No 36

On this page

• 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

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding.

This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 93 (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 exceptionally personalised care. Staff found creative ways to ensure care and support reflected people’s individual needs, personalities and wishes. A relative explained, “[Person’s] needs are met daily and the staff go above and beyond to ensure [they are] well looked after.” Staff knew people well and discussed their individual needs with each other to ensure people received consistently high-quality care.

Everyone living at the service had made progress and achievements since moving there. These included improvements in health, independence, as well as reduced anxiety and distress. People had better relationships with each other, staff and other people in their lives. A professional explained, “Since moving to the home, [people] are thriving and are happier overall.”

One person who moved to the service expressed themselves physically often harming themselves and staff at their previous home. This resulted in restrictive practice at that service. Staff at No 36 carefully assessed how the person communicated and focussed on building trusting relationships. They helped to build the person’s confidence enabling them to try new things and have more control over their life. Staff continued to review and develop the person’s care plan, setting new objectives and helping them plan for their future. As a result, there were no restrictive practices, and the person was happier, more independent and expressed their needs in a more positive way.

The impact of this personalised care planning and support was evidence for everyone using the service who had improved quality of life.

People were supported by familiar staff who knew them well. Staff worked closely with other professionals to ensure people received continuity of care. People were able to access the care and support they needed both at the service and in the community. Staff, people using the service and relatives had access to out of hours support when they needed this.

People were provided with a range of accessible information about their care, treatments and support, how to keep themselves safe and how to report any issues of concern. The provider produced information in different formats to meet people’s individual needs. For example, pictorial, large print and easy to read. There were posters of information and notice boards around the home telling people about different aspects of the service, menus, plans for the day and staff on duty.

Staff worked with external professionals to make sure communication was tailor made for everyone. Some people had sensory impairments. Staff learnt communication techniques to overcome barriers. They presented information in a meaningful way that people understood. For example, videos and stories to describe what would be happening when people went for an appointment.

Some people communicated using signs, pictures and objects of reference. Staff always found ways to ensure they made themselves understood and could understand what people wanted to express. Staff used innovative ways to communicate with people. For example, 1 person who was due to go on holiday abroad for the first time. Leading up to this staff regularly drove them to the airport so they could experience this environment and understand what happened there. They showed them videos and created stories to describe what would happen. They also took them to a museum where there was a stationary passenger plane so the person could spend time sitting on this and understanding the layout. This meant that when the person went on holiday, they recognised the sounds, sights and feel of the airport and what it felt like to be on an aeroplane.

Staff shared information with people and their relatives through private social media groups where they shared photos of events and information about these. The registered manager told us, “We want families to feel involved and not just hear from us if something is wrong.”

The provider found exceptional ways to involve people and listen to them. People’s views and decisions were at the centre of everything the organisation did. Staff told us the provider would ensure the environment was adapted at people’s requests and that there was no restriction on anything people wanted purchased or to do.

Staff understood the different ways people communicated and took time to ensure people gave their views and these were not misunderstood.

The provider actively sought feedback about what was important to people. Part of the recruitment and selection of new staff involved people using the service. Potential staff were observed interacting with them and people were asked for their feedback about these staff.

Staff involved people’s relatives (when they wanted this), made sure they were asked for their views and informed about what was happening. Relatives told us staff shared regular updates and photographs with them. For 1 person, spending time with families had not always been easy. Staff recognised the value in this relationship and provided support to enable better contact. As a result, the person and their relatives enjoyed spending time together and the person was able to visit their family home. A staff member commented, “We try to have open and honest communication with families, listen to their concerns and keep them involved. I think this is important because families know their loved ones very well and we are all working towards the same thing.”

People were asked to complete satisfaction surveys about their experiences or give feedback in other ways. Each person regularly met with a key member of staff to discuss their care and how they felt about the service. People’s feedback was used to help form specific targets and objectives in the provider’s plans for improvement. One of the provider’s values was, “For the people that use our services to have ownership over the running and improvement.” Staff demonstrated that this value was central to the way the service operated and people’s views were always listened to and valued.

Staff provided seamless care to ensure people had good experiences and could access services that may often be unavailable to people with additional needs. For example, 1 person found crowds and public transport challenging. Staff supported them to take increasingly more complex trips and learn to feel safe. As a result, they had experienced new things and now enjoyed this experience.

Staff made sure people felt included and were central to any event that happened. Staff took part in the same activities as people, ate the same food and always did things together with people. A relative told us that during a recent visit to a Central London attraction the staff at this venue originally mistook the group for friends on a day out or an extended family. They commented, “That’s how the staff approach their work with care, compassion and fun.”

People were supported to attend places of worship or to worship at home if this was what they wanted. Staff always advocated for people. This was particularly evidenced when a person was admitted to hospital and staff ensured the person’s views and needs were always represented.

Staff communicated with people using a range of signs, objects of reference and other personalised communication systems. They ensured people had the information and time they needed to make informed choices. Staff recognised that communication was an essential part of communal living. They taught people who could use words to communicate using sign language and the communication tools others used to help empower people to communicate with each other independently. This helped people to have conversations with each other without the need for staff support.

Staff supported people to continue with their education through learning literacy, numbers, storytelling and using the computer at home. They created bespoke learning opportunities for different people based on their needs and how they wanted to learn. This helped develop skills people could use in other settings to enhance their independence and life opportunities.

People’s care was tailor made for them and staff provided exceptional equity in outcomes and experience. The staff did everything in their power to overcome barriers. They supported 2 people to travel to a country on the other side of the world to be part of a staff member’s wedding. They then supported them to travel around the country for an extended holiday. Everyone was supported to go on holidays to places they had chosen. This included trips abroad and camping holidays. The ethos of the organisation was that people should have the same experiences as everyone else.

Staff also supported people to access everyday services that they had previously found inaccessible. This included supporting 1 person to attend a barber. The person had been fearful of anyone cutting their hair and the noises of equipment. Staff had supported the person at home, slowly reducing their anxiety and associating the haircut with positive experiences the person enjoyed. They then took trips first walking past and then into the barbers until the person felt confident and willing to experience a haircut there. Staff supported other people to overcome their fears of needles and medical interventions. This helped ensure they could have tests and procedures they needed to stay healthy.

People regularly attended cinemas, theatres, music halls and sports centres. Staff understood people’s fears around sensory overload and found ways to minimise this whilst still ensuring people had positive and different experiences.

Staff undertook training about equality and human rights. Support plans included information about people’s personal history, interests and goals.

Staff supported people to plan for the future. They helped people to develop personalised objectives. They regularly reviewed and monitored these to help people achieve the things they wanted. As part of this planning, staff created small achievable goals to work towards future plans. These included learning new skills and familiarising themselves with different settings and environments. Staff also supported people to improve their health, diet and mental wellbeing, recognising that improvements in these areas helped to ensure people had better opportunities in the future.