HF Trust Gaston 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 provider met people’s needs. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

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.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. The registered manager demonstrated a commitment to person centred care based on people’s likes, dislikes and personal routines. They were working with staff to ensure the culture of the home was focussed on meeting people’s individual preferences and choices. All staff received training in person-centred care (PCAS) to ensure they understood their role in enabling people to experience greater levels of inclusion, independence and choice. The registered manager explained, "All staff do a PCAS training workshop, and I do PCAS observations and give feedback.” During our assessment we observed person-centred interactions between staff and people which demonstrated staff understood people’s individual preferences and responses. Support plans reflected people’s physical, mental, emotional and social support needs.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Managers and staff worked with other care providers and healthcare services to ensure people received continuity of care. For example, the registered manager had met with the learning disability lead at the local GP surgery and agreed an appointment pathway which supported accessibility, continuity of care and positive outcomes for people.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Working in conjunction with speech and language teams, staff used a variety of tools to communicate with people according to their needs and abilities. Each person had a communication support plan which detailed how they communicated and informed staff how to communicate effectively with people. People used a variety of tools to support their communication. This included pictorial information, objects of reference and body language. Information was available in different formats to support accessibility. For example, the complaints procedure and people’s care and support plans were available in easy read and pictorial formats.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. Relatives told us they were involved and informed about the care people received. One relative told us, “We are answered immediately if we ask anything and are kept involved.” Another relative said, “Anything that happens to him they always tell me, in all aspects of his life.” Relatives told us they would not hesitate to raise concerns or issues if they felt they needed to. One relative said, “I keep an eye on what is happening and would not be afraid to say something.” The registered manager provided assurance they would listen and act on wishes and concerns raised by people, their relatives, staff and advocates. They told us it was important every person felt able to share their concerns and explained, “At the end of last year, I had a meeting with each person we support about how to make a complaint, how to recognise they are unhappy and how they can raise that." The service had not received any formal complaints in the 12 months prior to our inspection.

The provider made sure people could access the care, support and treatment they needed when they needed it. Care plans contained information about how people demonstrated pain or discomfort when they were unable to verbally inform staff how they were feeling. Where people were demonstrating changes in their presentation, staff referred people to other healthcare professionals to ensure all potential causes had been explored and investigated. For example, 1 person was demonstrating increasing levels of anxiety. Staff had referred the person to their GP and the dentist to eliminate physical or dental causes for their heightened responses.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. The registered manager was aware of the barriers people with disabilities could face and was confident to challenge healthcare inequalities. They advocated on behalf of people to ensure they were able to see healthcare professionals when they needed to, and reasonable adjustments were implemented when required. People’s care plans contained information about the support or reasonable adjustments they required to attend healthcare appointments to promote equity in experience and outcomes. Where people did not have family to support them in expressing their wishes, the provider arranged for advocates to ensure decisions were equitable and in people’s best interests.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Where people and/or their relatives wished to plan for their end-of-life care, this was recorded. The registered manager told us they would support people to remain at the service as their health deteriorated and would engage with other healthcare professionals to ensure people received appropriate care and support at this stage in their life.