Part of Healthwatch Norfolk’s work programme is to carry out Enter and View visits to health and social care services to see and hear how people experience care. The visits are carried out by our authorised representatives. We can make recommendations or suggest ideas where we see areas for improvement.
The Health and Social Care Act allows our representatives to observe service delivery and talk to service users, their families and carers on premises such as hospitals, residential homes, GP practices,
dental surgeries, optometrists and pharmacies.
Enter and View visits can happen if people tell us there is a problem with a service. Equally they can occur when services have a good reputation, so we can learn about and share examples of what they do well from the perspective of people who experience the service first hand.
From September 2022 – March 2023, our Enter and View visits are part of a project called ‘My Views Matter’. This project is specifically focused on residential and in-patient care for people with learning disabilities and autistic people in Norfolk. We are implementing this project in response to the tragic events at Cawston Park, in which three residents with learning disabilities died between 2018 and 2020. One of the key findings from the Safeguarding Adults Review was that residents and their families were not being listened to.
My Views Matter will involve visiting around 20 residential homes across Norfolk to find out what people with learning disabilities and autistic people, and their families, want from their residential care. It will also investigate whether residents’ and their families’ views are being taken into account in how care is delivered. The 20 homes have been selected to provide a representative sample of homes in different areas of the county, different CQC ratings, different
sizes of home, and different sizes of provider chain. These are all aspects which professionals have told us affect the ability of homes to deliver personalized care effectively.
Alongside the Enter and View visits to homes, we are also interviewing family members and professionals in the sector and organizing focus groups with care home residents outside their homes. The project is being implemented with the assistance of About with Friends, NANSA (Norfolk and Norwich SEND Association) and Opening Doors.
A final report from this project, which will report on data from across the county, will be published in May 2023.
During this Enter and View visit we focused on what residents thought about their care, and the degree to which they were being listened to by the home staff. We considered the following themes, with the following findings:
Overall, we were impressed at the great efforts that staff at Holly Cottage go to, to provide care for their residents in a way that is skillfully adapted to their preferences and often quite complex needs. Work clearly needs to be done to repair their relationship with Norfolk County Council, however.
Voice, choice and personalisation: The staff had a good knowledge of the people they were caring for, and used this knowledge to personalise people’s care effectively. The family members we spoke to were also very happy with their interactions with the home, and with staff’s understanding of their relatives’ needs.
Premises: Holly Cottage is homely rather than institutional, as well as being well-equipped and pleasant. A lot of thought has clearly gone into adjusting the home to the needs and preferences of individual residents.
Activities: There were a range of activities to help residents to stay active, including outings in the local community. Residents who were reluctant to go out were encouraged to develop more confidence. The managers told us
that the availability of outings was limited for some residents by the level of funding they received.
Relationships and community: We observed caring and friendly interactions between staff and residents, and the people we spoke to were happy with their carers, as were the family members we spoke to. There were also
regular outings in the local community, and residents were able to see their relatives regularly.
Health and food: The weekly menu was constructed in consultation with all residents, trying to accommodate everyone’s preferences. Alternatives were offered to any resident who did not like the set meal. Residents were quite
active, and their annual health checks were regularly carried out.
Interactions with the broader health and social care system: The owner/managers reported that they were not happy with the support provided by Norfolk County Council, and there seems to have been a concerning breakdown in this relationship. Relations with the local GP surgery have generally been very good.
Overall, we were impressed at the great efforts that staff at Holly Cottage go to, to provide care for their residents in a way that is skillfully adapted to their preferences and often quite complex needs. Work clearly needs to be done to
repair their relationship with Norfolk County Council, however.
