Hylands House 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. 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.

Care plans demonstrated information had been gathered from people and, or their relatives, to ensure individual routines and preferences were recorded. For example, whether people preferred male or female care staff, what their daily routines were and what time they liked to get up and go to bed.

One person had recently moved into the home and had been supported to bring their pet cat with them to live in their bedroom. The provider had recognised this was important to the person and had ensured risk assessments were in place to enable this to be done safely. Designated staff had taken on the responsibilities involved in caring for the cat and reflected their commitment to ensuring factors that were important in developing person led care, were considered, and where possible, actioned.

The management told us they felt the home benefited from being small and this enabled staff to know people well. They told us that often, when larger homes had not suited people, they were referred to Hylands House and achieved more positive outcomes.

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 maintained good relationships with other health and social care professionals to enable timely referrals to services such as the continence service, dieticians and dentists. There was effective communication between services and shared information was recorded in people's care records.

People benefited from receiving continuity of care from a consistent and long-standing staff team who had time and opportunity to learn about people’s individual needs.

The regional operations director told us that as part of their governance, they reviewed local healthcare needs. This supported them in developing the service based on what people wanted and what was available locally.

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

People’s sensory needs and communication needs were reviewed and recorded in their care plans. This included any aids people needed to support their communication such as hearing aids or glasses and how they preferred information to be shared with them. Staff told us they adapted their communication style to suit individuals needs and we observed them doing so.

During our inspection we saw some information was available in accessible formats for people. For example, large numerical clocks in communal areas and some bedrooms supported people with visual impairments or memory issues with clarity and orientation to the date and time of day. However, others were without clocks, and the reason for this was unclear. One person told us, “I haven’t a clock, they [the provider] don’t think it is necessary.” Another person who did not have a clock in their bedroom, said, “I would like to have a clock, very much.”

A monthly planner was available to inform people what activities were planned for the day however this had not been updated for the new month at the time of our inspection. This meant people did not know what activities were planned and could therefore not make informed choices. A daily menu informed people about the planned meals however these were not displayed in an accessible format, and one person told us, “I do get to see the menu, but it is too small for me to read.” Other people had magnifying glasses to enable them to read smaller print more easily.

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, relatives and other visitors to the home had opportunities to provide feedback through a complaints and compliments book, a suggestions box and feedback forms available in the entrance to the home. Information about the provider’s formal complaints process was displayed and provided people with details about other organisations they could escalate their concerns to if they felt they had not been responded to appropriately.

People were also invited to provide their feedback at regular ‘residents meetings’. Minutes were reviewed of a recent meeting and agenda items included activities, upcoming events, what was happening in the home and food and dining. One staff member told us how the timing of lunch had been discussed at a recent meeting. As a result, lunch had been put back by 30 minutes to reflect people’s feedback.

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

There was a range of equipment in place to support people to mobilise and move around the home including lifting mobility equipment and wheelchairs.

Managers and staff knew how to support people to access external healthcare when it was required. For example, staff monitored people for any changes in their health so they could access emergency healthcare support when they needed it.

The registered manager told us that when people were physically unable to attend external appointments, they arranged for visits inside the home, for example dentists. Where possible, adaptive transport was arranged and an escort provided. This helped to ensure people with protected characteristics had access to the services they wanted.

There was an on-call system in the home to provide 24-hour management support to staff.

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’s care plans recorded their protected characteristics and the support they needed from staff or the equipment they required to ensure they received equal opportunities as others within the home.

Staff were trained in equality and diversity, and they could explain what this meant and how it was put into practice.

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.

We saw evidence of when the service had worked well with people to improve their health and help facilitate a return to their home from Hylands House following a period of respite care. Compliments received reflected that people were grateful to the team for their care and the support they received to regain their mobility and independence, enabling them to plan for future independence following their return home.

Staff demonstrated compassion and respect in their delivery of end-of-life care at Hylands House. The service had received compliments from relatives about the care their family members had received as their health deteriorated. One relative who’s loved one had recently passed away in the home told us, “It’s just all about the staff. They are patient, empathetic and caring. They knew [Name] so well, including what clothes they liked to wear and what was important to them. Even when they were busy, they made time to look after [Name] and us. It really meant something.”

Planning end of life care was started during assessment as the operations manager told us, “It’s important we get it right and know vital information from the second people come through the door.”

Care plans contained some holistic information about what was important to people in their final days. For example, 1 person had indicated they wished to have photographs of their family near to them. Another person had stated they would like to receive a faith visit by a representative from their church. Where people had DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) orders or advanced decisions in place, these were recorded and available to staff to ensure care delivery met people's expressed wishes.

Health care professionals told us they supported staff to manage people’s medication needs at the end of their life, and how a joined-up approach usually prevented an admission to other services. The manager and the operations manager were trained in verifying death and did so in conjunction with the GP surgery. A healthcare professional told us staff at the home were particularly good at supporting people at the end of their life and felt they had systems in place to ensure people were comfortable and pain free.