Dormy 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

The service was responsive. Improvements had been made and people received individualised care, at a timely manner and that met their needs. The service identified people's information and communication needs by assessing them and recording this in their care plans. Feedback from people, relatives and others were gathered and acted upon to make positive changes. Complaints were taken seriously, investigated, responded to, and used to improve the quality of the service. The service offered a social programme for people to prevent social isolation and promote inclusion.

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 received person-centred care that met their needs and placed them at the centre of the service they received. They remained in control of the care and support delivered to them and included their families as part of the process. People told us they were happy with the quality of care they received. People said “[Staff] are marvellous. I like it here – a lot” and “It is all fine – there is nothing else you need to know”. Relatives added, “All I can say is that I could not be more happier that my relative is living here. If I could no longer care for myself I would be happy to come here…[The person] is in a very good home and I’m grateful for that. It is like one big family” and “[The person] has declined a bit. Until recently, [the staff] were maximising [person’s] interest and abilities and do activities. I feel [the person] is much liked, as well as, looked after”.

The manager and staff worked together to ensure people could receive the most appropriate care and treatment for them as the service made reasonable adjustments where necessary. People’s care plans included information regarding their physical, mental, emotional and social needs. The manager said, “We do our [meetings] and we discuss people if we need to adjust or do something differently for the people like specialised cutlery for [a person] due problems with dexterity. I said to all the staff that we can try something, and then we can try other things until we get what is best for that person”. Staff understood the importance of providing individual and co-ordinated care and support that would have positive effects of people. They said, “Each resident is an individual. Through the risk assessment and care plan you facilitate person centred care” and “Person centred care is discussed in supervisions”. People were supported regarding their condition, care and treatment options keeping them and family informed with any advice.

We observed people received care and support specific to their needs, preferences and routines. Care planning was focused on the person's whole life, including any specific aspects to support individual care. People and those who mattered to them were regularly involved in planning and making shared decisions about the care and treatment, so it was centred around them and their needs.

People and relatives were positive about receiving continued care based on their needs. People received care and support that was co-ordinated, and everyone worked well together. People and their families were in control of planning people’s care and support, and were supported by the staff team and managers. One relative said, “I think [the staff] do manage very well and [the person] can be anxious and needs reassurance, they are doing the best they can. [The staff] encouraged us to do parties and get together [at the service]. They take photos and chef consults us what we want. It has been very very very impressive to help us achieve this”.

People received care and treatment from the staff team that understood their diverse health and social care needs. The manager and staff worked together using reviews and regular communication with different external services that supported the continuity in people’s care and treatment. The manager added they were supported by the external services well and flexibly which helped to delivery care and treatment to people and in a way that met their assessed needs. This also allowed them to plan and provide care based on what people wanted and what was available locally.

Healthcare professionals who often worked with the service were positive about the improvements made which ensured continuity of care. There was a clear sense of partnership working from both the service and professionals which benefited people and improved their outcomes. One professional added, “During a visit I spent time with nursing staff who explained that home use [escalation tool] for residents who are unwell. We discussed the protocol for residents who have had a fall and the nurse was able to clearly describe all the required actions, ongoing monitoring, and appropriate escalation routes. She understood the role of remote monitoring in falls and knew the Aria policy on this well”. Another added, “I have noticed that staff consistently provide holistic care to residents, including those who present significant challenges. The deputy manager is very open with discussion and work very well with the care home support team.”

The service worked with professionals to ensure people received continuity of care, support and treatment. People's choices in relation to activities, health and welfare were respected and staff ensured they fully supported them with accessing them. People’s care and treatment was delivered in a way that met their assessed needs from the services that were co-ordinated and responsive. People’s records were kept so staff could share information with other professionals, as required, to aid continuity of care, support, and treatment.

People were able to get information and advice that was accurate, up-to-date and provided in a way that they could understand to ensure it met their communication needs. Relatives told us the service communicated with other professionals to ensure consistent care was delivered and they were continuously informed of any changes. One relative said, “Communication used to be zero and now [the staff] call me a few times a week - they’re always up-dating me about my relative”.

The manager understood their responsibilities in relation to the accessible information standard which applies to people who use a service and have information or communication needs because of a disability, impairment, or sensory loss. Where needed, they would use technology to help people understand information given such as when completing capacity assessments and giving information in the way people understood to be able to make decisions. The registered manager also noted some of the staff could speak certain languages and support a few people to be informed about their daily life. Staff agreed they had access to all the information they needed to provide safe and effective care and support. They told us they kept regular communications with people and their families to ensure it supported people’s rights and choices.

People had care plans noting how they had to be supported in regard to communication and receiving information. People and relatives were able to access their records any time or at the 6-monthly reviews.

People knew how to give feedback about their experiences of care and support including how to raise any concerns or issues and were able to do so in a range of accessible ways. People and relatives felt confident that if they complained, they would be taken seriously and treated compassionately. One person said, “I would not hesitate to say if I wasn’t happy. I would tell my [relative]”. One relative added, “Yes we have complained in the past, to [provider’s] management team and I had not had to do it recently. Yes, it would be taken on board, if I made a complaint now”. Relatives agreed if they had any problems or issues, they were able to contact the manager and/or other staff easily. Some noted they were happy the way their family member was looked after.

The manager took feedback, complaints and concerns seriously and used this as an opportunity to review and improve the quality of the service. The manager also told us they encouraged everyone to come to them or any staff to ensure they were able to capture any issues in a timely way. The manager added, “I am pleased that families get engaged…If there is a formal complaint or any concerns, I will always ask if it was recorded and then we deal with it accordingly. Everyone is free to reach out to us, and there is complaints policy available…We discuss any complaints with the team. But I deal with complaint straight away, I do not want to wait as people or families may get [upset]. We check that tasks from complaints, incidents or accidents are done correctly. Reporting is done as necessary for transparency. We also send out the letter to follow duty of candour. We give opportunities to ask questions or invite to the meeting, but usually families are happy with the actions we have taken”. Staff confirmed they held regular communications with people and families using care reviews or meeting. Staff confirmed people and families were able to provide any feedback regarding care and support. Staff were confident any issues would be dealt with appropriately. One staff added, “Any verbal complaints are investigated. We email and speak to the (complainant) to say ‘We are doing an investigation and we will get back to you’”.

People had regular opportunities to provide feedback on the service. Any feedback received was reviewed and action taken to address the shortfalls. There was a process to manage complaints and those were taken seriously, investigated, responded to, and used to improve the service. Complaints and concerns were used to help identify any learning, themes or trends. The service completed regular reviews with people and their families, and gave them opportunities to provide feedback and suggestions. Staff had regular meetings and they all had opportunities to have discussions on any matters.

People were able to access the care, support and treatment they needed and when they needed it. People were able to access services when they needed to, without physical or digital barriers, such as GP visits at the service, dental support, chiropody, physiotherapy and other services. People said, “You can ask to see a doctor. I’ve seen a doctor for a routine check-up”, “I have seen a dentist recently – the home arranged it. We can ask to see the doctor” and “If you need to see the doctor, you can ask. I have my own chiropodist. My [relative] would take me to any hospital appointments”. Relatives agreed people had access to care, treatment and support because the service ensured timely response to changing health or wellbeing needs and made reasonable adjustments.

The manager worked with the staff team and different professionals to ensure the service was flexible and accommodating in meeting people’s needs. The manager and staff were alert to discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support. They said, “The advantage of cultural staff, we accept and adapt to different cultures including people and staff because we know we do not deal with one culture. We have that understanding and acceptance of the differences. Staff would come to me if there were any issues”. Staff confirmed people were able to access the care and treatment they needed. they said, “All people have access to suitable support”, “[We ensure people access the different parts of the home] through providing support e.g. to mobilise. We are working with professionals to assess needs and access equipment” and “We are really well supported by the physiotherapist and occupational therapist [to ensure people could access parts of the home and the local community]”.

Health and social care professionals who often worked with the service and the provider told us improvements had been made and people had better streamlined access to care when they needed it. One professional said, “I have consistently encountered a familiar staff members on the floor who are ready to learn and provides valuable support in implementing protocols and recommendations after each assessment”. Another professional added, “One of the team will make themselves available to provide information and support the resident when I have visited them. I have noticed when management and senior nursing staff have demonstrated this proactive approach to the rest of the care team, this transfers to the wider team and positively benefits interactions and visits”.

There was a system in place to ensure people were able to access the treatments and support when they needed that. People's changing needs were monitored appropriately to ensure their health needs were responded to promptly. The manager and the staff team worked together to oversee people’s needs and respond effectively. People were referred to various health professionals in good time to address any issues with health or changing needs. The staff were knowledgeable and well informed about people's health and wellbeing. Staff team took action promptly and referrals were made to other health and well-being professionals. The care for people's health and wellbeing was proactive and organised well. During our visits, some people were not feeling well, and the staff referred them appropriately for further treatment. We were informed they had started treatment to help them manage a health ailment.

People’s care, treatment and support were organised and managed in a way that promoted equality and ensured people’s rights were protected. People and relatives were empowered to give their views about their experience to ensure they had positive experience while living in the service. One relative said, “Staff show tolerance and kindness [to each other]. One person [has changed completely in behaviour] but the staff tolerated it well and had that understanding of people and their dementia”.

The manager and staff team worked together to ensure people’s care, treatment and support promoted equality, removed barriers or delays, and protected people’s rights. The manager understood there were diverse groups of people in the service and a staff team supporting them which could have opportunities for discrimination. However, the manager also told us how they managed this to ensure people and staff were included and supported. They said, “The senior management and we are aware of the industry and the company is hiring from different countries and what support staff may need to do their job…We remind our staff about the policies, and we have policy of the month to review and ask questions about it, and all the information is shared across the members. For people, the person comes first and then their cultural or religious needs, and we support that”. The manager worked with other teams in the organisation to ensure staff were treated fairly so they could continue providing care and support to people to achieve positive outcomes for them. The staff told us they have not witnessed any discrimination or inequality at the service. They worked together and communicated with people and families which ensured people were treated fairly to receive individualised care and support.

There were policies and processes to manage issues with people’s care, support, treatment, as well as, staff performances. The manager was aware of potential issues with human rights, discrimination, having regard to the needs of people with different protected characteristics and reasonable adjustments to support equity in experience and outcomes. The management team had processes in place which enabled them to continuously seek feedback from people, relatives, staff and others and use it tailor people’s care, support and treatment.

People were supported to make informed choices about their care and plan their future care with support from families and the staff team. People and relatives had regular reviews of support and plans of care. One relative said, “We had a meeting regarding end of life care when [the person] declined. [The staff] handled it very sensibly. They were very diplomatic how to raise it and very sensitive. They talked us through to exactly what would happen and [made arrangements]. Then [the person] bounced back!”.

The manager told us about the process to help people make informed choices about their care and plan their future including support with end of life care. This was discussed and recorded at the start of the admission with people and relatives. The manager said if the condition changed, the care and support would be adjusted too. The manager said they held discussions about advanced treatment and the GP supported the families to understand the process better. Many relatives used that option, and it was useful for them to see GP. Some relatives wanted to understand the options and also how staff prepare to support the person and family when the time comes. This was also talked about at the relatives’ meeting. The manager also said they had a meeting for relatives’ and a dementia specialist to support them understand people and how dementia affected them.

At the time of our visit, there was no one receiving end of life care. The manager worked with GP and health professionals to review people’s specialised medication to have it ready to use when the time came. If and when people’s needs changed, the person and family would be involved to review and create appropriate plans of care regarding people’s wishes and preferences how they wanted to be cared for at the end of their lives. The manager used meetings to inform relatives about different aspects of the service such as the online system they used for referrals to various professionals. Another meeting was planned to cover standards and management of texture modified foods and thickened liquids which would help relatives understand the differences in the process.