Ambleside Lodge - London

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 71 (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’s care records did not always show people were at the centre of their care and treatment choices. Important information about their needs were not always included in their care plans and risk assessments.

People’s care plans were generally person-centred. However, they did not always fully reflect people's assessed needs. We found information about some people's health needs had not always been transferred into care plans and risk assessments, despite this information being recorded elsewhere in care records. We also found mental health care plans were limited and did not always provide staff with clear guidance about how to support people to manage anxiety or recognise early signs of a deterioration in mental health. This meant care records did not always provide a complete picture of people's individual needs and the support required.

Despite this, people were involved in reviews of their care and had regular meetings with their key workers to discuss support needs and future plans. There was evidence people were involved in discussions with mental health professionals and other agencies involved in their care. Staff worked with people’s social workers and mental health teams to agree plans to ensure needs were met. One person told us, “They do things the way I want. No problems. They ask me what I want to do when we go out.” Another person said, “They seem to know what I need. I can tell them anyways.”

Staff understood the principles of person-centred care. One staff member said, “We need to make sure we are there for people when they need us but giving them space if they need it too.”

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.

People benefited from coordinated care and support. Records showed regular engagement with health, mental health and social work professionals to help meet people's needs. Staff had access to information from mental health teams, commissioning services and other health and social care professionals. There was evidence of multidisciplinary meetings regarding people's care and support needs. The registered manager told us information was shared appropriately with consent and described how the service had worked with commissioners and mental health professionals to support people to move on to more independent living arrangements successfully when appropriate.

People told us they generally received the information they needed. Weekly residents' meetings were used to provide information, seek feedback and discuss matters affecting the home. People's communication needs had been assessed and recorded.

No one using the service required information in accessible formats at the time of our assessment. Staff had received training in confidentiality and data protection, and records were stored securely. The registered manager told us accessible communication methods would be provided if required in future.

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 knew how to raise concerns and were confident they could speak with managers or staff if they were unhappy. Weekly resident meetings provided opportunities for people to discuss preferences and give feedback about the service. The provider had a formal complaints procedure and complaint records demonstrated concerns had been investigated and responded to appropriately with outcomes recorded where necessary. Family involvement and contact with mental health professionals also helped ensure people's views were heard.

We saw evidence of regular key worker meetings where people were encouraged to discuss their needs, wishes and goals. Although actions arising from some meetings were not always clearly recorded as completed, people nevertheless had regular opportunities to contribute to decisions about their support. One person told us, “Yes. I would talk to manager or staff. I don't think I have raised a concern. They are good.”

Staff described how they supported people to share feedback. One staff member said, “We have key worker meetings with people and they can tell us then.” Another told us, “Most people will come to us and complain. If they want help, we will give it. It’s usually something that can be sorted out quickly.”

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

People told us they received support when they needed it and knew who to approach if they had concerns. Most people were able to access the community freely and independently. Where people experienced barriers, staff supported them to overcome these, for example, by accompanying them to appointments or places of their choosing. The home environment was accessible, and close to shops, open spaces and public transport. A ground-floor bedroom and bathroom were available for a person with mobility needs.

People were involved in reviews of their care and support, and staff demonstrated awareness of discrimination and inequality people could experience in the wider community. The registered manager told us reasonable adjustments, including accessible information, would be provided if needed. A staff member described equality in practice as, “Being fair and making people get the personal support they need.”

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

People's cultural, religious and personal preferences were recorded within their care plans and staff had received equality and diversity training. Care plans were individualised and staff understood people's personal needs and preferences.

People experienced support that reflected their individual preferences and were offered choices about meals and daily living. Communal menus were planned with people on a weekly basis and included culturally diverse food options. Alternatives were available if people preferred something different. The registered manager told us no-one living at the home at present required support with religious observance. They confirmed such support would be provided should anyone need this.

One person told us, “Well they know what I like and they respect that. I don't need care and I can go out when I want as long as I let them know.”

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

Staff supported people to make plans about their future independence and life goals. Staff worked with people, commissioners and mental health professionals to support moves into supported living and other opportunities where appropriate. The registered manager described examples of people who had successfully moved to supported living with support from the service. The records of people’s key worker meetings showed future plans and wishes were discussed with them. One person told us, “We have meetings about my care and what I want.”

Records did not show that anyone living at the home had documented wishes about future healthcare or end-of-life care. The registered manager told us people generally did not wish to discuss these issues. A staff member told us, “I don't think people like to talk about this as it upsets them.” This reflected why formal end-of-life discussions had been limited.