Albany House - Tisbury

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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

We reviewed 7 quality statements for this key question. People were happy with their care, but staffing levels sometimes restricted their experiences. This was because staffing levels did not enable any external activity, so people were reliant on their own independence or relatives to go out. Staff were aware of people’s needs and promoted individual preferences. People were supported to access services to meet their healthcare needs without discrimination. There were informal systems to raise any suggestions or concerns and people felt they would be listened to. They were confident any concerns would be resolved. People and their relatives were supported with end-of-life planning to ensure their preferences would be respected. Staff worked alongside health care professionals to ensure people received a comfortable and pain free death.

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.

People gave us variable feedback about their ability to follow their preferred care routines. Some people said they could choose what they wanted to do. This included going to bed when they were tired or having a lie in if they wanted one. However, other people said staff availability impacted on them. For example, two people told us staff woke them early but then there was a long wait before they received assistance to get up or be offered a drink or their breakfast. Leaders told us they would investigate this.

Staff told us they felt the standard of care people received was good. They said this was because they knew people well and provided support in line with individual preferences. Staff told us they had also built good relationships with relatives, which helped increase their knowledge of the people they supported. Leaders confirmed this and said staff really cared about people and provided personalised care as a result.

There were many natural conversations between people and staff, which demonstrated positive relationships had been established. Staff knew people’s preferences such as what they liked to eat and the size of meal they preferred. People were supported to get up when they wanted and offered choices about where they wanted to spend their time. People were offered drinks of their choice, and able to eat their lunch in the dining room, lounge or their own room.

People told us their healthcare needs were met through staff and other health professionals. Relatives confirmed this and said staff ensured specialist advice was sought, and outpatient appointments were remembered. People told us their religious needs were met at the service and within the local community. They said they were supported to attend various places of worship depending on their faith. People told us local clergy also visited them individually or by facilitating a wider service for others within the home.

Leaders told us people received consistency and continuity with their care due to the small staff team who knew them well. They said many healthcare professionals had also known the person and their relatives for many years, often before they entered the service. This enabled extensive knowledge and experience to be used when assessing the person and determining any support required.

Feedback from partners confirmed the service ensured each person was placed at the centre of their care, with joined up working with others to support this. Partners said staff worked well with them and sought advice as required. One partner said people were encouraged to practice their faith if this was important to them. They said additional services were held within the home to celebrate religious festivals and documentation such as church magazines, were left for people to peruse if they wanted to.

There were systems to enable staff to get to know each person’s individuality and diversity. This included assessments, care planning and informal discussions with staff and leaders. Staff noted any events people wished to attend in the diary, so they were not missed. Care records demonstrated activities such as Holy Communion people had participated in.

People told us they had regular discussions with staff and were informed of anything they needed to know. Relatives confirmed this. They said they were always kept informed of what was going on in the home. This was through talking to staff whilst visiting their family member or leaders calling them with any information, they needed to be aware of.

Leaders told us they would ensure information was conducive to people’s needs. This included staff reading mail to a person, if consent had been given. They said information could be written in different sizes or fonts, but currently this was not required. Staff told us different formats had been used in the past and some people had benefited from flash type cards and white boards. These methods had enhanced communication.

There was signage around the home to help people find their way around. People had their names on their bedroom doors to enable better recognition although some of the writing was small. The daily meal choices were written on a blackboard in the dining room. This enabled people to view what was available to them.

People told us they regularly spoke to staff about their care. They said they felt listened to, and any changes they requested were actioned. Some people told us there were meetings where they could share their views about aspects of the service. This included menu or event planning. They said leaders were good at listening and would try any new ideas that were suggested. Relatives confirmed leaders and staff were very receptive and would always take their views into account.

Leaders told us it was important for people to feel confident in sharing their views about the service. They said resident and relative meetings had not been successful, but they spent individual time with people instead. Staff said talking to people and their relatives was an integral part of their role. They said they would always relay any information to leaders if consent was given, to ensure people’s wishes were addressed.

There were policies and procedures such as complaint management to promote the sharing of information. People received formal reviews of their care, but these were not always regular in frequency. Records demonstrated when the reviews had taken place, but people’s input and that of their relatives had not always been documented. This did not evidence people’s involvement or whether any requests had been implemented.

People told us they were very satisfied with their ability to access various health care services. This included the GP or senior nurse, who visited every week, and additional appointments which could be made such as the podiatrist. Some people told us about outpatient appointments they had attended. People expressed confidence in staff liaising with the relevant health care professionals if they became unwell.

Leaders told us the service was very lucky with the support received from local health care professionals and others within the community. They said all professionals responded promptly to any requests and visited in a timely manner when needed. Staff confirmed they had established good relationships with involved professionals. One staff member told us how they had proactively worked with a care professional to enable a person to safely go out independently.

Partners told us leaders and staff were good at ensuring people received the services they required. They said staff effectively made referrals and did so in a timely manner.

The risk of discrimination was minimised through established relationships with health and social care professionals and a clear understanding of what was available. Leaders were passionate about ensuring people received what they were entitled to.

Some people told us they regularly went out with their relatives and also enjoyed events within the service. Relatives told us the service was very much a home, and attention was given to positive experiences to promote people’s wellbeing. One relative told us staff enabled and promoted their family member’s community involvement, as they knew how important it was to them.

Leaders told us experience and outcomes were an important part of the service. They said family and friends were encouraged to come in and out as they pleased, and community events were attended. Other events such as church services were promoted within the home and calendar events were celebrated. However, staff told us more could be achieved if staffing levels were increased. They said staffing currently enabled a good standard of personal care, but not a holistic approach to people’s needs. One staff member said there was so much more they wanted to do, but staff availability restricted this.

People relied on relatives and friends for any social activities outside of the home. However, those people who did not have this support were restricted in their experiences. This was because there were not enough staff to support people to go out if they wanted to. This was discriminatory, and did not promote equity within the service.

Relatives told us they had been involved in end-of-life planning for their family member. They were confident their family member’s wishes would be respected, and their care and emotional needs would be met. One relative told us leaders and staff looked after them as well as their family member. They had no doubt they would be well supported during their family member’s end of life journey. Another relative told us staff had spoken to the GP about ‘just in case’ medicines. These medicines ensured people were comfortable and pain free, as they neared the end of their life. The relative told us they were thankful for the staff’s preparedness and forward thinking as this gave an indication of future care provision.

Leaders told us staff really cared about people, and the impact of a death affected everyone. They said all end-of-life care had to be good due to its importance, and staff provided this. One staff member told us they enjoyed providing end-of life care as it was the last thing you could do for a person. They told us all staff ensured people were well cared for, and their families were supported too. Leaders and staff told us they received good support from health care professionals such as the GP and community nurses to ensure people were comfortable and pain free as their health deteriorated.

End of life care was discussed during a person’s initial assessment, and records demonstrated people’s preferences. This included spiritual needs, and how these should be met. Other information informed staff if a person wished to be admitted to hospital or they would rather be supported at the home.