Lexrae Support Ltd

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider consistently demonstrated exceptional practice in ensuring people’s care and treatment were highly effective. We saw comprehensive and holistic assessments were carried out with each person, placing their voice, goals and preferences at the centre of all decision‑making. These assessments explored every aspect of a person’s health, wellbeing and communication needs and were completed in partnership with the individual, their relatives (where appropriate), and a wide range of health and social care professionals. This collaborative approach ensured staff had a deep and well‑rounded understanding of the person’s needs from the outset.

People’s diverse characteristics and identities, including their cultural background, religious beliefs, communication preferences and sexuality, were sensitively explored as part of the assessment process. This ensured planning was personalised and respectful, capturing what mattered the most to the individual.

Information gathered through pre-needs assessment was used intelligently to develop detailed risk assessments and support plans that promoted both safety and independence. Staff demonstrated an exceptional understanding of how to balance risk with people’s aspirations. For example, staff told us about encouraging a person to walk but also brought along their wheelchair if they became exhausted. Another example given, where a person was being supported to enable them to self-administer their medication.

The registered manager told us, the undertaking of assessments identified the specific skills and competencies required for staff to support each person effectively, ensuring the service was equipped to meet complex or changing needs.

The needs assessment carried out prior to a service being offered were not treated as one‑off events but as dynamic, evolving processes. They were reviewed frequently and meaningfully with people and their families, ensuring support remained relevant and responsive to change. One person told us, “I am always involved in reviewing my support plan.” The provider also produced information in easy‑read and pictorial formats, enabling people to understand their assessments fully and engage in decision‑making with confidence. Staff were able to tell us about systems, visual aids and practices used to assist people to communicate their needs. This entailed pictorial images, symbols, communication cards and the use of Makaton. (Makaton isa language program using signs, symbols, and speech to aid communication for people with learning or communication difficulties). One person’s support plan identified they required the use of a protective item to ensure their safety. However, the person’s support plan used a phrase that person understood and removed the element of fear. This demonstrated a strong commitment to accessible communication and empowerment.

The provider worked proactively with external partners, including healthcare specialists and multidisciplinary teams, to ensure assessments were comprehensive and accurately informed by professional expertise. This was observed in support plans. This collaborative approach helped the service respond quickly to emerging needs and provided continuity of care that significantly enhanced people’s outcomes. A staff member told us, “Support plans and risk assessment provide vital information and help us care for people properly.”

Assessment findings were used to continually review and adapt the service, ensuring support was always tailored, forward‑looking and aligned with each person’s ambitions. One person told us, “I would like to go to Blackpool.” They were confident staff would support them to pursue this ambition. The registered manager told us about people who had previously used the service and were now living independently. This commitment to reflective practice, continuous improvement and personalised care underpinned an approach that consistently delivered exceptional and highly effective outcomes for people.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The registered manager and the staff team demonstrated a strong and up‑to‑date understanding of Right Support, Right Care, Right Culture, and recognised good practices.

To maintain high standards of care, staff had access to a comprehensive programme of mandatory training, alongside additional ad hoc and specialist learning opportunities. This approach ensured staff possessed the knowledge and skills required to meet the diverse and complex needs of the people they supported. Support plans provided staff with detailed, person‑specific information about individuals’ health conditions, risks, and support requirements.

Discussions with staff and the records we looked at showed where necessary people were supported to access Speech and Language Therapy (SALT). Staff received clear guidance on recommended communication strategies, nutrition needs, and safe‑eating practices. This ensured people were supported to maintain a healthy diet and reduce associated risks. Staff were confident in following clinical advice and adapting support plans in response to ongoing professional input.

Positive and trusting relationships had been developed between staff and the people they supported. People consistently reported feeling comfortable expressing their needs, preferences, and concerns. Staff listened, responded appropriately, and worked with individuals to ensure their care remained person‑centred, respectful, and empowering.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Skilled and competent staff were able to effectively meet people’s specific needs, drawing on shared knowledge, clear communication pathways, and a culture of teamwork.

Staff had access to detailed and up‑to‑date information about each person. Detailed daily records outlined key events, changes, and observations from each shift, ensuring staff had a continuous understanding of people’s needs and could provide seamless, consistent care. Staff told us accessible and accurate information enabled them to feel confident in their roles and to deliver personalised support.

Information sharing was embedded in the way the service operated. Regular one‑to‑one supervisions, team meetings, and reflective practice sessions provided structured opportunities to discuss people’s progress, review support plans, and identify any emerging concerns. Staff also engaged routinely with healthcare professionals and external agencies, ensuring clinical advice, specialist input and multidisciplinary recommendations were incorporated into people’s care.

The registered manager worked proactively with external partners to deliver an integrated service. This included close collaboration with healthcare professionals, specialist therapists, community teams and other agencies. This ensured people received a coordinated service, that promoted both their health and wellbeing. Communication across all involved partners was consistent, timely and focused on achieving the best possible outcomes for individuals.

The service demonstrated a strong, well‑coordinated teamwork and effective partnership working, ensuring people benefited from safe, consistent and holistic care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were encouraged to choose healthy food options, and staff supported them to understand and access nutritious meals that reflected their preferences and dietary needs. One person told us, “I choose the meals I like and I enjoy baking.” Staff also promoted regular exercise and physical activity, adapting support to ensure everyone could participate safely and comfortably. One person was supported to attend regular swimming sessions, enabling them to engage in an activity they enjoyed while benefiting from physical exercise.

People were supported to attend all relevant medical and healthcare appointments, ensuring their health needs were regularly reviewed and any concerns were responded to promptly. Staff worked closely with a range of specialist healthcare professionals, ensuring people received the right clinical advice and interventions when required.

Support plans contained clear, detailed guidance on maintaining good oral health, including easy‑read and pictorial formats to help people understand routines and expectations. This enabled individuals to be actively involved in their own oral care. People were encouraged to maintain their personal care needs as independently as possible, with staff offering sensitive, respectful support when needed.

The service demonstrated a strong commitment to helping people stay healthy, active and engaged, with staff providing consistent encouragement, tailored support and access to specialist input. This ensured people led healthier and more fulfilling lives. One person told us, “The staff take me to the doctors, and they are helping me to lose weight.” Another person told us they required support to open medicines packaging and they said, “Then I am able to take my medication myself.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The registered manager placed a strong emphasis on promoting people’s independence, aspirations, and overall wellbeing, to ensure the individual was supported to reach their full potential and experience positive outcomes.

Regular reviews of support plans were carried out in partnership with the person, their relatives, and staff who know them well. These reviews allowed them to identify areas where care could be improved or adapted in response to changing needs, preferences, or goals. A relative told us, “I don’t like being excluded and I am always involved in care reviews.”

Ongoing discussions with people who used the service ensured their voices remained central to decision‑making, and their feedback directly shaped how support was delivered.

A range of accessible communication aids was used to support people in expressing their wishes and making informed choices about their daily lives. These included pictorial formats, easy‑read materials, and personalised visual tools. Staff were skilled in adapting communication approaches to suit each person’s needs, empowering individuals to participate in planning their routines, activities, and long‑term aspirations.

Through consistent monitoring, effective communication, and a proactive approach to improvement, the service ensured people received the support they needed to achieve meaningful outcomes and lead enriched, self‑directed lives.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People we spoke with told us they were able to make choices about their daily routines, activities and lifestyle, and staff consistently respected these decisions. Staff promoted a culture of autonomy, recognising people’s rights to make decisions, even if those decisions involved an element of risk.

To support informed decision‑making, people had access to a wide range of communication aids, tailored to their individual needs. These included pictorial communication cards, easy‑read materials and visual prompts. Staff described clear and effective approaches to support decision‑making, such as enabling people to point to items they preferred or using communication cards to help them understand options. One support plan informed staff of the importance of using clear, concise short sentences when talking to a person, also to give them time to respond to the question. Staff were skilled in Makaton, enabling them to communicate effectively with people who used this method and to ensure their choices were clearly understood and respected.

Where individuals were assessed as possibly lacking mental capacity to make a specific decision, a mental capacity assessment had been completed. These assessments provided staff with clear guidance on the type of support required to maximise each person’s ability to make their own decision. Staff were knowledgeable about the need to assume capacity unless proven otherwise and demonstrated an understanding of acting in a person’s best interests where required.

People also had access to advocacy services, to ensure they were supported to express their views independently when needed.

The registered manager actively promoted people’s rights under the Mental Capacity Act, ensuring they were empowered to make choices, supported to understand their options, and provided with the advocacy and communication tools they needed to make informed decisions about their care and treatment.