Lavender Fields

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 inadequate. At this assessment the rating has changed to good. This meant people’s needs were met.

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 choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

There had been significant improvement in the provider’s approach to person-centred care since the previous assessment. Care plans contained more detailed information about people’s support needs, life histories, preferences, routines and who was important to them. Staff demonstrated a better understanding of people as individuals and care records generally reflected what mattered to people. People and relatives told us they were more involved in care planning and reviews. Comments included, “We are involved. There’s a lot to it, it’s very long (the care plan). My (other relatives) were involved, they made suggestions and things were changed” and “I was surprised how detailed the care plan was.”
Care plans generally contained clear individual information about personal preferences, communication needs, activities, cultural wishes and end of life choices, although this was a work in progress. Some care records did not provide the same level of personal detail as others. This created a risk their care may not be as personally adapted when new or agency staff were providing their care. Although obvious improvements had been made, work was still needed to ensure the same level of quality in people’s care records was maintained for everyone, to ensure person centred care planning was consistently applied.

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's care was more joined up and coordinated than at the previous assessment. Staff worked effectively with GPs, district nurses, speech and language therapists and other healthcare professionals to support people’s needs. Care plans demonstrated evidence of professional involvement and specialist advice was generally reflected within people’s care plans. Hospital admissions, health changes and incidents were more consistently reflected through reviews of care documentation. There was evidence people received coordinated support following changes in their health and wellbeing. Relatives spoke positively about improvements in continuity of care and consistency of approach from permanent staff.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider generally supplied people and relatives with information they needed, and people told us communication had improved over recent months. Care records generally contained detailed information to support staff in understanding people's needs and preferences. However, some relatives continued to describe occasions where information had not always been communicated in a timely way, and they sometimes became aware of changes through visits rather than direct communication. Whilst information systems had improved, further development was required to ensure accurate and consistent communication with families in all circumstances.

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 told us they generally felt listened to and involved in decisions about their care and support. Feedback from people and relatives was used to support improvements and relatives described greater opportunities to participate in discussions regarding care arrangements. People and relative involvement was evident within care planning, reviews and discussions regarding future care needs. Leaders actively sought feedback from people and families and there was evidence concerns raised were acknowledged and acted upon appropriately. A relative said, “I would go to management, they are open to comments and help with questions, as do the new staff.” Relatives recognised that improvement work remained ongoing but consistently described noticeable progress compared to their previous experiences.

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

People were supported to access healthcare services, specialist advice and support according to their needs. The provider worked with external professionals to ensure people received support for long-term health conditions, mobility needs, mental health conditions, nutrition and swallowing difficulties. Care planning demonstrated consideration of individual health conditions and referrals were made when concerns were identified. A person living with a long-term progressive health condition was experiencing difficulties and a deterioration in their symptoms during the assessment. Managers were in contact with a specialist healthcare professional to seek their expert advice and support. People were able to access support and services required to maintain their health and wellbeing. There was evidence healthcare involvement had improved considerably since the previous assessment.

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 were now supported according to their individual circumstances and there was evidence staff understood the importance of promoting dignity, independence and choice. Care plans considered people's individual histories, interests, cultures, relationships, communication needs and personal wishes to ensure their individuality was captured. Activities were designed to support involvement with a wide range of people, and staff made efforts to engage people who chose to stay in their rooms as well as those spending time in communal areas. People and relatives confirmed they were happy with the arrangements in place to support engagement in some daily activity. Relatives said, “They email the activities programme every week and [relative] gets a paper copy. They’ve started doing newsletters more frequently and they have Facebook” and “The activities are fantastic. A chap comes and sings once a month, we all like that. There’s the gardening club. Before if she was asleep or whatever they didn’t try to involve her, but now they do, they make an effort.” A staff member told us, “A lot of people come out of their room now, some go back to their room or sit in the lounge, before it was only 1 or 2 and they would be asleep.”

People’s protected characteristics and individual identities were reflected in care planning and support arrangements. Whilst some care plans remained stronger than others, people generally received care tailored to their individual needs and circumstances.

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.

There had been substantial improvement in advance care planning and future care discussions. Many care records contained detailed information regarding people’s wishes, preferences and priorities should their health deteriorate. We saw some lovely examples of personalised ReSPECT forms, end of life wishes, funeral arrangements, spiritual preferences and family involvement in important decisions. Relatives confirmed they had been involved in discussions about future care and support needs. A relative told us “They’ve discussed it with me. I’ve had that conversation.” Whilst some examples were more detailed than others, there was evidence the provider recognised the importance of supporting people to plan for the future and ensuring those wishes were documented and respected.