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• 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

We looked at 7 quality statements under this domain: Person-centred care; Care provision, integration and continuity; Providing information; Listening to and involving people; Equity in access; Equity in experience and outcomes; and Planning for the future. We found people received care and support based on their individual needs, routines and preferences. Care records evidenced people's diverse care and support needs were assessed and planned for. People were supported to access health services. People were encouraged to be involved in discussions and decisions about their care and support. We received feedback from people and their relatives who confirmed they were provided with access to care and support. The service provided a service user guide in an easy read format that gave information about the service and what people could expect. We saw examples of people’s future care and support needs associated with end of life care.

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 care and support based on their individual needs, routines and preferences. A person told us how staff supported them with activities and routines that were important to them. They confirmed they were given choices and these were respected. Comments included, “It's good living here, I like my bedroom, I go out to places every day, I choose what I want to do, where I want to go.” Relatives confirmed care and support was based on people’s different needs, routines and wishes. This included supporting people with any specific needs associated with cultural needs and wishes.

Staff demonstrated how they provided care and support based on people’s different needs, routines and preferences. They clearly knew people well and what was important to them. A staff member said, “We follow support plans, consistently and continuity is very important, we promote independence and daily choices, listen and respect.” Another staff member said, “People get the opportunity to go out daily in the community, they are kept active, they choose the activities they want to do, and we encourage new activities. People are supported to go on holiday, to keep active and healthy; walks, swimming. A person is due to start college in September.”

Staff engagement with people was good. Staff interactions with people reflected support plan guidance. Staff clearly knew people well, understanding and anticipating their individual needs effectively. Staff consistently promoted independence and choice making.

People received consistent care and support from a stable staff team that knew them well and understood their diverse needs. Relatives confirmed they were confident that staff provided consistent care and worked well with external agencies to ensure continuity. This included staff following any recommendations made by external health and social care professionals

Staff understood and had guidance about people’s individual needs including protected characteristics under the Equality Act. Staff confirmed how they worked with external health and social care professionals in providing consistent care based on individual needs. A staff member said, “We share information with others when required, and follow recommendations made.”

Healthcare professionals we spoke to were positive about how well staff were meeting complex individual needs within the service.

Assessments confirm people's diverse care and support needs are assessed and planned for. Records showed people supported to access health services, referrals to external health and social care professionals were made in a timely manner and recommendations made. There were detailed communication support plans completed and staff engaged well with people.

Relatives confirmed people’s individual communication needs and preferences were known and understood by staff. A relative said, “They (communication needs) are being met, documents are sent to us about how [name] is functioning, yes at times I’ve thought things might help like speech therapy, it’s been looked into but not led on to anything, it’s not for lack of trying.”

Staff demonstrated a good understanding of people’s different communication needs and preferences. They confirmed support plans were well detailed and supportive. Staff gave examples of how information was provided in an easy read format to support people’s understanding. This included using social stories as an effective way to support people with a new activity or event. Staff confirmed care records were kept electronically and they understood the importance of managing information inline with GDRP. A staff member said, “Records are electronic, we have a duty to respect information and keep it confidential.”

Communication support plans provided staff with detailed guidance about people’s individual communication needs and preferences. Easy read information was available for people; for example complaints and safeguarding information. The provider had a GDPR policy that this was adhered to.

People received opportunities to take part in discussions and decisions about their care and support as fully as possible. A person told us how they met with staff monthly to discuss the activities they had participated in and to agree what activities they wanted to do the following month. This person also told us how they represented the home by attending the provider’s co-production meetings. People knew who the registered manager was and told us they would raise any issues or concerns with them. A person said, “[Name] is the manager, I would speak to them if I had a complaint, they would listen.” Relatives told us they felt confident to raise any issues or concerns and trusted the registered manager to respond. They also confirmed they were involved in discussions and decisions about their relations care and support. One relative said, “Yes, no difficulty (about complaining) if we felt we needed to, not felt a need to in recent times. We are regularly invited to submit comments of how things are going can raise concerns, we have got numbers and contacts of people, mainly manager’s, no difficulty who to contact, information on display on wall, we’ve got that information.”

Staff told us how individual meetings with people were held monthly, this was an opportunity to discuss the months activities they had participated in and to plan activities they would like to do for the following month. Staff confirmed the provider had developed a co-production and development hub and how a person living at the service was a participant in this group. An example was also given how a person at the service was supported by an independent advocate.

The provider had a complaints process. At the time of the assessment one complaint had been received and action had been taken in response to this in line with the providers policy. Advocacy information was available and one person using the service had an independent advocate. People received opportunities to be involved as fully as possible about their care; each person met with their keyworker monthly to discuss the activities the person had participated in and planned the next months activities. The provider had developed co-production meetings and opportunities for people who used the service to be involved in the development of the service / organisation and to share their experiences and to represent others using services. These opportunities demonstrated the provider’s inclusion commitment and valued people’s participation.

Feedback from people and their relatives confirmed access to care and support was available to all. There were no issues or concerns raised in relation to discrimination. People had access to all areas of the service, including a large spacious and secure garden that was easily accessed. People had been provided with an easy read service user guide detailing what they could expect from the service.

Staff confirmed people had equal access to all areas of the service. Staff demonstrated a good understanding of upholding people's rights to equality and human rights. An example of this was ensuring people had information and access to the same opportunities as others. This was demonstrated by staff providing people with information and support should they have wanted to have voted in the recent general election.

Feedback received from an external professional was positive how staff supported a person to access services. This included understanding the person’s individual routines and preferences, these were all considered and planned for.

People’s individual care and support needs were assessed before they transferred to the service. This included consideration of any protected characteristics and any adjustments required. This protected people from discrimination. The environment layout, premises and equipment met people’s individual needs and safety.

Feedback from people and relatives confirmed they received opportunities to share their experience about the service and felt listened and involved in their care and decisions. Relatives were confident their relation experienced no barriers or discrimination issues in relation to accessing services, having their individual diverse care and support needs met.

Staff told us how they ensured people did not experience any form of discrimination and that they had the same access to health and social care services to ensure they achieved positive outcomes. For example, staff told us how they supported people to attend health and screening appointments . Where people found it too challenging to attend community services, staff arranged some health appointments to be completed within the home. They also used social stories to support people to develop a greater understanding and help with a particular situation.

The registered manager and provider ensured all people using the service received positive opportunities, experiences and outcomes based on their individual needs and routines. There were good communication and monitoring systems and processes in place to ensure this. For example, daily handover’s, monthly meetings between people and their keyworker, review meetings with social workers, relatives and collaboration with healthcare professionals.

A person told us how they were making future plans with the support of their social worker and staff, to move into supported living service. Some relatives told us future end of life wishes had not been discussed and planned for, and that these would be addressed when needed. However another person confirmed these discussions and plans had been made. A relative said, “They have been discussed, that’s something staff have discussed with [name]. [Name] said they are not religious. Question was asked and record of responses. It’s all been addressed.”

Staff demonstrated a good awareness and understanding of people’s complex care and support needs. Staff confirmed they had received additional training to ensure they were competent in meeting people’s individual needs; for example some people had specific health conditions and staff confirmed what training they had completed to support their understanding of these conditions. Staff were aware that some people had an NHS – planning for the future document that recorded end of life and funeral wishes.

We saw examples of people’s future care and support needs associated with end of life care such as an NHS End of Life wishes document had been completed for a person. The management team advised discussing and planning end of life wishes with the young people living at the service and their relatives was difficult but acknowledged the importance of this. Whilst keyworkers met monthly with people to discuss activities they had participated in during the month and planned future activities, the registered manager advised how they were working on implementing work around future goals and aspirations.