Satisfaction survey: our care home residents

Adults with acquired brain injuries, learning disabilities and complex needs

In addition to surveying the families of service users in our care on an annual basis, we also complete a questionnaire with the individuals themselves, which asks specific questions about different aspects of their lives within the care home. They are asked to respond using a satisfaction rating of 0 – 4 where 4 is the most satisfied. All of our service users have complex needs and some are unable to answer the questions, so staff either help them to answer the questions or observe their behaviours to ascertain their needs.

The results from each individual are combined to give average scores, which are shown below. There are up to five questions in each section, so the totals show an indication of satisfaction in each area.

However, as every person is different, and has different needs, our approach is always individualised, person-centred care.

bar chart showing satisfaction survey results

Service user satisfaction survey results 2017

The following gives you more information about the specific areas covered in the satisfaction survey.

Know how to complain
This question assesses how well the individual knows what to do if they have a complaint. The average overall score across the homes was 3.63 out of 4. It excludes the individuals who were unable to understand the question.

People you live with
This is very important to all of our service users, and satisfaction ratings can vary according to the type of care home as stable populations with long term residents tend to have a higher satisfaction rating. The Mews, which focuses on short-term intensive rehabilitation for adults with acquired brain injuries, naturally has more of a changing population. This can affect the dynamics of relationships between the residents. We work hard to ensure that any incoming service users will not upset the balance in any care home and we continually review our admissions policy to ensure that we receive sufficient information in advance of a full assessment of any potential new residents.

There is very much a family environment within our care homes, and many strong friendships develop between individuals. However, like a family, it doesn’t mean that everyone gets on well with everyone else all the time. Therefore it is important that we focus on relationships between individuals and use mediation and psychology to manage any disagreements. As a last resort, we can move individuals into another of our homes but this is rarely necessary.

Decision making
These questions covered how involved people feel in decisions relating to their care plan and risk assessments as well as making choices in their everyday lives.

Staffing
These questions ascertain how well service users know the support staff in their home and how they feel that they are treated by them: whether the staff are approachable, as well as whether they would like to be involved in the interview process. Many service users said that they would not want to be involved, which has reduced the average score.

Food and drink
As well as being asked about their choice of food and their cultural needs, individuals were also asked about how involved they wanted to be in menu planning and food preparation.

Activities
Many of these questions were qualitative: describing current activities undertaken or potential new ones, so a numerical score was not given. The activities that we provide are very much tailored to the individual and if something is requested but not achievable or affordable then we explore alternatives.

Environment
These questions simply asked how satisfied service users are with the communal areas of the home, the garden and their room.

Homes gain high scores in independent assessments

Headway Approved Providers
Two of our residential care homes for adults with acquired brain injuries – The Mews and 144 Boughton Green Road – have been recently re-assessed by Headway, the brain injury charity. The assessment process requires the home to demonstrate the provision of appropriate specialist care for people with complex, physical and/or cognitive impairment due to acquired brain injury. Headway has identified six key themes, or domains, against which it assesses the level of care provided, as well as issues such choice and dignity of service users. The domains are; Communication, Culture, Development, Governance, Quality, Environment (psychological/emotional) and Environment (physical).

We are pleased to report that both The Mews and 144 Boughton Green Road scored well in all of the domains to retain their Approved Provider Status for a further two years. This is subject to passing unannounced visits from Headway assessors during this time.

Headway Approved Provider

Quality Checkers
2&8 Kingsthorpe Grove, our homes for adults with learning disabilities, were recently assessed by Northamptonshire Quality Checkers. This is an independent assessment by an ‘expert by experience’ who meets residents in the home and performs a standardised quality check from the service users’ perspective. They are then supported by a co-ordinator to produce a report of their visit.

The Quality Checker on this occasion was Paul, who was visiting the homes for the first time. He met two service users with learning disabilities who live in the homes. One of them answered a series of questions and Paul used their answers to form the basis of his report. He gave the homes a top rating of ‘Very Good’ for all of the categories assessed, which were; home and bedroom, support staff, activities, food and drink, friends and people in the service user’s life, the service user’s health and what it’s like to live there.

Paul then asked the support staff and manager questions about procedures and safeguarding. As he was so pleased with the home, he made no recommendations for improvements to be made.

Information about other independent inspections of our care homes click here

Using online apps to stay in touch

Online applications are transforming the way that we live and work, and at The Richardson Partnership for Care we are using them to help service users and their families keep in touch, and for the families to participate in the review process.

Our service users with learning disabilities have an external review every 12 months where their care team and case workers review their care plan and discuss their progress. The service user can choose whether or not they take part in the review, but under The Care Act 2014, reviews should be attended by a family member or advocate.

Some family members live too far away to attend all of the reviews or find it difficult because of work and other family commitments. We recently arranged for a family to participate in a review using Facetime. This application, similar to Skype, enabled the family to make a video call over the internet.

This was the first time that we had used a video call to enable a family to take part in a review and it was a great success. We received positive comments from the family as well as the care manager. The family were able to contribute fully to all areas discussed: they could see and hear the review team and ask questions as well as providing their thoughts and feelings on the care package. They said that it was just like being there!

On this occasion, the service user declined to take part in the review, but they had a video call with their family afterwards and spoke with their care manager and review coordinator about what had happened in the review.

We are now setting up regular video calls for service users and their families to stay in touch, which benefits everyone and in particular, reassures parents who live some distance away. It also enables family members overseas to stay in touch and be involved.

iPad showing different apps

Scale of over-medication is now out in the open

The Care Quality Commission, Public Health England and NHS Improving Quality have recently published reports commissioned by NHS England into the prescribing of psychotic drugs to people with learning disabilities. The research found that there is an alarming rate of over-prescribing of these drugs to people with learning difficulties: the report authored by Public Health England, estimates that up to 35,000 adults with a learning disability are being prescribed an antipsychotic, an antidepressant or both without appropriate clinical justification.

The research concluded that:

  • There is a much higher rate of prescribing of medicines associated with mental illness amongst people with learning disabilities than the general population, often more than one medicine in the same class, and in the majority of cases with no clear justification
  • Medicines are often used for long periods without adequate review
  • There is poor communication with parents and carers, and between different healthcare providers

Dominic Slowie, NHS England’s National Clinical Director for Learning Disabilities admitted that this is an historic problem and the research was needed to find out the scale of the problem so that action could be taken.

This is something that we feel strongly about at The Richardson Partnership for Care, and we regularly review the medication that our service users take with the aim of reducing it over the longer term wherever possible. Our focus is on behavioural therapy and all staff are trained in managing actual or potential aggression using the least restrictive techniques.

This is what the uncle of one of our service users with learning disabilities said about his care:

“Over a period of ten years, my nephew has presented with very challenging behaviour. Having his time with the Richardson Partnership for Care, his behaviour has improved as a result of excellent care. This consists of reducing the ‘chemical cost’ of drug therapy with a range of behaviour modification and genuine and dedicated care, which we greatly appreciate.”

Michael C

Psychological support
Our team of psychologists support our service users to help them to manage their behaviour and maintain their mental health. We have found that personalised care and the right level of clinical psychology provision has enabled individuals with even the most challenging behaviour to make good progress and reduce their medication.

One of the techniques used by our psychologists to help modify behaviours is Applied Behaviour Analysis (ABA). Support staff complete specialised recording forms, which are collated and analysed by the psychologists. The results help us to understand the relationship between specific behaviours and the environment. This means that things that may negatively affect behaviour can be more positively adapted, as part of a learning process.

In addition, each service user has their own health passport to give them ownership of their medical information and clarity regarding the medication that they are taking.

Jane is Finalist in National LD and Autism Awards

Jane Payne, Service Manager at The Richardson Partnership for Care is a finalist in the National Learning Disability and Autism Awards 2015.

She was nominated for the Employer Award for her commitment to providing top quality care to people with learning disabilities by heading a group of specialist residential care homes in Northampton. Jane has responsibility for supervising the managers and support staff, and has overall accountability to the owners. She is entirely service-user focused and always assesses the impact on service users when making decisions.

Jane has been praised for achieving a careful balance of providing empathetic, ethical care and maintaining a successful business. She believes that the two can go hand in hand and that profitability is vital to safeguard placements and provide a sustainable stable home for service users. Thanks to Jane, The Richardson Partnership for Care has thrived and grown over the last few years.

One of people who recommended Jane for the award was the father of a service user who has learning difficulties. He said: “I have worked with Jane, as my son’s advocate and in other capacities, for the past ten years and I am very familiar with, and a great admirer of the leadership she provides for all of her staff and, through this, the incredibly high quality of the care the homes provide. Jane’s personality shines through all of the dealings I have had with the Company. Her dedication to her staff and residents, from the major strategic issues down to the tiniest detail is outstanding.”

He added: “Through the leadership provided by and the example set by Jane, the culture of the company is a very open one, not only internally but also with respect to residents’ families and advocates. I can genuinely describe the excellent staff led so brilliantly by Jane as a ‘happy ship’ – and a very professional one.”

Jane Payne

Jane Payne, Service Manager at The Richardson Partnership for Care

How psychology support helps adults with learning disabilities

At The Richardson Partnership for Care, service users with learning disabilities are offered psychological support as well as learning opportunities and health and social care. The level and nature of the psychological therapy depends on the service user’s individual needs and is determined following an initial assessment or regular ongoing assessments. For example, intensive psychological support will be required if the previous placement has broken down and/or the service user is presenting with challenging behaviour due to difficult and stressful circumstances.

We find that regular, weekly sessions with an Assistant Psychologist assist with mental health, psychological well-being, confidence and communication. They can also reduce dependence on medication.

These weekly sessions are tailored to meet the individuals’ needs and include:

  • Talking sessions to develop self confidence and focus on the positive aspects of life
  • Relaxation sessions to promote calm behaviour and mental well-being
  • Psycho-education sessions which focus on subjects such as healthy lifestyles
  • A ladies’ group which includes arts and crafts, beauty and baking sessions, and provides a valuable opportunity for ladies to spend some time in an all-female environment

These weekly sessions enable structured activities where service users can develop their hobbies and improve their hand-eye co-ordination. They help service users to increase their social participation, work as a team member and interact productively with other service users in their home.

Each psycho-education session includes a mental state/orientation assessment, and a mood/feelings assessment (using pictorial aids if appropriate). Regular monitoring and assessment helps us to ensure that the psychology sessions are effective at improving or maintaining the service user’s mental health as well as identifying any issues.

Assistant Psychologist, Julita Frackowska

Assistant Psychologist, Julita Frackowska

Managing the transition for young adults with learning difficulties

Now that Spring has arrived, we are looking forward positively to the year ahead. This is often a time when young adults with learning difficulties are preparing to move from school or college to a new environment. Below we outline how we can help to enable a smooth transition and assist service users in settling in to their new environment.

Supporting young adults with learning difficulties
Moving to a new environment can be daunting for both the individual and their family so we try to make the transition as stress-free as possible. Members of our Admissions and Referral Team often take part in transitions events organised by local schools and county councils, where they explain what life is like in our care homes for young adults who have learning difficulties.

Even if a placement is not needed in the near future, it is advisable to plan for a few years ahead. This extra time can reduce the pressure and stress on families and enable them to find out about the different funding arrangements for adults.   We appreciate that the transition from children’s to adults’ services means a significant change in funding. Our Admissions and Referrals team is experienced in providing information and evidence to support funding applications.

Familiarisation visits
We get to know service users and their families and facilitate visits to our homes. These may be initial visits to have a look around, then perhaps a day visit where they meet the other service users. We also arrange overnight or weekend stays. The transition can take many months, or longer, so that the service users gradually become accustomed to their new home.  In other cases, it is better for the service user to just move in, it depends on the individual.

Pre-admission assessment
Each service user has a formal, detailed assessment when they are admitted to one of our residential care homes and we develop a personalised care plan on which their care and treatment is based. Where appropriate, family members and existing social networks are consulted and involved in the assessment process.

During the pre-admission assessment, we monitor the person in different environments, such as at school and at home, so that we can continue any therapies that are seen to be working well. We also take note of situations that cause difficulties and see how these can be managed better.  If service users continue to attend school, then we liaise closely with the school, often using communication books, so that we can monitor and manage any changes in behaviour.

The individual care plan ensures that the service user’s needs are fully met. This includes their daily care support, medical needs, psychology and psychiatry support, physiotherapy, speech and language therapy and occupational therapy as appropriate. We also continue to support their education with learning programmes and college placements.

For more information call our Admissions and Referrals Team on 01604 791266 or take a look at our Frequently Asked Questions

Sian Richardson

Sian Richardson, a member of the Admissions and Referrals Team

Supporting Greenfields School

We’re supporting Greenfields School and Sports College in their bid to win £3,000 from the Lloyds Bank Community Fund.  This secondary school for students with severe learning and physical disabilities is hoping to create a covered all-weather play area for the students. The play area would enable the school’s more vulnerable students to benefit from a range of outdoor activities.

To add your support and vote for Greenfields School
you can vote by text – just text VOTE CMSB to 61119.
Voting closes on 1st November!

Greenfields School

 

Hazel’s Story | Living with a Brain Injury – Independently In My Own Home

In 2010 Hazel was working as a personal assistant for a senior executive and was admitted to hospital with a serious bowel condition. Unfortunately her condition led to her being in intensive care for six months. During that time she sustained a hypoxic brain injury. This type of brain injury is caused by an interruption of the supply of oxygen to the brain.

Ten months after leaving intensive care, and at age 61, she moved to The Richardson Mews (in Kingsthorpe, Northampton). At that time she was using a wheelchair and needed help with all her daily tasks like making meals, washing, showering and dressing.

As at the time of writing, 13 months after moving into The Mews – Hazel is moving into her own home to live independently. Our multi-disciplinary team have been working with her during her time with us – in re-learning some vital skills and she has undergone amongst other rehabilitation programmes: Speech & Language Therapy; Physiotherapy and Occupational Therapy. Despite physical difficulties with her feet, she no longer requires a wheelchair and walks using sticks. Hazel has made steady progress and now makes her own meals and enjoys baking cakes. This is what she has to say about her experience of living in our home:

Gardening Tools | Image courtesy of www.123rf.com“Staying at The Mews has been fantastic. I can do lots of things now that some people thought I would never be able to do. I was determined that I wanted to walk again and I’ve achieved that with the help of the people here. Everybody is really friendly and helpful. And the carers have gotten to know me very well, so occasionally, if I’m feeling a bit off colour then they can tell, which really helps.

It’s like home from home and I think my progress has been brilliant, helped by the combination of therapies that I’ve received. It’s little things that make a difference, like being able to change my stoma bag myself – I felt it was the worst thing that someone else had to do for me. I’m really excited about moving into my new home. I love gardening and I’m looking forward to having a garden again.”

We are really pleased that Hazel can now live her life, independently, in her own home. This is a great success story for us, as this is an ultimate goal that we hold for any service user who is able to progress this far. If you would like to find out more about how we tailor our care and rehabilitation programmes on each service user – please call our Admissions and Referrals Team on 01604 791 266, tweet us on @RPC_residcare or email us on info.ld@caresidential.co.uk (learning difficulties) or info.bi@careresidential.co.uk (brain injuries).

Residential Care: Professional, Considered Care of Vulnerable Adults

I felt compelled to write something in a response to the recent news items on the cases of criminal neglect of people with disabilities while in the care of a private hospital. This is the most horrific catalogue of abuse and neglect that I have ever heard of.  The program was horrendous to watch and as a care home owner I was sickened to the core.  The jail terms were welcome but quite honestly not long enough for the severity of the crimes in my opinion.  The rights of people with disabilities have still got a long way to go in even just safeguarding the basic human rights and preserving the individual’s needs and wants.

While we do not run a medical facility (i.e. a hospital), our service is residential care for adults with acquired brain injuries (ABI) and/or learning difficulties. We create a home and all that comes with that. My mother and father started The Richardson Partnership for Care in 1989 when identifying that there was a serious lack in professional care and attention for people who had sustained an ABI or indeed had a learning disability. In fact I grew up with some of the Service Users who are still residing in our homes today. But, the question that I asked myself late into the night after watching that BBC programme was: “How do I know that this is not happening in my homes?” And, actually, the answers came quite quickly and simply:

  • Our homes have been developed, maintained and staffed – purely with the needs of the Service Users in mind
  • Complaints (if received) are taken seriously and investigated fully (by my senior staff, my husband and myself)
  • We employ staff with a minimum of 12 months experience (so that we are sure that they have understood the environment before starting to work with us – we then have an intensive training programme we put our staff through that not many other care homes do)
  • We train our staff to become accredited through the Crisis Prevention Institute (non-violent crisis intervention )
  • Our staff all have training every 3 weeks so that we keep their skills and learning on top form and ensure that the learning is directly implemented into their roles
  • Our staff are regularly supervised and we have performance management appraisals built into our people management structure
  • We have high staff ratios versus Service Users (there is always enough staff to support each other and the Service Users – even for the toughest of days)
  • My husband and I (as the managing partners) live in walking distance of the homes and often bump into people (Service Users and staff) when we are going about our daily life
  • We have monthly internal audits of the homes
  • All of our five homes have had a fully compliant Care and Quality Commission inspection report within the last year (all “surprise” visits and we have received satisfaction ratings and wonderful feedback from the inspectors themselves)

This leads me to want to defend my profession and say that if done responsibly Residential Care can be a positive life choice for people who have a need for it.  Social isolation is regularly an issue for people with disabilities and the support system, encouragement, fun and laughter that I witness within a group environment is one reason that I love my job.

Service Users that lack self-esteem and enthusiasm regularly thrive when involved in meaningful community activities. We are having great success in giving people the skills and confidence to go out into the community and live independently much more quickly than could have been imagined. Also our Service Users have valuable personal space in their own rooms or transitional suites to make sure that they can pick and choose when they feel like interacting.

Hopefully I have managed to share the fact that Winterbourne View is terrible example of what really can’t be described as “care” – and to let you know that there are providers, like ourselves, who are seriously committed to person-centred care, where the individual is respected as any person would and should be. The prevailing passion that started when we opened our first home 23 years ago in which we lived and my parents worked at the time (I was 10 years old) is to run a positive place that people enjoy calling their home and are supported by a professional, compassionate team of staff and a group of peers to fulfil their potential. I am committed to listen to complaints and feedback both positive and negative to ensure that my homes are not destructive places to live.

If you would like to chat to me at any point, or ask me any questions about The Richardson Partnership for Care – then please contact me on 01604 791266 or connect with me on LinkedIn.