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. We can make recommendations or suggest ideas where we see areas for improvement. The Health and Social Care Act allows our authorised 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.
Until March 2023, our Enter and View visits will be 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.
We visited Swanton House Care Centre in Swanton Novers on 04/10/2022, and the visit was announced in advance, in order to minimise disruption to the people living there.
We spent around two hours talking to residents and staff, and observing life in the home on that morning, and examining the building and its facilities. We alsointerviewed three family members of residents. In total, we spoke to five of the 14 residents living in Bluebell, the part of the service where people with learning disabilities are cared for. We also spoke to four staff members, including the manager.
During this 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:
Voice choice and personalisation: People seemed to have a good amount of control over their lives and how the home was run. This was achieved through regular residents’ meetings and good relationships between staff
and residents. Family members that we spoke to were happy with how the home communicated with them and responded to requests.
Premises: The home has recently undergone extensive renovations, was pleasant and tidy, and is set in extensive grounds. There is a good amount of communal space and good facilities on site, some provided in response to
residents’ requests.
Activities: The home is in quite an isolated rural location, making outside activities more difficult to access. However, the home compensates for this by bringing in activities from external providers, employing dedicated activities staff on site, and having good on-site facilities.
Relationships and community: Relationships between residents seemed to be good, and people were well-supported to see their family members regularly. The staff seemed to have friendly relationships with residents, and to understand how to anticipate potential tensions between residents.
Food and health: All of the people we spoke to said they enjoyed the food at Swanton House. The weekly menu offered a range of healthy dishes, and people were regularly consulted about the weekly menu. People were offered alternatives if there was a dish that they did not like.
Relations with the broader health and social care system: The manager reported that Swanton House has a good relationship with Norfolk County Council and the local GP surgery, who send a nurse in once a week to see
anyone who requires it.
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, the care we witnessed at Swanton House seemed to offer people a good range of options for living an active and happy life, and to care well for people with quite complex needs.
Recommendations
The residents that we spoke to told us that they were happy living at Swanton House, and the standard of care that we witnessed was good. The relatives that we spoke to were also happy with the service provided at Swanton House, and were reassured to know their relatives were well cared for. Despite the remote location of the home, the use of external providers and an activity team on site meant that there was a good range of activities for people to choose from.
Relationships between staff and residents seemed to be good, contributing to well-personalised care.
The standard of the premises and the facilities provided was impressive, and is due to be improved. The one recommendation that we would make would be to include residents in decisions about how buildings, and particularly bedrooms, are decorated. We felt that this would add to the homely atmosphere.
