Larchwood Grove

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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 ratedrequires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

This service scored 61 (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 did not make sure people were at the centre of their care and treatment choices, and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People had care plans in place which showed their basic care needs. However, people did not have care plans in place in relation to their diagnoses such as diabetes, epilepsy and mental health. This meant staff did not have the guidance and information they needed to work with people safely and did not have clear information about their needs and how their diagnosed affected their lives. People had not been supported to identify and achieve goals and wishes. The care did not follow Right Care Right Culture Right Support guidance which is national guidance for supporting people with learning disabilities.

Relatives told us they had been part of care planning. A relative said, “I have seen her care plan. They asked me to comment on it and sign it off. If I wanted a copy, I think I could get one.”

People told us they had personal care such as showers when they wanted. We observed a person asking to have a shower, staff explained the person liked to have their shower at a particular time in the day. When the person returned to the lounge area staff told them how nice they smelt as the person had put on aftershave. Staff told us this was important to the person to smell nice, and they liked to receive praise for smelling good. We observed people with nicely painted nails. A person said, “The staff help me paint my nails.”

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 had support from staff that they knew well. Agency staffing was not used. Information was shared with staff during handover regarding any changes to people’s health or care needs. The service worked with other health professionals involved in people’s care. Staff told us how they supported people and their relatives. Most relatives told us they felt staff communicated well with them.

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

We observed communication was tailored to meet people’s needs. There were easy read documents in place if anyone needed them. Despite staff not being trained in Makaton sign language we observed staff communicating with people. Staff told us how people made their needs known if they were unable to verbally tell staff what they wanted. We observed this happening in practice in the service. A person was not able to speak English as a first language, but they were very clearly able to communicate in their own way with staff and others. When they wanted help to translate something, they also asked a staff member who could speak their language to explain.

Relatives told us communication met their loved one’s needs. A relative said, “They are very skilled in communicating with her. They know how to determine if she has needs and how best to meet them.”

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.

The provider had systems in place to support people and relatives to express their views. The provider told us surveys were sent to people annually. We reviewed the survey results from January 2026, and these were all very positive. People had been involved in residents’ meetings providing feedback about food and this was listened to. For example, a person fed back they did not like cauliflower in their food which had been communicated to the cook. Most people and relatives told us they felt listened to. A person said, “I would talk to staff if I had a problem they would listen, I got stuck in the bath, they listened to me and they put in a shower room. I have no complaints at all.” A person told us they hadn’t always felt listened to; this was communicated to the registered manager as the person wanted to speak with a local authority social worker about their mental health. The registered manager listened and did what the person had asked and provided them feedback and reassurance that they had acted.

Relatives said, “Yes [to taking part in meetings] when had get togethers relatives meet up and chat at parties rather than specific relatives get togethers. It has not been done in a while, a few others we know and speak to each other”, “I did attend relatives' meetings when they were held and found them helpful” and “I haven’t been able to go, I do talk to staff and they do say things to me, no meeting in a long time, I try to get involved.”

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

People were supported with emergency medical appointments and any routine or follow-up appointments that needed to take place. There were processes in place to ensure that people could receive care, support and treatment when they needed it. The service utilised the local GP surgery, hospital or minor injuries unit if they required it.

We observed interactions between staff and people during our visit. We saw safe practice whilst enabling people to maintain their routines and come and go around the service as they wanted. People were able to move about the home independently, there was a passenger lift in the service, but people chose to use the stairs. People knew the way to their rooms and communal spaces such as lounge and dining room. People had access to the garden. Some people had personalised their bedroom doors.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People were not always involved with learning/developing or gaining new skills in the service such as shopping, meal preparation and cooking, cleaning and their laundry. The kitchen was not accessible to people as it had a safety gate across it. The registered manager told us this was because 1 person may pull items off the side and injure themselves. The laundry room was locked with a key code.The nominated induvial for the provider told us, “Restrictions on unrestricted access to the kitchen and laundry are based on identified health and safety risks rather than an intention to limit independence. The kitchen safety gate is required due to a known individual risk of a resident pulling items from work surfaces and potentially injuring themselves. The laundry room is small and presents additional risks for residents requiring mobility/moving and handling equipment. Residents can still participate in appropriate laundry-related activities with support.”

People were enabled to maintain contact with friends and relatives. We observed relatives visiting when we were on site. Some people did not have active involvement of relatives. They had advocates who supported them.

People were not always 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.

Some people had a DNACPR (Do not attempt cardiopulmonary resuscitation) form in place. This is an advanced decision not to attempt CPR. It is not about other treatments or care. However, these required reviewing as the DNACPR for 1 person had not been completed correctly by the GP and so it did not show the person their capacity assessed to make the decision and did not show they had been involved in the decision. The reason given on the document not to complete cardiopulmonary resuscitation was stated as learning disability. NHS guidelines state that a learning disability, autism, or dementia is never a valid reason to issue a DNACPR order. The registered manager told us 1 person’s DNACPR had been disputed by a relative. The registered manager was going to seek a GP review of these records. A person had ReSPECT (Recommended Summary Plan for Emergency Care Treatment) forms in place. A ReSPECT form records a person's wishes about a range of care and treatments. No other work had been undertaken to discuss and document people’s future wishes in relation to future care and support should they become unwell or be at the end of their life. The age range of people living at Larchwood Grove ranged from young adults to older people who were in their 70s.