Mulberry 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

Responsive – this means we looked for evidence that the service met people’s needs. This is the first assessment for this service. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People's care plans were not always accurate and up to date. For example, we found people's care plans contained other people's names and did not always contain enough information about meeting their well-being and safety needs. However, the delivery of people's care was personalised, and they had support to pursue their interests, such as participating in community-based activities, and staff promoted people's independent living skills. A staff member told us, "People's progression plans are around promoting people's independence, for example, with cleaning, cooking and attending places."

There were shortfalls in how the service met people's diverse needs. People did not always receive the level of staffing they needed at night to promote theirs and staff safety. The registered manager was unable to tell us, or provide us with evidence, of how much one-to-one and two-to-one support people should have received. People's care plans also contained guidance around needing 2 staff members at times to promote their safety, but this staffing level was not always in place. Leaders told us these care plans may no longer be current and needed review. These increased risks, relating to planned care not being reflective of people’s current needs and a lack of day-to-day oversight from the registered manager, meant the provider failed to ensure people always had access to the care they were accessed as needing. However, a relative gave us positive feedback about consistency. They said, “They do everything well, but communication and consistency is very good. I would not wish to change anything”.

The service did not always ensure care plans were accurate and up to date about people's individual communication needs. For example, a person's care plan contained inconsistent information about using Makaton to support communication. Makaton is a system to support people with communication. However, we also found examples of good practice to support people’s communication; people had access to pictorial exchange communication systems to support them in making choices. Another person's care plan stated staff should use objects of reference to communicate with them. Staff we spoke with understood people's communication needs. A relative told us, “The staff are excellent. They are well trained, including medication and very quickly got to know my loved one, how they communicate, their likes and dislikes.” Staff were also employed who could communicate with people in other languages they spoke.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result. Regular keyworker sessions were held with people where their achievements, goals and future plans were discussed. A staff member told us the service regularly kept people’s relatives informed and involved, "We hand over with relatives over the phone so we can send photos and updates of people's goals." We also found there were communication books in place to support effective information sharing as people went from their homes to the service and other services they used.

There were systems in place to regularly seek feedback from people and relatives. This promoted equity in access. We did not identify any concerns in relation to people being able to access external services. A relative said, “They provide a safe, calm and supportive environment where my [relative] is able to continue to develop [their] independent living skills, access new activities and opportunities to socialise with peers and just be [themselves].”

Staff and leaders did not always act and listen to all information about people who are most likely to experience inequality in experiences and outcomes. Safeguarding concerns not always identified or reported, and accident and incident forms were not always being completed or reviewed by leaders increased the risk of people not consistently experiencing positive experiences and outcomes. Care plans were not always reflective of people’s needs and did not always provide guidance on how to support them with known risks. The provider had not always considered accessibility in relation to the environment, for example, they failed to identify showers did not effectively meet a person's mobility needs, despite mobility aids being available. However, the provider did have systems to share information with people’s relatives and communicate with them information about how their respite stays had been.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future. The registered manager told us the service focused on positive outcomes being in place to enrich people’s lives. This service, being a respite service did not support people at the end of their lives.