Cow Lees Care Home

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.

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.

People and relatives said they were supported by a good staff team. One relative said, “They are good at what they do and seem to know my [Relative] well. They know what he likes and what he doesn’t like. They look after him and everyone else very well.” Another relative told us, “Staff know their job and they know my [Relative]. I didn’t think he would settle, but he has done.”

Staff told, us how they supported people in a person centred way. One staff member described how they used hot towels for someone to encourage them with their personal care. Staff knew people’s risks and the care plans we reviewed, matched staff’s knowledge of how to support them in a way they preferred. People’s relatives were involved and if they were changes, they were consulted and informed at each stage. One relative said if their family member had fallen, they were told and kept up to date about any treatments or interventions from other health professionals. Care plans detailed people’s individual needs, preferences and routines and were accessible to all care and clinical staff. The electronic system provided prompts to staff to ensure people’s individual needs were met. For example, 1 staff member told us, “There are nutrition alerts on there (the system) telling you when to give fluids and things like that.” Staff told us they were able to be responsive to any changes in people’s needs because it was communicated to them in daily ‘huddles’ and handovers between shifts.

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 reviewed local healthcare needs to help them develop the service based on what people wanted and what was available locally. People were supported to obtain help from other health and social care professionals and referred to specialist health teams where appropriate. Commissioners of care feedback to us was of an improving service and where improvements were identified, actions were taken to make sure people continued the right levels of care.

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

A nurse told us no one in the unit required information in different formats, but was aware of how people's sensory needs could affect communication if these were not met. To this end, they had a gold box with sensory support equipment in. For example, this contained spare batteries for people's hearing aids. They told us they had a person who spoke a different language but who understood verbal English, communicated single words in English, and appeared to be speaking fluently in another language. Nurses said this person’s family member had advised that this person was not always speaking specific words. Nurses and staff recognised this, saying, “You offer choices like food by showing for [person’s name] to choose from.” Staff said they were confident this person would get communication transcripts when and if needed, from managers.

People's communication needs were identified and recorded in their care plans. Where English was not a person’s first language, action had been taken to support communication. Information on how to report a concern or a complaint, planned activity sessions and information for visitors promoting good hygiene practices were displayed around the home.

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 felt involved, listened too and felt able to provide any feedback. One relative said, “I’ve not made a complaint. The woman in the office can’t do enough for us. She’s very good. If I did have a complaint I would speak to her.”

Staff said if there were any concerns or complaints from relatives, they would take it to the senior staff member on shift who would look into the concerns promptly. Staff gave us an example where a relative had said 1 person was fidgeting at lot. he relative thought the person might not have had personal care, but the staff member who had supported the person was able to reassure the relative. Relatives feedback was positive saying if they had any concerns, they would raise it with managers. Relatives said communication with staff was good, especially when their family members needs changed, they were always informed.

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

Based on discussions with staff at all levels and our observations we saw staff contacting GPs for health and medicine reviews, regardless of people’s cognition. Care plans included information about people’s health conditions so staff could recognise any signs or symptoms which may indicate a deterioration in their condition. A recent visit from commissioners had identified some care plans for a specific health condition needed more details and we were assured action was taken. An advanced nurse practitioner had recently commenced regular ward rounds at the service which meant people could get healthcare support promptly and when they needed it. Staff supported people to attend external medical appointments to facilitate conversation and understanding of issues relating to their health. The service was accessible for people who were immobile or had limited mobility. We reviewed care records for a person who was immobile, and staff ensured the person was able to access care, support and treatment when they needed it.

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.

A nurse gave an example of how they supported one person from a marginalised section of the community, to continue to live their daily lives as they wished. The staff said they responded promptly for anyone who needed any additional care or support from external organisations. The manager told us they had worked closely with the veteran’s society which meant anyone who worked for the forces would be referred more quickly. We did discuss the feedback and our observations with management to ensure people had equity in access to outside areas, especially the courtyard area.

People were not 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.

A senior staff member spoke about the loss of people and impact on staff and said this had been hard for staff to lose people they cared about. This was in connection with the COVID-19 pandemic. Reviewing records, we found an inconsistent approach to recording people’s end of life wishes. People's care plans included the Recommended Summary Plan for Emergency Care and Treatment form (ReSPECT). This plan provides clinicians with information about whether attempts at resuscitation should be undertaken for the person. For some people, there was limited information in respect of any religious, cultural or personal wishes to ensure people spent their final days as they wished to. For others, people’s decisions and what matters to them were delivered through personalised care plans. We reviewed the care plan for a person who was identified as having weeks to live. Staff involved the person and their family in planning their final days and wishes for their death, for example, care planning for the funeral directors they wish to use and where they want to be cremated. Staff told us they felt supported, and on occasions, extra nurses were on shift. One staff member said family were a long distance away and for a person at end of life, this staff member realised the person liked a particular musician. The staff member played records by that musician. The provider had facilities for relatives and friends to spend time with people in the final stages of their life.