The Cotswolds

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

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.

The provider worked with people, relatives or representatives to provide as much person-centred information about people as possible. There was room for improvement to adapt certain processes such as reviews or care plan formulation into different formats for based on people’s communication needs.

One relative told us that since a recent change in their health, they found it difficult to attend the service to see their relative or be involved in their care. The provider had offered to organise them getting to and from the service, as this was important to them and the person using the service.

Amongst expected care plans and assessments, the provider utilised documentation to reflect people’s personalities, past, hobbies and interests. Staff appeared to have good knowledge of people as individuals and therefore were able to adapt their care. There was room for improvement to ensure that staff consistently had enough time to read person centred information about people, as many reported they often didn’t have time to do this, particularly in relation to someone new moving into the service.

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.

The provider was able to demonstrate good understanding of the neurorehabilitation which was a large focus of the service, but they also understood the other challenges and conditions people with acquired brain injuries were likely to face. This was embedded into people’s individual care.

The provider aimed to use less agency staff, but where this was not always possible, they would request and use the same agency staff members to ensure continuity. They also provided ample information through care plans and risk assessments, to better enable staff members to meet the needs and preferences of people using the service.

Leaders within the organisation demonstrated their willingness and drive to work with external organisations, including commissioners, to ensure people’s care was joined up and as smooth as possible.

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

During our assessment, there was information displayed around the service in different formats, such as easy read, or pictorial. This included posters with the colours of staff members uniforms to enable people to identify staff members different job roles, and how to raise a concern.

Welcome packs were provided to people and relatives in different formats, and this included information about local amenities such as shops and places to eat or stay.

We found evidence that the provider took steps to include people whose first language is not English. For example, staff had recently started to learn phrases in a different language to ensure a person, recently using the service, could communicate with them.

There was room for improvement to ensure that all information pertaining to individual people was in a format that they may understand, as this was not consistent across the service.

Staff were had good knowledge of different people’s communication needs and were provided with training around General Data Protection Regulations (GDPR), however, there was not always a clear understanding of this. This was fed back to the provider who were going to review their GDPR training and work to embed knowledge amongst staff.

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.

The provider actively sought feedback from people, staff and relatives through surveys and questionnaires. We saw evidence that findings were analysed, and actions were taken. For example, their most recent residents’ feedback saw the provision of yoga mats for people and more social trips.

There was not always evidence that people had been involved in the formulation of their care plans. The provider had already identified this and were changing this process, it was not fully embedded at the time of our assessment.

The provider had created a family forum, which was still in its early stages. Relatives told us they don’t feel the provider seeks suggestions from them, but that they did feel able to raise concerns or make comments and the provider would take action.

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

The provider had a large multi-disciplinary team which consisted of qualified staff from varying different professions. This included Social Workers, Occupational Therapists and Nurses. This enabled people to access specific types of care and support promptly.

There were clear emergency protocols, for individuals, as well as for the service. This included emergency equipment, plans and an on-call system so staff could access support from leaders at any time. The on-call system consists of a nurse, as well as a manager from the wider organisation.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes.

The provider was good at involving people, where people and their relatives were forthcoming, or eager to be involved and be heard, in planning and reviewing their care. There was room for improvement to ensure where people faced challenges or difficulties being involved in this, were given this opportunity.

Staff and leaders were provided with training on the equality act and appeared confident to advocate for people to tackle discrimination or barriers. Where people had different needs based on their culture, background or religion for example, they were supported with this, and their care was adapted.

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.

People were supported to set and achieve short and long-term goals, although there was room for improvement to ensure this was consistently applied to everyone using the service.

Where people had advanced decisions about dying, these included within care documentation.

We saw evidence the provider worked with relatives and people, for situations such as hospital admissions.

One person told us, their goal was to not require this level of support forever, and they had aspirations to return home. They felt the provider was supportive on the journey and were as eager to see them achieve it as they were themselves.

Staff received end of life training; however they felt it only prepared them for supporting someone through an idealistic and peaceful death.