Cartref 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 75 (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.

Care plans and risk assessments described people’s preferences, routines, strengths, goals and individual support needs. Staff knew people well and adjusted their approach according to how each person communicated and presented. Staff used individualised coping strategies to reduce people’s distress.

We observed staff supporting people to make everyday choices about their meals, activities, personal care, and where they wanted to spend their time. People appeared relaxed with staff and spoke positively about the support they received.

People were supported to develop skills and independence in line with Right Support, Right Care, Right Culture. For example, people received varying levels of support and supervision from staff as they increased their skills and independence. This included personal care, medication, cooking, budgeting, household tasks, going out to places they wanted and accessing education or work.

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

The provider was aware of the importance of continuity in people’s care to ensure safe, effective and responsive support for people. Regular agency staff were used to maintain safe staffing levels at the service but the provider found agency staff did not know people as well as regular staff. The service was recruiting to try and fill their vacancies and improve continuity for people.

Staff worked with GPs, mental health teams, social workers, commissioners and other professionals. A professional told us the service was responsive, communicated concerns early and worked with others to prevent breakdowns in people's care arrangements.

Staff supported people during transitions in their care. Staff continued to support a person who was in hospital by collecting and delivering their medicines. They supported another person to visit them which supported continuity in their friendship.

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

People’s communication needs and preferred methods were recorded in their care plans. Staff knew people well and knew when people required additional support to communicate their needs such as use of picture cards to express emotions. These communication approaches helped people understand information and participate in decisions about their daily lives.

Visual information was also displayed around the home giving guidance about completing laundry, cleaning or other household tasks.

Staff also adjusted their verbal communication. They gave short, simple prompts or explanations to guide people when supporting them to meet their needs. They checked to ensure people had understood what was communicated. For example, we observed staff showed people their medicines, explained what they were for and supported them to count or name them. Staff explained what they were recording and responded when people asked what was happening.

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.

Staff responded to people’s needs and wishes during the inspection. For example, staff supported people to prepare meals and attend to their personal care at times that suited them. They also supported people to go out and see people or do things they wanted to. People appeared comfortable approaching staff and expressing what they wanted.

The service held meetings for people to share information and seek feedback. Topics included respecting each other, how to complain and choices about the environment. When people did not want to attend group meetings, staff used one-to-one conversations and recorded these in their care records so that people were still able to share their views. People had asked to visit a zoo and staff arranged the trip. People also influenced meal planning, activities, holidays, household decoration and their personal goals.

The service worked with people and their relatives where appropriate, they respected people’s wishes about information that was shared and supported people to maintain relationships.

The service told us they had not sent out surveys recently. These were being drafted at the time of the inspection to be sent out in future to give further opportunity for people and those important to them to feedback.

The provider made sure people could access the care, support and treatment they needed when they needed it. Staff supported people to attend GP, dental, optician, learning disability, mental health and other specialist appointments. A professional confirmed that staff supported people to attend appointments and worked closely with GPs to help people access the right care. Records showed staff sought medical advice and emergency treatment when needed for example when people became unwell or injured. The service also arranged additional staffing for hospital visits.

Staff adapted community access to people’s individual needs such as 1-to-1 or 2-to-1 support if needed. Staff told us they linked arms with a person where this helped the person feel safe, chose quieter environments and used planned calming time before or after journeys to building people’s skills to access the community independently.

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

The service supported people with learning disabilities, autism, physical disabilities and emotional needs. The service followed the principles of Right support, right care, right culture in practice. Staff considered people’s individual needs and planned care with people to meet them. Adjustments included visual information, structured routines, accessible activities, individual staffing, support to maintain family relationships and personalised strategies to reduce anxiety and distress.

People received support to participate in ordinary daily and community life. This included shopping, cooking, banking, using public transport, completing education and work, visiting family, going on holiday and pursuing interests. People were supported to have goals and future aspirations such as paid employment work and work towards a qualification linked to their employment ambition. A professional described the service as person-centred and strengths-based and gave an example of support which enabled people to work toward greater independence.

People were supported to plan for important life changes so they had enough time to make informed decisions about their future, including changes in their care and support.

The service focused on helping people develop skills for greater independence rather than viewing it as a home for life. People’s care plans included individual future planning and goals based on people’s wishes. These varied for each person including education, employment, independent living, community access, budgeting, cooking, personal care, relationships and managing medicines.

Staff used gradual plans to support change safely such as reducing direct observation and increasing independence in people’s skills to manage their own needs. Monthly reviews covered people’s holistic needs. A professional confirmed the provider communicated when people were approaching the end of their care pathway and worked with partners to maintain continuity.

No one was receiving end of life care at the time of the assessment.