HF Trust - Orchard View

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

This assessment did not assess all quality statements within this key question. For the quality statements we did assess, improvements had been made. The overall rating for this key question has improved to good based our findings at this assessment. People received person-centred care from a staff team who knew people well. Staff understood the importance of ensuring people lived the lives they wanted to and involved people and their relatives in all aspects of their care and support. People were now encouraged to live fulfilling lives and pursue hobbies and interests important to them. During our assessment we saw people taking part in a range of activities both in their home and their local community. Staff also respected when people chose not do activities and wanted a more relaxing day. One relative told us, "I am confident now they get their allocated hours in the home. I am certain this is taking place where it wasn’t before. She is getting out now a lot more." Staff told us there was now a culture of staff spending time with people, interacting with them more and encouraging them to do as much for themselves as possible. Staff described how this approach had a positive impact on people’s wellbeing. People were comfortable to ask for the support they wanted from the staff team caring for them. Where people required support to make some choices, staff now consistently offered people options to choose from. Staff used their knowledge of people’s preferred communication methods and care preferences to ensure they were receiving the support they wanted. People's care plans were personalised. Managers and staff understood the importance of ensuring people were treated equally and fairly and addressed any barriers to improve people’s healthcare experiences. For example, the manager had worked with the local GP surgery to ensure reasonable adjustments were made when facilitating people’s annual healthcare reviews.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives spoke about the improvements over the past 12 months. They explained people were now encouraged to live fulfilling lives and pursue hobbies and interests important to them. One relative told us, "I am confident now they get their allocated hours in the home. I am certain this is taking place where it wasn’t before. [Person] is getting out now a lot more." Another relative told us how staff facilitated a holiday for a person to enable them to see their family.

Staff explained how improvements had been made over the last 12 months to ensure people were given opportunities to complete meaningful activities both inside and outside the home. They told us there was now a culture of staff spending time with people, interacting with them more and encouraging them to do as much for themselves as possible. Staff described how this approach had a positive impact on people’s wellbeing. Comments included, "We know their capabilities better and we can encourage them to do more so their skills improve" and, “We are working in a more person centred way and people are getting the support they need. We are letting them do as much as they can in their time." Staff gave us examples showing how they involved people and those important to them in decisions around their care, as people’s needs changed. This helped to ensure people’s individual needs and preferences would be identified and care plans adapted to meet their changing needs.

People were comfortable to ask for the support they wanted from the staff team caring for them. Where people required support to make some choices, staff now consistently offered people options to choose from. Staff used their knowledge of people’s preferred communication methods and care preferences to ensure they were receiving the support they wanted. We saw staff promoted people’s choices and encouraged them to decide what care they wanted. For example, what interesting things they may wish to do, where they wanted to spend their time in the home and what they may wish to eat and drink. During our assessment we saw people taking part in a range of activities both in their home and their local community. Staff also respected when people chose not do activities and wanted a more relaxing day.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People were given information in a way they could understand.

Staff described how they took time to involve people in decisions about their care. For example, where they wished to eat their meals and to decide what level of independence they wished to maintain in key areas of their day to day lives. Some people living at the service could not communicate their needs verbally. Staff gave examples of how they understood people's behaviours and knew if people were happy through their body language so they could be sure people had the support to live the lives they wanted. Staff explained how they had supported with one person to understand a specific medical condition and respected the person's wishes to decline treatment having followed best interest decision processes.

Records showed people and their relatives were provided information about their care. Easy read records were seen as well as pictures and symbols to aid communication and decision making. Records reflected people's preferred communication style.

Relatives felt involved with people's care and felt communication between staff and them was good. One relative commented, "They are very good at involving us in their care." Relatives felt able to raise ideas or concerns about the care people received. One relative told us, "The management team are very approachable. We can talk to them or email them. We haven't got any complaints but they encourage us to message them. It is an open book with two way communication. They will also contact us, drop us an email about changes to [person's] health or anything important going on. We feel very well informed." Another relative told us, "Staff hearts are in the right place. We are happy. I cannot say I have any complaints and if I did I discuss them and we move forward. Problems I did have previously, we have addressed and feel we have moved past that now."

Staff told us they felt able to raise concerns and share ideas they had about people's care. Comments included: “It is all talked about in staff meetings. [The managers] will discuss things to make the house better and any issues, we all try and work together" and, “We had a team meeting yesterday and we talked about what works well and what could do with changing." Staff told us they were supported to understand their roles through regular meetings with senior staff. One staff member told us, “As soon as [staff] come in there is handover. You also get a verbal report from senior [staff] if there has been any incidents or changes in medicines, if you have been [away from work] for a while. In staff meetings, we talk about the people we support, food, activities, changes in [people’s] behaviours and plans for the week.”

Records showed regular team meetings and handovers took place which ensured staff could raise concerns. Mental capacity assessments and best interests meetings were held to show people were involved in their care.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Staff spent time reflecting on how to address barriers people may experience in achieving positive outcomes. Staff ensured people had equal access to healthcare. One relative told us, "[Person] was refusing to eat and lost a lot of weight. Staff worked very hard to improve things for them. They cared and they didn’t leave a stone unturned until they got on top of it." Another relative explained how staff had worked with a variety of different healthcare professionals to ascertain why one person was expressing distress through their behaviour and told us, "We have to go through everything and work it out. I do feel involved with this."

Managers and staff understood the importance of ensuring people were treated equally and fairly and addressed any barriers to improve people’s healthcare experiences. For example, the manager had worked with the local GP surgery to ensure reasonable adjustments were made when facilitating people’s annual healthcare reviews. This included the way information was shared and the timing of appointments. Staff explained how they felt confident to challenge any discrimination which could disadvantage people. For example, staff had advocated for one person to be screened for the menopause so any support needs could be identified and addressed.

People's care plans were personalised and provided information to staff on how to support people in the way they wanted. Care plans were regularly reviewed with people and those important to them to ensure they reflected in any changes in people’s needs or how they wished to spend their time. Records showed staff were actively supporting people to take part in activities and events that were meaningful to them.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.