Gloucestershire Health & Care NHS Foundation Trust

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• 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 service met people’s needs.

At our last assessment we did not rate this key question. At this assessment the rating is good. This meant people’s needs were met through good organisation and delivery. The service made sure people were at the centre of

their care and treatment choice. The service treated concerns and complaints seriously, investigated them and learned lessons from the result. The provider was making sure the new provision met needs of the peoples before they moved in.

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.

We scored the service as 3. The evidence showed a good standard. The service 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

Relatives were able to give feedback, share ideas, or raise complaints about the care, treatment, and support provided. Staff involved people in some decisions about their care. For example, individuals were shown the new provision they would be moving to before discharge to ensure they liked it. One person chose the colour of their flat.

People had access to independent advocacy, including an Independent Mental Health Act (IMHA) advocate.

The staff team ensured that relatives had access to information about external support organisations. The information board displayed details about IMHAs, the Mental Health Act (MHA), tribunals, how to make an MHA complaint, and how to speak up.

Relatives mostly felt that staff responded to concerns they raised.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff supported people to maintain contact with their families and carers with regular home visits arranged by the staff team.

They took patients out into the community for activities such as going for food, exercise and told us if patients wished they would support them to access a place of worship.

Staff from the new provider spent time getting to know individuals’ routines for continued continuity.

Relatives spoke positively about the home visits.

We scored the service as 2. The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored

to individual needs.

Staff did not always make notifications to external bodies as required. For example, safeguarding referrals were not always made in a timely manner.

Staff reported that they regularly updated carers, families, and commissioners about people’s progress. Some relatives felt this communication worked well, while others believed it could be improved.

Staff ensured that relatives could access information about treatments, local services, people’s rights, how to complain, and related topics.

The information provided was mostly in a format accessible to the specific people involved. For example, staff used a set script and symbols to ensure consistency when informing someone about moving to another placement.

However, this approach was inconsistent for other individuals, with limited use of pictures or accessible materials.

Information governance systems included confidentiality of patient records. Care records were electronic, and staff locked their computers when they were leaving their desks to ensure confidentiality of content.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service maintained oversight of complaints. They reviewed themes, investigated appropriately and communicated outcomes to relatives. In the past year, there were two complaints regarding noise. Both complaints were investigated, and double-glazed windows were installed to address the issues.

Learning from these complaints was discussed during daily meetings.

Staff knew how to handle complaints appropriately. All complaints were discussed directly with complainants, with the aim of local resolution. Formal complaints were allocated to managers for investigation.

Staff sometimes received feedback on the outcome of investigation of complaints and acted on the findings.

Relatives expressed mixed views about their experience of the complaints process. Some stated they understood the procedure and would raise a

complaint if unhappy with any aspect of care. Others felt that making a complaint would not lead to any change.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service maintained oversight of complaints. They reviewed themes, investigated appropriately and communicated outcomes to relatives. In the past year, there were two complaints regarding noise. Both complaints were investigated, and double-glazed windows were installed to address the issues.

Learning from these complaints was discussed during daily meetings.

Staff knew how to handle complaints appropriately. All complaints were discussed directly with complainants, with the aim of local resolution. Formal complaints were allocated to managers for investigation.

Staff sometimes received feedback on the outcome of investigation of complaints and acted on the findings.

Relatives expressed mixed views about their experience of the complaints process. Some stated they understood the procedure and would raise a

complaint if unhappy with any aspect of care. Others felt that making a complaint would not lead to any change.

We scored the service as 3 .Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes.

Staff within the service and the wider organisation mostly promoted a culture where people using the service felt empowered to express their views. Staff had received training in equality, diversity, inclusion, and human rights.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff are trained in equality, diversity, inclusion and human rights. With compliance over 90% for the team.

However, the experience of equality of outcomes varied among the people who were receiving care and treatment. One person and their relative reported positive outcomes, but this view was not shared by all relatives.

We scored the service as 3. The evidence showed a good standard. 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.

Staff supported people to make decisions about their care, treatment, and future. For example, they regularly met with identified new providers to contribute to planning for where current residents would be moving.

When people were unable to verbalise their preferences, staff used their knowledge of the person to inform aspects of the new provision. People were involved in these decisions wherever possible.

Staff used personalised care plans that mostly reflected individuals’ needs, wishes, and feelings to ensure plans for the future were documented clearly.

Staff ensured that all relevant healthcare professionals and other appropriate bodies were involved in planning the care and treatment of people with complex needs.

Relatives were mixed about their involvement in peoples future plans with some relatives being very positive and others feeling they would welcome more input.