California House

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 good. At this assessment the rating has remained good.

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

This service scored 86 (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 was exceptional at making 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 families and healthcare teams were all involved in care and treatment decisions where appropriate, were integral to the development of care and support plans and were involved in outcome reviews. This included guidance from specialist nursing and medical practitioners. Staff kept people updated through effective communication.

One relative told us, “They communicate well and ring me if there are any issues or news to report.”

Risk assessments and positive behavioural support (PBS) plans were person-specific and person-centred. These were aligned to individual person-centred goals and targets to account for individual challenges, behavioural triggers and positive risk taking.

Care profiles also considered general risks associated with being in the home and bespoke individual risks linked to care and support activities such as hair and nail care, independent cooking, use of kitchen equipment, sleep-walking and independent outings.

Staff demonstrated a clear understanding of each person’s behavioural needs, potential risks and associated de-escalation techniques to prevent or minimise distressed reactions, unwanted outcomes or restrictive practices. There was a clear focus on positive reinforcement, respect, safety and wellbeing.

There was a strong person-centred culture where the needs of every individual person were recognised. Staff spoke warmly and passionately about the people they cared for and were proud of the difference and positive impact they had on people’s lives.

Staff supported people to achieve their goals and ambitions through a collaborative person-centred approach. People who had previously felt limited or unable to make changes independently, were guided and empowered by staff to take positive steps to tackle those things they were unhappy about.

Staff told us how they cared about their job, the importance of what they do, and how they chose to work in the service, “to make difference to people and their families and we absolutely do!”

Staff commented how they don’t just care and support people but “really work together with them, with purpose, to gain a deep understanding of their needs to improve their quality of life.”

A healthcare professional told us the focus of care, the priority of the staff and the management of the service is always, “person-centred.”

The provider understood the diverse health and care needs of people and their local communities. The service was primarily set-up to offer respite placements to support people and their families locally. However, the service had evolved to offer longer term care and support for those who required it. This limited respite provision at times due to capacity issues.

Family members described the respite stays as “invaluable.”

The provider recognised the importance of continuity and worked with partners to ensure care was joined up so people did not have existing provision interrupted during their stay.

Staff knew people and their families well and had spent time getting to know them through regular contact, repeated visits and reassessment of needs prior to an arranged stay. Families described how they were involved in all aspects of care planning and risk assessments which were shared with them.

This complete approach allowed staff to develop and establish therapeutic relationships.

Where people required urgent care or emergency assistance, the service had information passports and protocols in place to ensure timely support share information and ensure people’s safety.

A healthcare professional told us the service shared information appropriately and communicated well to support care provision and integration. They added, “The service is proactive, committed to best interests of service users and want to engage with other professionals for the best for people.”

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

There was information, materials and signage displayed around the home in several formats to support people. This included easy-read, simplified text, pictorial, British Sign Language (BSL) images and Makaton. Staff were also trained in BSL and Makaton to assist people’s understanding of information.

Staff provided information to people using picture exchange communication systems (PECS), QR-codes and had adapted technology to support two-way communication and information exchange.

People also received information in an accessible electronic format. The provider had several software packages which had been developed to support those with sensory loss. This included the use of video, audio and visual deficit text reading.

People and staff benefitted from the provider’s inclusive approach to providing accessible information which ensured everyone, regardless of ability or method of communicating, had the opportunity to give and receive information in a manner most suited to their needs.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Their inclusive approach to communication allowed people to be heard and involved.

The provider had several platforms where people, including relatives and healthcare professionals, could provide feedback about the service. This included in-person and on-line meetings, surveys and real-time experiential feedback.

The provider had designed feedback options which were accessible, usable and inclusive. This allowed people with needs arising from visual, auditory, motor and cognitive impairments to get involved and meaningfully contribute to service development. These included assistive technology and adapted software to ‘I’ statements and picture communication symbols on laminated cards.

Real-time feedback was collated by staff during a person’s stay which allowed them to get immediate views about their experience. This allowed staff to make any changes or adjustments in response to address concerns or improve outcomes.

All feedback received was reviewed by managers and staff to identify good practice and areas for improvement.

People could access their care and support plans and discuss any aspect of their health and social care needs with staff. People were involved in reviews and relatives reported being kept up-to-date and involved in care and support decisions.

One person told us, “They communicate well and ring me straightaway if there are any issues.” Another said, “We were involved in the risk assessments and epilepsy care plans which they have shared with us.”

People were actively involved in every aspect of home life. Mealtimes were a particularly positive and engaging time for people. Staff had recently supported one person to complete hospitality and cooking qualifications which they utilised in the home. Staff used these times as opportunities for people to promote independence, lead on choices and decision making, develop skills and share their learning with others.

People were involved in staff recruitment, home upkeep and improvement initiatives. This allowed people to shape the team who supported them and the environment in which they lived.

People could also get involved in the Lived Experience Advisory Board and Trustee Committee to further contribute to local and wider initiatives to support care, treatment and support of people living with a learning disability and autism.

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

Staff ensured existing care arrangements were not interrupted when people stayed in the service for a short period.

Key contact information was recorded in people’s care plans which enabled staff to speak to the right people at the right time. This supported good communication, timely access and referral where needed. People accessed care and specialist support services without difficulty or obstruction and knew the healthcare professionals involved in their care.

Staff supported people to engage and get involved with their local community regardless of their health conditions, perceived limitations or accessibility issues.

Staff challenged barriers and obstacles to access by advocating for those they cared for. Staff had been in dialogue with local public transport providers to ensure adequate accessible provision was made available on services in their locality.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored care, support and treatment in response to this.

People had individual care profiles which had been compiled with input from them, their family and any healthcare professionals involved in their care. This allowed staff to identify where reasonable adjustments were required or additional support needed. This helped avoid potential discrimination or institutional shortfall.

Staff ensured people could continue to maintain those relationships important to them during their stay and supported people to maintain contact. Staff also ensured any existing care and support arrangements were maintained to meet planned outcomes.

Staff introduced opportunities to people so they could broaden their interests and enjoy new experiences. This saw people who had been isolated or who found it difficult to engage socially, make new connections and access services in their local community.

Staff were proactive to ensure people they supported were not subjected to inequitable and discriminatory treatment from any source. This focus ensured people did not suffer unfavourable outcomes.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Where people wanted to achieve future personal goals, health and wellbeing targets or increase their independence to reduce their need for future care and support, this was recorded in care plans. Staff supported people with those short-term and longer-term plans.

Where people stayed for short respite periods, staff told us people did not always want to discuss plans at their end-of-life, and this was respected. At the time of the assessment, there was no one receiving end of life care.

The service had links with hospice and palliative care services which had been accessed for people with life limiting conditions. Such care was led by external healthcare partners.

Staff had completed bereavement training to support people who may have recently suffered a loss of a loved one.