Halland House

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

People received support that was person centred. Staff helped to ensure people were treated fairly, with respect and without fear of discrimination. Information was provided in a range of formats such as pictorial and Easy Read to meet people’s individual needs. Improvements were needed to ensure all relatives who wished to be, were involved in communication about their loved ones. Consideration was also needed to be given to the range of activities available to people who had become more frail with age.

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.

Feedback from people’s relatives demonstrated that people received support that was person centred. Relatives gave examples of how support given to their loved one’s met their individual needs and choices.

Staff were familiar with people's individual routines and likes and dislikes. They knew people well and understood the importance of providing person centred care and offering people a choice in relation to how they chose to live. Staff provided detailed information about people’s likes and dislikes. For example, they told us about people’s food preferences and added small details about how they liked it served and presented. One staff member said, “That is person centred care.”

People were supported in a kind and caring way and in line with their choices. People had daily planners which had been developed with people and showed what they were going to do each day. If people changed their minds about what was on the planner staff adapted the routines to suit the person. One person had decided they did not want to go out in the morning, when they later changed their mind staff supported them to go out.

One relative told us how staff had, “Persevered and drawn in other agencies,” to ensure their loved one received the support they needed. Relatives told us staff maintained contact with health and social professionals to ensure their loved one’s continued to receive any specialist support they may need.

Staff told us how they worked with external professionals to help ensure people received the support they needed. They told us this also helped ensure they were aware of the most appropriate support for each person. One staff member told us how they had worked with speech and language therapists to help ensure a person was able to continue eating and drinking foods in a texture that was suitable for them and they enjoyed.

Health professionals told us there had been improvements in communications between themselves and staff at Halland House. This had helped ensure people received the health care and support they needed. One professional said, “Communication is now very positive, people are increasingly frail and some have dementia, so regular communication is very important and at the moment it is working well.”

Records showed that health and social care professionals were involved in people’s care and support.

There were systems in place to ensure people received information in a way they could understand. One relative told us, “They (staff) have introduced a communication board, pictures and a weekly timetable.” We received mixed feedback from people’s relatives about their own experiences with communication from the service. For example, one relative said, “I like feedback but it’s patchy depending on staff on duty.” Whereas another relative told us, “I have frequent contact. I receive emails, and staff take time to come and speak to me.” Others spoke of regular meetings with people and staff to review care, support and well-being needs of people.

The management team told us how they supported people to receive information in a way they understood and met their needs and choices. They told us people who were less able to communicate verbally were supported through the use of Makaton, pictorial menus and daily planners. When people moved into the home, or for example, required a medical procedure a social story was developed. This provided details of what was going to happen in a pictorial format, using language that was appropriate for each individual. Some people liked to know who they were receiving support from each day and they were given a staff planner with photos of who was supporting them each day. Some people became anxious when staff from their usual support team, or members of the management team were not at work for a long period of time, for example on holiday. Therefore, daily planners were developed which showed when the staff member was away and when they would be returning. Staff said this worked well as the person had the information they needed and understood when staff would return. Staff told us how they presented information to people in a format they could understand. For example, showing them pictures of meals or real food to help them make dietary choices.

There was a whole range of information available for people in formats that supported their individual needs. This included pictorial and Easy Read documents. There were hospital passports which people could take with them to medical appointments. These gave hospital staff information about the person and how to support them. This was also presented in a way that people were more able to understand. Communication care plans were in place. As already identified throughout this report improvements were needed to some aspects of care plans. Some communication care plans contained clear guidance for staff and others less detailed, for example reminding staff to use their knowledge of people’s body language and phrases to communicate with them. We identified this as an area that needs to be improved.

One person told us if they were worried they would talk to their keyworker. People’s relatives told us they were able to raise any concerns and generally they would be responded to. One relative said, “Issues are listened to, clothes used to go missing but it is better now.” Another told us, “I was concerned about dirty fingernails, I was listened to. Now there is a chiropodist and podiatrist.” A further relative said, “I raise observations rather than criticism.” We received mixed feedback from relatives about care plan reviews. Some relatives told us they were aware and involved, one relative described a care review meeting where they had made suggestions and these were supported. Another relative told us, “I am not aware of a care review.” We observed people approaching staff if they had any worries of concerns and staff supported people appropriately to identify and resolve issues.

Staff told us if people or their relatives raised any concerns or provided feedback, these would be listened to and addressed. If staff were unable to resolve the concerns themselves they would report to a team leader or one of the management team. Staff told us there were regular 'house meetings' in each house. This gave people the opportunity to take part in discussions about plans, ideas, and ways to improve their home, meal planning and activities. The management team told us about the recent introduction of ‘Key Worker’ meetings. This was designed to give people the opportunity to spend individual time with their key worker and discuss their needs and wishes, which would also involve setting goals with people. We were told this was a new approach to the key worker role and time was needed for it to develop.

There were processes to ask people and their relatives for feedback. A recent survey had been sent out and the provider was waiting for responses. There were regular meetings and minutes of these meetings were recorded. Care plan reviews were taking place and work was ongoing to ensure all relatives, who wished to, were involved in the reviews. There was a complaint process and complaints were responded to appropriately.

People’s relatives told us that if there were any concerns with their loved one’s health or well-being they were confident appropriate professionals would be contacted to provide the required support and guidance.

Systems were in place to help ensure people were not prevented from receiving the care and support they needed due to their health or disability. Staff told us they supported people to attend relevant health and social care appointments. As far as possible, people were supported to attend appointments in person. However, if they were unable to then arrangements would be made for people to receive treatment at the home, for example, regular dental checks.

Healthcare professionals told us staff were proactive in seeking appropriate support for people.

There were processes in place to ensure people received the care, treatment and support when they needed it without delay. The management team ensured referrals were made promptly when extra support was needed. The systems helped ensure people were able to access regular health and well-being checks, including annual health checks by the GP.

One relative said, “We know [name] is safe, but equally important is their quality of life. Here he is happy as well as safe.” We saw that people were supported to make their own choices each day. People told us and demonstrated to us that they were supported to spend their day as they wished. Some people had some set activities, for example, attending a day centre or pre-arranged clubs. Other people chose, with support from staff, each day. This including going out as a group or individuals. Some people chose not to go out and staff supported them to engage in activities that they wished to do.

Staff knew people well. They understood and promoted people’s rights to live the life they chose and receive the care and support that met their individual needs. They told us how they supported people with their individual choices each day. They told us how people were supported to choose and engage in a range of activities that they enjoyed and introduce them to new ideas and activities they might enjoy. This included horse-riding, trampolining and visits to local attractions that interested individuals. They also told us how they supported people to increase their own skills and abilities. This included supporting them to choose and prepare their own meals. Also, people were encouraged to engage in activities that promoted their health and well-being. They told us how some people had asked to go on holiday. This had been discussed in groups and as a result 3 groups of people had been on holidays to locations of their choice. Staff told us discussions were underway for next years holidays. Staff told us they would ensure the opportunities were open to everyone.

Some people’s needs had changed since they moved into the home. They were increasingly frail and less able to take part in activities they had previously taken part in and enjoyed. However, changes to the activities for these people had not been fully considered. We observed some of these people spending time unoccupied and unstimulated. We discussed this with the management team. They told us this was something they were aware of and were working with staff to develop new ways of identifying activities that people could enjoy and engage with. People had individual activity plans which showed what their interests and hobbies were and what they liked to do each day. However, some improvements were needed to ensure people’s care plans contained all the relevant information about people’s interests and activities within care plans. Some people enjoyed spending time away from others at the home. An area of the home had been developed to provide this space and opportunity for people. Records showed staff had received training in Equality & Diversity. People were supported to take part in meetings to discuss what was going on at the home. Work had commenced with key workers to ensure they had the knowledge and skills to support people to identify individual goals and work towards achieving these.

One relative told us end of life wishes had been discussed and a funeral plan was in place for their loved one.

Staff told us how they support people at the end of their lives. They told us how they took each day at a time as people became frailer. They gave examples of how on one day a person may be tired and wish to stay in bed, the next day they feel more like getting up. Staff explained that they received support from the hospice team and the district nursing team to help ensure people’s end of life needs were met. The management team told us about support they provided following a death at the home. They told us that people were given the opportunity to share their memories, discuss their feelings and celebrate the person’s life. People were also given the opportunity to attend the person’s funeral. We were told this was very important to some people to help them process the loss. The management team told us how they had developed a relationship with a funeral director who understood the needs of people at the home. This also helped people throughout the grieving process.

People had end of life care plans in place. The detail in these varied from person to person depending, for example, on how much people wished to discuss. Care plans showed that people’s representatives were involved. We were told detailed plans were developed as people’s needs changed.