ASD Support LTD

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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

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

This is the first assessment for this newly registered service. This key question has been rated 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 89 (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 ensured 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.

Relatives were satisfied their family members were receiving personalised care and support from staff who understood their needs. A relative said, “You worry all your life that it’s the wrong care company, and the wrong people looking after [person], but I know they are in good hands.” Another relative told us, “[Person] has the right care and support. They are in the right place”.

The service developed creative and personalised ways of encouraging people to look after their own well-being and be as independent as possible. A relative told us, “They respect [person’s] dignity when showering by making games up. They make it into a challenge for them.” Another relative said, “I am impressed how they [staff] help [person] to cook. They try to involve them in the process and help with their skills. They are so good.”

The staff were skilled at exploring and resolving any conflicts and tensions when people were being supported. For example, staff didn’t let one person know they were going out until the last minute to reduce the person’s anxiety. A relative told us that when a person sat on the floor of a shop, staff sat with them and encouraged them in their own time to move. This was successful. The relative said, “They gave [person] a minute, no fuss.” Another relative told us staff were ‘very good’ when a person was reluctant to return to their accommodation.

The service understood people’s needs, preferences and wishes can change, and made sure it continuously adapted its approach with people. This was particularly evident where people grew in independence and confidence . Relatives praised the successes staff had had in supporting people to do more. A relative said, “They have helped [person] develop choices and involved them in different activities.” Care plans were reviewed at least three monthly and reflected the changes in people’s lives as they became more active and social.

People’s cultural needs were recorded and met. People, relatives, and staff worked together to ensure people could be themselves and live the life they choose. Where appropriate, people were encouraged to learn about and engage with their cultural roots, for example, by trying foods and listening to music in keeping with these.

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.

The service actively identified and responded to those most at risk of experiencing poorer care or facing barriers to accessing care. Staff understood the diverse health and social care needs of the people they supported and were committed to tackling health inequalities. They worked in partnership with people, relatives, and health and social care professionals to ensure people had the services they were entitled to.

Some people came to the service with needs that hadn’t always been known or met. Through rigorous assessment and getting to know the people they supported, staff were able to pinpoint issues that caused people distress. They sought specialist help where necessary to give the person the best chance of having all their care, treatment and support needs met.

For example, a person had a behaviour that made it difficult for them live successfully in the community. A service manager advocated relentlessly for this person to get specialist support from a mental health service. This enabled staff to understand the person’s behaviour and address it in a positive and empathetic way. As a result, the person flourished at the service, building good relationships with staff, going out into the community, and accepting that the place they now lived was their home.

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

Staff identified people’s communication needs during the assessment process and created
care plans which included any barriers affecting their communication, for example limited vision or hearing loss. People’s communication plans were linked to their positive behaviour support plans, their autism profiles, and one-page profiles. This meant meeting people’s communication needs were central to all the care and support staff provided. When needed a speech and language therapy team (SALT) worked alongside people and staff to implement communication strategies and plans.

People who needed them had communication boards in their homes to display what was important to them in pictures and words, for example, the staff who were on shift, activities, and meetings. Some people had ‘now and next’ boards to help them plan and transition between activities.

Though training, staff learnt to communicate effectively with a person who could become distressed. Staff learnt to adapt how they spoke to the person and be aware of what they said and how they said it. This had a positive impact on the person, helping them to develop trusting bonds with the staff team. All staff had communication training as part of their induction, so they understood how important communication skills were when supporting people.

Relatives said staff were excellent at communicating with their family member and understanding what they wanted. A relative told us staff used picture cards and a communication board to support their family member to make choices about meals, activities, and personal care. Some relatives said the way their family members communicated was subtle and easily missed but staff knew them well and could understand them. A relative told us, “[Person] is non-verbal, so the staff watch their behaviours. They observe them at all times.”

Staff told us a person was non-verbal and staff said they understood a lot, were very intelligent, and could indicate ‘yes’ and ‘no’. To enable better communication, staff put together a communication book for the person full of places, activities, food, etc, so the person could point out what they wanted to staff. The visual aid enhanced the person’s ability to make informed choices about how they wished to spend their time and supported them to exercise greater autonomy and control over their daily activities.

The provider ensured information about the service was available in accessible easy-read or pictorial formats and if a person has specific communication needs the information was adapted so they could understand it.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support.

The service demonstrated exemplary practice in handling feedback and complaints. Processes were clear, person-centred and transparent and prioritised empathy, timely communication and a commitment to learning and improvement.

Feedback was actively sought from people, relatives, staff, and professionals through meetings, reviews, surveys and informal discussions. This was collated and saved, and records showed the high level of satisfaction with the service.

People’s feedback was carefully and sensitively sought. For example, minutes from regular ‘people we support’ meetings showed how central people and their views were to the meeting. The agenda was based on what was important to the person and addressed any concerns they had. A relative said both they and their family member attended the meetings. They told us, “[Person] has their say and the staff to listen to them.” If people were unable to attend their ‘people we support’ meetings due to their complex needs best interest decisions about this were made and recorded. At the meeting itself staff who knew the person well advocated for them and expressed their likes, dislikes, and preferences. This helped to ensure the person’s voice was heard.

The service was planning a ‘Have your say day’ to encourage people to have greater input into the operation and running of the service. This was to have games, food and drink, and accessible information with the aim of enabling people to feel as relaxed and comfortable as possible. People would be encouraged to mix other people using the service, managers, and directors in an informal way so they could express how they felt and how they thought the service could improve.

Relatives were aware of the service’s complaints policy and knew who to go to if they were unhappy about any aspect of the service. A relative said, “I know the complaints policy. I have never had to use it. I would write to the manager if needed.”

Complaints were managed in line with policy and viewed as opportunities for learning and service improvement. Records showed the service addressed complaints in a responsive, understanding, and transparent way. Following a complaint about noise from a property, the service manager visited the complainant to provide reassurance and was able to establish a good line of communication with them.

Another similar complaint about noise and a damaged fence was also addressed with a visit to report that the fence had been repaired and staff spoken to about the noise. Both complainants were given contact numbers for managers at the service in case here were any further issues. From these complaints the provider learnt that when acquiring a new property, it would be beneficial to introduce themselves to neighbours prior to anyone moving in. This would enable them to build relations and put people's mind at ease, should they have any concerns before these become a larger issue .

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

Reasonable adjustments were made to ensure equal access to the service for all. An example of this was the way people’s homes were adapted and designed to meet their needs.

A person’s vision deteriorated, and this impacted on their wellbeing and ability to lead a fulfilling life. In response, the service identified a new property for them that could be adapted to meet their needs. Staff worked with commissioners to determine what would be best for the person in terms of adaptations, furniture, and layout. This meant that once renovated the home was suitable and safe for the person to live in.

Another person lived in bespoke accommodation designed to meet their sensory and other needs. To ensure it was right for the person staff liaised with a specialist autism team who visited the home and made recommendations. These were implemented in the design process and allowed the person to make a smooth transition and feel comfortable and secure in their new home.

The people’s homes we visited were spacious, personalised, and suited to their needs. In one home padding had been incorporated into the design of each room so risk was reduced and at the same time the property retained its homeliness. A person had a wardrobe designed specifically for them to make it easier for them to find items of clothing. Another person was proud of the sports theme in their bedroom and keen to show it to us. People and relatives contributed to the design and decoration of their own homes which were kept and maintained to a high standard.

People had legal tenancy agreements, and their living arrangements provided them with privacy, dignity and independence. Staff supported people to maintain their tenancies and uphold their legal requirements.

Staff and leaders were innovative in how they listened to information about people who were 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.

Staff demonstrated a strong understanding of the people most at risk of experiencing inequality in their care and outcomes and took proactive steps to reduce barriers to inclusion and improve overall experiences. A key focus was ensuring people had meaningful opportunities to participate in and enjoy community life.

Positive risk-taking was a central element of the service’s support approach. By encouraging individuals to take part in activities within their local communities and contribute to community life, the service helped them challenge stigma and overcome barriers often faced by autistic people and those with learning disabilities.

For example, through volunteering, one person regularly engaged with members of the public, developed new skills, and built confidence and self-esteem. The service highlighted how this person ‘brought a smile to everyone they met’ with their ‘great sense of humour’, reflecting a positive and mutually beneficial impact for both the person and the wider community.

As not all support staff drove, the service employed a dedicated driver. This initiative ensured that a lack of transport did not become a barrier to community access for people. By providing reliable, coordinated transport the service promoted greater independence, reduced people's isolation, and enabled them better access to their communities, relatives, and friends.

People were constantly out in the community taking part in a wide range of activities. A relative told us, “The staff send me photos and videos every week of what [person’s] been doing. They take them to [animal and bird sanctuaries] and out for meals.” Another relative said, “Staff try and get [person] out of the house. In the spring and summer months [person] enjoys the garden. They go to discos, the cinema, and trips out on the bus to get their nails done.”

People were encouraged to make friends with others, including those also using the service. They went to each other’s homes for meals and social events. A relative told us, “[Person] has friendships and they celebrate together. It’s a very good place for [person] to live.” Another relative said staff were always looking for things their family members would enjoy and trying out different activities with them.

People had the opportunity to determine their own lifestyles and make choices about what they did and when. Relatives told us there were no restrictions on bedtimes and getting up times and people could help themselves to healthy snacks and drinks when they wanted to. A relative said, “[Person] knows their own mind and can take themselves to bed and watch TV.”

Staff told us people were encouraged, where possible, to use community services rather than services specifically for people with disabilities. For example, if a person needed an optician staff enabled them to use a high street service, checking with the service first to ensure they could accommodate the person.

Staff were confident about understanding people's equality-related needs and felt able to meet them. For example, a person was looking to explore their sexuality, and staff supported them to look at various educational resources so they could gain a greater understanding of themselves.

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.

When people’s future preferences were for greater independence, education, or work, staff supported them to progress towards their goals.

Where appropriate, people’s end of life wishes were discussed with the person and their relatives. Their decisions and choices were recorded in a care plan to be shared when the time came with relevant people, including other services, staff and people that mattered to the person.