Drovers Call

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People's needs had been assessed and incorporated into the care plans. The registered manager and senior team worked with external health professionals to ensure people's health and medicine needs were accurate and being regularly reviewed and met. External professionals gave positive feedback about the improvements at the service since March 2024. Teams generally worked well together. However, we found communication between the different staffing teams could improve. People's consent for any restrictions had been sought and where people did not have the mental capacity to consent, the best interest and DoLS process was followed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were happy that their needs had been taken into account and staff were supporting them in ways they preferred. One person told us about new equipment the provider had supported them to access following a review of current equipment. They explained how this had made their life much more comfortable. Relatives told us their family members needs had been assessed. They told us staff knew their family member well. One relative said, “They know [my family member’s] likes and dislikes and accommodate those.”

The registered manager and senior staff ensured peoples needs were fully assessed prior to moving into the service. They understood the need for regular reviews. Staff had a good understanding of people’s preferences and knew how to escalate and changes identified. One staff member said, “Drovers Call have a very good friendly approach and friendly training. They make us aware of what each person has been diagnosed with and we use the care plan to deliver what people expect. [Managers] give us extra training to enhance our skills and knowledge.”

Systems were in place to review people’s care needs and preferences prior to moving into the service. People’s needs were then reassessed as and when changes occurred or annually. Care plans were monitored monthly by staff to ensure the guidance for staff was correct and up to date. Senior staff and the registered manager worked with external professionals to ensure people had the correct equipment and medicine or to advise on safety.

People told us they were involved in planning and reviewing their care and agreeing any changes to the support given. One person told us, “[Staff] have asked us what we wanted. I need help with all [aspects of personal care] now. [Staff] always ask, they are very good.” Feedback from relatives was mixed, some relatives felt fully involved and informed and others felt communication and planning of care reviews could improve. A relative told us, “We don’t get invited to care reviews. [Staff] do them apparently.” Another relative said, “Since the last time CQC were involved [staff] asked us to redo [my family member’s] personal history so this is an improvement recently. [My family member] has also changed a lot since they have been in there.”

Staff had an up to date knowledge of people’s needs and current best practice. Some staff told us they were refreshing their knowledge on a lot of training courses and had learnt to do some things differently, including considering the language they used when speaking to or about people. One staff member told us what they had learnt about how living with dementia could impact a person in order to better support them in practice. They said, “We have had the dementia bus out and that is coming back for others who didn’t attend the first sessions and we also have online training. The bus one we did was very good and gives you good insight into people lives. I didn’t realise about their senses, their sight, their touch, noises and things like that and how it can be triggers for people. On the bus we had put on gloves and put spikes in our shoes to give us insight and we felt very disorientated.”

The registered manager ensured staff attended all training relevant to their role and encouraged further reflection and understanding of the legal requirements of their roles. They worked closely with external professionals to ensure any changes in need where highlighted early and reviewed to ensure good care. Regular meetings were held involving all relevant people, staff and professionals to discuss and agree changes. A professional told us, “I look forward to going now, we talk through every resident. Sometimes no issues and others need to review something, I find them forward thinking and proactive now. They have rearranged things slightly as they were moving residents to different rooms for the care needs. High dependency top and middle and then bottom are less risk, more residential. Getting on board with respect forms as well. They are there to make sure we give the residents the care they want. It has changed for the better.”

People and relatives told us staff now worked well together and this had improved with the increase of permanent staff and changes to management. They told us how staff worked with other health professionals too when their family members went into hospital or needed to see a doctor. One relative told us about how the staff team had organised physiotherapy for their family member. Another relative said, “When [my family member] fell, [staff] got an ambulance as soon as they could. They also rang us to let us know and then they called us to meet them in the hospital.”

Staff told us there was now an improvement in how the team worked together. However, some staff felt communication amongst the team could still be better. Staff understood the importance of working as a team with both internal staff and staff teams from external partnerships such as the GP surgery, other health agencies and social workers. One staff told us, “Loads of social workers come in and do 1:1 with the families and do concerns.” Another staff member said, “I do feel supported by the manager and owner, they are always In and walking round. They are quite open and say if you need anything don't hesitate and that matters. On top of that we have meetings quite often and a lot of the team are involved in the decisions as well which I personally feel is great as being on the floor is different to not being; so great they involve us. They don't do shifts but if we needed help, they wouldn't hesitate to help. They listen and I feel happy to speak up and make suggestions or raise concerns.”

Health and social care professionals told us there had been improvements in partnership working at the service. They told us the new manager and the clinical lead were approachable and pro-active. One professional explained how they had worked through concerns about processes from different teams. They said, “[The registered manager and clinical lead] were receptive to help and always made us welcome in the home. They would contact me for support and for my advice. This often resulted in facilitating conversations and trying to improve relationships with other partners. [We] arranged a face-to-face meeting in an attempt to help understand each other’s processes and the impact of people’s actions.”

The registered manager and senior staff held regular meetings with staff and external partners. Staff now received regular supervision, which staff told us was an improvement. Observations of staff practice were in place so that lessons could be learnt about what worked well and what required improving. People’s care records were stored and accessed digitally, which meant information could be kept up to date immediately and shared, with permission, with health and social care partners if people went into hospital or transitioned to another service.

People told us how they had been supported to change their lifestyle and make healthier choices. This had resulted in a significant improvement in 1 person’s health and well-being as they were now more interested in socialising and had more energy. Relatives spoke about the way staff ensured their family member had access to health professionals such as doctors, dentists or chiropodists. Some people chose not to access some services and this was respected but reviewed. One relative said, “[My family member] has seen the doctor with a chest infection and a sore throat. They also see a chiropodist.” Another relative said, “[Staff] use the online system to the doctor’s surgery. Because I have Power of Attorney, I can see when a message has been sent to the doctors and I can see the treatment on the NHS app. They also have a nurse practitioner who comes in regularly.”

Staff encouraged people to make healthy lifestyle choices in relation to their weight, diet, health checks, smoking and alcohol consumption. Staff told us how they supported and checked regularly on people who chose to spend time in their bedrooms to make sure they were not becoming lonely or depressed. Staff understood the importance of people’s choices but knew where to seek advice if they had concerns.

People’s care records detailed their lifestyle choices and health needs. These were reviewed regularly both formally and informally. The GP visited routinely to have an overall check on people’s wellbeing in addition to regular liaison with an advanced clinical practitioner. People were encouraged to attend health checks and outcomes of these were monitored for any changes required to people’s care plans.

Feedback from people and relatives about outcomes was mixed. However, some of these were historical concerns and overall, people and relatives agreed they were well cared for and had achieved positive changes in their quality of life. Relatives told us how open the registered manager and provider were about the required improvements and tried to involved them in plans for the future. One relative said, “When [Drovers Call] had the inadequate rating I rang to ask for an action plan as to how they were going to improve. They did send it to me. There are definitely improvements with the amount of staffing. The staff are friendly and helpful.”

Staff were aware of the previous concerns but also of plans for improving the care provided. They told us they had been included in decision making and information was shared openly. Staff had concerns about sustaining the improvements and continuity of managers. They told us they hoped the new registered manager stayed long term to continue progressing the changes already made. A staff member said, “It is really improving a lot, at 1 stage we feel it is done and then we go back to a poor situation again. So, it is important for regular monitoring and to maintain it.”

There were processes in place for monitoring outcomes for people and their quality of life. Regular meetings occurred with a variety of people, relatives, staff and external professionals to review care and make suggestions for change. Where clinical decisions were beyond the scope of the staff team and clinical lead, they sought expert advice.

Most people told us staff always gave them choices and sought their consent before providing care or sharing information. A relative said, “[Staff] do take pictures of people doing things but I haven’t signed the form yet and so [my family member] is never in the pictures.” Some people chose not to make their own decisions. Another relative told us, “[My family member] doesn’t make their own decisions because they don’t want to. If they need anything the [staff] will ask [another relative] or myself.” One person, however, who was lawfully considered not to be able to safely make their own decisions about their care, was not happy with their relative making decisions for them. We discussed with the provider and registered manager about the possibility of seeking advocacy support for this person about their decision making.

Overall, staff had a good understanding of consent and the principles of the Mental Capacity Act 2005 (MCA). However, some staff struggled to describe this in practice. For example, 1 staff member told us, “I can't remember if I have had training on [Deprivation of Liberty Safeguards] (DoLS), I will need to refresh. I normally make sure people can say yes or nod or give me a smile (for consent) as some people are non-verbal and use facial expression.” However, another staff member said, “Just because people [are unwell], it doesn't mean they can't make decisions for themselves. They have the right to make wise or unwise decisions. I would talk to management if I thought someone couldn't make decisions.”

The registered manager ensured people understood about any restrictions and sought their consent for these to promote safe care. Where people were unable to make decisions for themselves, they followed the best interest process and applied for a DoLS. These were reviewed and decision making included relevant others and external professionals. Details of what people were asked and how mental capacity was decided were recorded. The least restrictive methods were in place and staff were given training. We discussed with the provider and registered manager how staff would benefit from sessions to look at how to build their confidence and understanding when applying the training to their daily roles.