Richardson Duston Limited

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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

This means we looked for evidence that the provider met people’s needs.

This is the first assessment for this service. This key question has been rated good.

This meant people’s needs were met through good organisation and delivery.

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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People, their relatives, and relevant professionals, were involved in the planning of their care and reviews were largely person centred. Needs and preferences were detailed throughout people’s plans, and we saw evidence that people were empowered to make their own decisions. There was some room for improvement to adapt this to people’s different communication needs to maximise their involvement in planning and reviewing their care.

We observed person-centred interactions between staff and people whilst at the service. Shifts were also scheduled in a person-centred way. Where people needed additional support to access the community, this was scheduled for a time of day that suited their needs, as opposed to the needs of the service.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff and leaders had a good understanding of the challenges people faced. To ensure a good understanding, the provider sourced specialist training, for example, specific training which focused on lived experiences of people with learning disabilities or autism.

People received care from a regular staff group which enabled continuity of care, and on occasions where agency staff were used to cover staff shortages, they would use the same agency and request staff familiar to the service.

There was some mixed feedback in relation to supporting people to be involved in their local community, and some people and relatives felt that more could be done to integrate people into the wider community. People attending a day service that recently closed, had their funding redirected to the provider for social needs. We received feedback that not enough was being done to encourage and promote interacting with their peers, however others were very happy with the support they received around this.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider had policies in place around General Data Protection Regulation (GDPR) and Accessible Information Standard (AIS), which were in line with current best practice. Staff and leaders had knowledge about these, and the provider’s policies were adhered to and followed. There was information available in different formats, however, there was room for improvement to ensure everyone using the service, had all information in a format accessible for them.

Staff and leaders were knowledgeable about their roles and responsibilities when it came to sharing information, and training was provided. Some relatives found that there can be a delay in communication from leaders and the provider.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People who could express themselves and relatives were aware of how to raise complaints. People who had raised complaints, received feedback on the outcome of their complaint. People and their relatives were also offered the opportunity to complete annual surveys to provide feedback to the service. This information was used to develop and improve the service.

Largely, people were involved in decisions about their care, along with relatives, advocates and other relevant professionals.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The service is a 3-storey building, with stairs to access the upper floors. There was no accessibility to the upper floors, so people who used wheelchairs had bedrooms on the ground floor, and all facilities that they required. The office where the manager is based is accessible, and there was a car available with adaptations to ensure all people could use it and access the community.

We found that people who needed additional support when outside the service were provided this based on their funding from their Local Authority (LA).

Staff and people were able to access support from senior staff and leaders, via an on-call rota. Senior leaders used the provider’s emergency protocols which considered those that required additional support or adjustments to leave the building safety.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

The provider recognised that where people rely on staff to anticipate their needs, they would likely not experience the same outcomes as others. To overcome this, they utilised tools and practices to provide similar opportunities and experiences. They used their knowledge of people to gauge their reaction to events or activities to establish how they felt about them. Additionally, they utilised communication tools, such as pictures, or personalised sign language, to explain events and activities, and enable people to communicate their feelings.

The provider listened to people and took steps to overcome any issues or barriers in their care. They also recognised specific areas where people could miss out, such as friendship groups and socialising with peers, so provided opportunities within their organisation for people from different services to meet and socialise with their peers. They provided access to specialist support and professionals via their multi-disciplinary team (MDT), which enabled people to navigate potential waiting times, and access the support promptly.

People were supported to plan for important life changes, so they could have enough time and support to make informed decisions about their future, including at the end of their life.

Staff followed principles of the Mental Capacity Act 2005 where necessary to ensure the person and the people important to them were involved in decisions. Some staff have received training in using Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) to record and navigate their way through the decision process.

Most people at the service, and their relatives had not wanted to discuss or make end-of-life plans, which the provider had respected.

Where people wanted to achieve goals, or were approaching important life changes, they were supported to be involved as much as possible, for example, one person had expressed a wish to go on holiday, so staff were supporting them to plan and organise this.