra calls. I now organise the shopping delivery to coincide with the care calls, and the staff will put the shopping away for [relative].

People’s care records provided the name and contact details of family members, as well as health and social care professionals involved in their care. Each person had a hospital passport, which accompanied people in the event of an emergency, for example if they were transferred to hospital. The document provided key information about the person to support health care staff in making treatment decisions.

The provider had systems and processes that monitored people’s care and support needs, including health conditions. People’s care plans and records confirmed how people’s care and support was provided, monitored and reviewed. Staff where required supported people to attend scheduled health appointments.

Staff were vigilant in noting any issues relating to people’s care and well-being. A family member told us how staff had noted their relative was taking too many tablets (medication). In response, staff liaised with the person’s pharmacist and G.P. to organise their medication to be packaged in a Dossett box, to make it easier for the person to manage their medicine safely, whilst maintaining their independence.

The provider had contingency plans in the event of an emergency. For example, staff absence, bad weather and medical emergencies to ensure care was never missed.

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 and family members we spoke with said staff treated them fairly. Staff completed training in equality and diversity and understood their role in reducing equality or prejudices, by supporting people to liaise with external services.

The provider and management team and staff were alert to discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support. The provider recognised barriers including language, culture and mobility. The provider targeted its resources and time in promoting and maintaining equality, diversity and inclusion across the service.

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.

A family member shared with us how the service had supported and cared for their parents during and after end-of-life care. They said, “Staff were absolutely amazing when [relative] was going through end-of-life care and then passed. Even the support of [relative’s spouse] afterwards was excellent, and gave us as a family, real peace of mind as we were all grieving.”

A member of staff told us, “We’re not supporting anyone with end-of-life care at present, the last person was 3 years ago. We had training at the time to better support the person.”

People’s care records, where applicable, detailed their advanced wishes regarding treatment if their health deteriorated, which included a DNACPR (a document which records people’s advanced wishes should they stop breathing) and a ReSPECT form (a document which records people’s advanced wishes regarding treatment in the event they unable to do so).