Drovers Call

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

Care records were mostly person centred and evidenced people’s involvement in their care. However, we found some relevant information was not always in care plans. For example, a person had a food intolerance but there was no information on how staff were to support them with that. Another person whose first language was not English had methods in place to support them to communicate but this did not include teaching staff key phrases and words. People felt listened to and were happy they could raise any concerns. People were being asked for more feedback about how they wished to spend their time and outcomes from this were reviewed. People's wishes in the event of illness and end of life care were recorded, where they wished to discuss this. Information was detailed in care plans for staff awareness. Staff were aware of extra sensitivities when supporting people at the end of their life.

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 told us they felt their views were respected and the support they received met their needs. One relative told us, “The staff are flexible with people. If someone says that they don't want their lunch they will get an alternative. That flexibility is really good. They accommodate the residents’ moods.” Another relative said, “[My family member] likes the chair exercises and the singers. We had a cake day when we all visited and everyone had some. [Staff] had an animal day for people, they brought in a chicken, a lizard and a rabbit. [My family member] liked the lizard the best.” A third relative added, “[My family member] has a good friend set. They like the food and have lots of extra puddings. In the sunshine they’re outside in the garden and they take part in the activities. They like mechanical activities. They like art and being outside. They like to look at the birds. They have a lot of musical things inside, its a lot more positive than it was a year ago.”

Staff worked hard to make sure people were at the centre of the support they gave. A staff member told us, “I listen to people to help them make decisions and what I tend to do is try and interact with the [relative] that turns up as they will tell you people’s background and likes and dislikes. I like talking to them.”

We observed staff working with people in a manner that demonstrated their knowledge of each person. A person who had come to the service very recently was being supported to become familiar with their new environment and staff were using the opportunity to get to know them.

People who wanted to, felt involved in their community and had access to social and health care community services. People spent their time in ways they preferred and could choose to access events or not. A relative told us, “For those who want to, when its Easter or any other special time, [staff] do get activity people in. They try to throw a party for people in the lounge which is nice. The entertainer that comes to the home seems to know the people’s names. They’ll say something like ‘Come on [person’s name] get up and dance.’” Another relative said, “There is a new [registered] manager now so there’s lots more activities. They have also combined two areas so there are more people. [My family member] likes the fact that there are more people about.”

Staff understood how to try and encourage people to access a variety of opportunities. They also understood how difficult some people might find it moving into the service for the first time. One staff member told us, “I mean it is always going to be slightly distressing (moving home) as it is a different environment, but having best practice and making [people] feel as comfortable as we can. Having their belongings with them helps it to feel a bit familiar and doing familiar tasks and making them feel really welcome and safe.”

Professionals who knew the service and staff felt confident the service was now moving in the right direction to work together to ensure people’s health and social care needs were met. One professional told us, “The staff understand the importance of yearly reviews for long term conditions of [people] and assist in helping me to achieve this.”

People’s health and care needs were assessed as part of the process prior to moving in. These were documented in care plans for staff awareness and reviewed on a regular basis. Staff encouraged people to access local amenities or maintain community connections. The registered manager and senior staff sought advice and partnership working with local health and social care professionals to ensure people’s needs were met safely.

People told us the communication from staff had improved now there more permanent staff. One person told us, “[Staff] talk to me now. They used to use a lot of agency [staff] and they often didn’t speak English or understand me, but all the staff understand me and I remember all their names now because they are permanent.” A relative told us, “The staff communicate well with family. They’re better about letting us know what’s happening in the home since the last inspection.” Another relative said, “The staff talk to me and offer me tea and cake when I visit. They will get out [my family member’s] file and tell me about them.” Other relatives said, “The staff are patient. I see them persevering with people who don't understand what’s being said to them.” And, “Staff communication with residents with cognition difficulties is really good.”

Staff tried various ways of helping people understand information as well as express their opinions. They used speech, gestures, objects, pictures and translation apps on their phone. One staff member told us about a person who no longer easily understood or spoke English. They said, “I see [person’s name] doesn't understand but I always speak to them and they smile. One of the managers tracked down some [relatives] for them as we thought they didn't have any. [The person’s relatives] brought pictures and it had us all in tears. They speak [the person’s preferred language], staff have the basics but not 100%.”

Information about people’s communication needs was documented in their care plans. Where people did not communicate easily, other methods currently used to support good communication was recorded to guide staff. General information was shared on notice boards and in meetings.

People and their relatives felt able to speak up. Prior to the last inspection, some relatives felt complaints had not always been responded to in a reasonable timeframe and outcomes had not been shared. However, most people felt they were now listened to and complaints were managed quickly. One person told us, “I’m not afraid to speak my mind but it’s not very often I need to. I can’t remember the last time I had anything to even grumble about.” Another person said, “I would be happy to make a complaint if I needed to. I’ve not found anything wrong here.” A relative told us, “I did speak to the [registered] manager about [my family member’s] care. [The registered manager] promised to look into it and came back to me, so I was happy with the outcome of my complaint.” Another relative said, “Some of the meetings they have run after work so I can go. They also do afternoon tea sometimes and invite relatives (to chat). I think that’s a nice thing to do.”

Staff understood how to encourage people to talk and how to identify a complaint. They were aware of the complaints process. A staff member told us, “I will always try talking it out with people and relatives. I wouldn’t necessarily go straight to a manager depending on the siltation. If it is that someone has been given sugar in their tea by mistake I would apologise and go make a fresh one. If it is something major I would either go to a nurse, the clinical lead or the [registered] manager depending on the severity. If it was something severe or being covered up I would go to CQC or the social workers.”

The registered manager and provider ensured a complaint policy and process was in place. People were supported by staff to raise complaints and staff demonstrated an awareness of all types of complaints. People’s views were also captured during surveys and meetings as well as recorded in notes following informal conversations. People, relatives and staff were included in decisions about improvements to the service.

People felt they had access to everything they wanted or needed. Relatives felt staff made sure their family members could still gain access to places and food they enjoyed. A relative said, “At lunch time I’ve noticed that [staff] ask if someone with diabetes can have a pudding (by checking their blood sugars).” Another relative said, “The members of staff are amazing because they do a [video call] to show [how my family member is].” A relative told us their family member was supported by staff to visit another family relations home after they requested it.

Staff understood the importance of diversity and ensuring people continued to have access to support their faith. One staff member told us, “We have quite a few religious people who are Christian and we have the church come in, read the bible and sing some songs. The activities people arrange it. This is for people no longer able to get to church who used to go.”

External professionals told us staff worked with them to ensure people had the right equipment and the correct guidance about meeting people’s care needs.

The staff team used assessments of people’s needs, information in meetings and feedback from people and relatives to ensure they were aware of what people wanted or needed. Where appropriate they made referrals to specialists for further guidance or access to support.

People’s relatives told us their family members who were vulnerable to experiencing inequality were listen to and staff monitored their care closely. One relative said, “[My family member] is not able to do a lot [due to their health condition]. [Staff] do call in to [my family member’s] room to see them. They do monitor what they’ve been drinking. [Staff] move [my family member] to sit with other people in the lounge so they are not isolated all of the time.”

Staff made sure people received the care to a good standard and was aware of ensuring they reviewed the care experience people received. A staff member told us, “Now, the whole culture is changing, it is better and it is more familiar and we have a better understanding of the residents.” Another staff member said, “You do read the billboards and what is in the building. It is about giving quality of life for [people] and [ensuring] their dignity is no different to anyone else. Even if they don't have capacity you have to show respect and give them what they require.”

There were policies and processes in place to ensure people and their relatives could speak up about their care. Regular reviews of people’s care ensured their quality of life was maintained and preferences promoted. Where required, specialists were sought to give additional advice or support to access what people needed.

People were all given the opportunity to regularly discuss their wishes for serious illness and for the end of their life. A relative said, “[My family member] has a respect form that’s all completed. When they went to A&E the respect form went with them.”

Staff told us there was not many people currently being supported who were at the end of their life, however, they understood what would be needed and how to consider additional needs for both the person and their relatives such as time, health care, personal care, comfort and pain relief. They told us they would work with the nurses and external professionals.

People’s wishes for the end of their lives was discussed with them prior to admission to the service and again at regular reviews. Not everyone wanted to discuss this, so those wishes were recorded in their care plans. Relatives were also involved in this process where permission was given. Where people had wanted to have discussions and make plans, they were supported to complete a Respect form to document their wishes or make arrangements for a Lasting Power of Attorney (LPA) to speak up for them should the time come when they could no longer make decisions for themselves.