Nicholas 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

People received care and support that was person-centred and staff knew people well. Information was provided to people in a way they could understand, and their communication needs were recorded and met. People and relatives were involved in their care and were able to give suggestions on how to improve the service. People’s end of life wishes with recorded and respected

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 in line with their needs and preferences. One person told us, “I think they’re lovely. The [care workers] are lovely and [Care worker’s name] is a sweetie… an absolute dream.” A relative echoed this and said, “I am happy and mainly because [family member] is happy. When [they have] the chance to express [themselves], [they] say [they are] happy and I can see [they are] calm.” However, one person was less positive and said, “Sometimes [I am happy], but I suppose when they’re busy, it’s not always as good, it depends. You have to wait, it’s a bit annoying really. I’m lucky as I can try to help myself a bit.” We fed this back to the general manager who told us they would discuss this in the next meeting with people and staff. We witnessed care workers delivering support in a kind and caring way, allowing time for people to express themselves, and listening to them. Personal care was delivered in a discreet manner that respected people’s dignity. People’s care plans and care records were recorded in a person-centred way and with respect.

People told us they received good care and their healthcare needs were met. People’s care plans clearly described people’s healthcare needs and how to meet these. For example, where a person was living with a chronic health condition, there were clear instructions for staff to follow, so they could anticipate the person becoming unwell and take appropriate action. We saw evidence people were visited by healthcare professionals and supported to attend health appointments as needed. Healthcare professionals involved in people's care recorded the outcome of their visits in people's records and any information or instructions for staff to follow. They included the GP, chiropodist, physiotherapist and Speech and Language Therapist. The leadership team had developed a good professional relationship with the local authority.

People and relatives told us communication was effective and they were provided with all the information they needed. A relative told us, “[Family member] is registered partially sighted and has long standing problems with dexterity in [their] fingers. [Activity coordinators] always invite [family member] to join in daily activities… they do their utmost to assist [them].” Relatives added that managers and staff communicated well with them and the culture of the home was one of openness. Their comments included, “The service, staff and management are brilliant” and “The culture of the home is first class. “There was a monthly newsletter for relatives which included photographs and planned activities for the coming month. These were also pinned on the notice board. Staff understood the importance of ensuring people had information that met their preferences and in a way they understood. For example, staff offered some people a visual choice of the meal options to help them make an informed decision about what they wanted to eat. People’s communication needs were assessed during the pre-admission assessment so information could be made available to them in a format that suited them. This included larger print, pictorial aids and assistive technology. People's care plans detailed their preferences and any aids they needed to support effective communication. Listening to and involving people

People and relatives were involved in the planning of their care and support. Care plans were reviewed regularly and people were asked for their feedback about the care they received and anything they would like to change. People and relatives told us they felt able to raise any concerns or issues and were confident they would be responded to. One relative told us, "I have no complaints or concerns. I have lots of praise. The management team is very effective.” Staff understood the importance of monitoring people’s care to identify issues before they could develop into complaints or concerns. The managers were visible and chatted to people informally to enable any concerns to be identified quickly. Information was available for people and their relatives about processes for sharing feedback or raising concerns. Records demonstrated that complaints received had been managed in accordance with the provider’s policies and procedures. We saw evidence that a current complaint from a relative was being addressed appropriately. Any learning from complaints and concerns were shared with staff to inform their future practice.

People told us they had access to the care and support they required and were happy with this. Relatives stated they felt their family members’ needs were met because the staff cared and monitored them closely. When their needs changed, they had access to further support to help them. One relative told us, following a decline in their family member’s health, “[Family member] needs total personal care and this is always done with dignity. Staff talk to [them] while they do it which [family member] enjoys and that takes away any embarrassment” and, “As soon as [family member’s] general health improved enough, staff put in place a plan to use a hoist to transfer [them] between bed-wheelchair-recliner chair in the communal area. Staff have been excellent at asking [family member] everyday if [they] would like to be in the main area or in the quieter conservatory area.” The management team felt they were supportive in ensuring people had access to a variety of services. The general manager told us, “We ensure we provide support and help people access the services they need. We identify their unique needs and make appropriate referrals. Having the physiotherapy in-house service has been hugely beneficial for people.” Care plans were regularly reviewed in order to identify any changes in a person’s care needs so the appropriate support could be found if needed. This included referring people to specialist therapies.

People's care and treatment promoted equality and protected people's rights. People told us they were consulted in relation to their cultural and spiritual needs. Their comments included, “We have the C of E [Church of England] who come once a fortnight and other retired vicars from the church pop in from time to time” and “The church come round and we have hymns and prayers but it’s not driven into you, it’s voluntary.” Staff told us they involved people in decisions about their care and respected their wishes. A staff member said, “Nicholas House is a really lovely care home with good staff and a good team of managers. We have lovely residents and we have built up a good rapport with them and we know their likes and dislikes.” The general manager told us they were dedicated to meeting the needs of people who used the service. They said, "I want nothing more than Nicholas house to succeed and remain a loving homely safe environment for the residents we care for.” People’s care plans indicated they had been consulted in decision making, including whether they preferred to receive care from a male or female care worker. Their care plans reflected people’s physical, mental, emotional and social needs. People’s protected characteristics were recorded if people wished to disclose these.

People and their relatives were involved in the planning and reviewing of their care including their end of life wishes. Where people were not ready to discuss this area of care, their wishes had been respected and recorded. The staff confirmed they received end of life care training and would know how to meet people’s needs when the time came. The provider ensured all staff received end of life care training so they would feel prepared and would know how to care for people who reached this stage. The general manager told us, “At this time, we don’t have anyone receiving end of life care, but we ensure the staff are trained in this so they know how to care for people.” Care plans reflected how people wanted their care to be when they reached the end of their lives. For example, one person’s care plan stated, “[Person] has expressed [they] want to be comfortable and around [their] family. [They] do not want to be on [their] own when the time comes. [They] want to be treated with respect and dignity.” Nobody was receiving end of life care at the time of our visit.