Carlton 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 requires improvement. At this assessment, the rating has changed to 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 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 their needs.

The service was extremely inclusive and reflected the individuality of the people who lived there. The home contained artwork created by people, along with photographs which showed people participating in activities, celebrations and social events. This helped to create a warm, personalised environment where people felt a sense of ownership and belonging.

There were no set mealtimes, and people could choose whether to eat together or separately. Where possible, people were supported to prepare their own meals. We observed people cooking and preparing food alongside staff and coming together to plan a weekly menu. People enjoyed trying new foods, often selected because they were favourites of others living in the home. This encouraged people to share their likes and dislikes and supported social interaction and choice. Staff consistently promoted independence, including supporting people to clean their bedrooms, complete their own laundry and carry out other domestic tasks.

Positive Behaviour Support (PBS) plans were highly personalised and developed collaboratively. Each plan was specific to the individual and showed clear evidence of input from the wider care team. Plans clearly identified individual triggers, early warning signs and appropriate de‑escalation techniques. Staff demonstrated a strong understanding of each person’s behavioural triggers and the most effective ways to support them. This ensured responses were respectful, proactive and focused on promoting wellbeing and autonomy. The strong person‑centred culture meant staff were confident in adapting support as needs changed, and they consistently used positive approaches to reduce distress and avoid restrictive practices.

We saw that one person shared an interest in going fishing. A member of staff who was also an experienced fisherman supported the person to obtain a fishing licence and accompanied them on a fishing trip. Following this experience, the person spoke enthusiastically with staff about their day and expressed a wish to continue this activity. This had a positive impact on their wellbeing and mental health.

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.

Leaders and staff showed a strong understanding of each person’s long-term goals, strengths and support needs, and worked proactively with external professionals to ensure care was cohesive, aspirational and enabling.

Staff consistently supported people to work towards outcomes that were meaningful to them. One relative told us about their loved one being supported to use the buses and how that with time and patience the person can now travel alone to visit them, which enables them to have time alone as a family. These examples reflected an embedded culture of promoting independence, aspiration and choice. Care was joined up, collaborative and focused on supporting people to achieve long-term outcomes, rather than solely meeting their immediate needs. The registered manager’s leadership was central to this approach, ensuring continuity of support, effective cross-team collaboration and highly personalised pathways that increased people’s confidence and future prospects.

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

Carlton House demonstrated outstanding practice in the way it provided information to people. Staff consistently went above and beyond to ensure communication was personalised, accessible and meaningful. Their strong commitment to tailoring information to each person’s individual needs had a positive and measurable impact on people’s wellbeing, confidence and involvement in their own care and support.

A wide range of accessible information was available to people. This included information about their care and support, policies and procedures within the home, and records of meetings in which they had participated. Information was consistently provided in easy‑read formats and was freely available, supporting people to understand and engage with decisions that affected them.

The registered manager demonstrated outstanding leadership in ensuring that information received from external professionals was shared in a way that was accessible, supportive and meaningful to people. This ensured continuity and consistency of communication and helped people feel informed and empowered.

We observed staff communicating with people in ways that were carefully tailored to their individual needs. For example, one person was supported using third‑person references, such as saying, “[person] has drawn a wonderful picture.” This approach was appropriate for the individual and clearly promoted reassurance, confidence and a sense of achievement. It was evident this way of communicating helped the person feel safe, well supported and empowered.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

The service demonstrated a well‑embedded, highly person‑centred approach. Each person was supported to have monthly one‑to‑one meetings with their keyworkers to review their progress in line with their Life Stars (progress across key areas of life, using a visual format) updates. More informal, ongoing keyworker sessions and daily check-ins, created regular opportunities for discussion, reflection, and feedback.

These discussions focused on identifying small, realistic and achievable goals that linked directly to people’s longer‑term aspirations. Staff used these sessions to listen attentively, explore what mattered most to each person and ensure their wishes were clearly reflected in meaningful, personalised plans. This approach helped people feel listened to, respected and empowered.

Staff showed strong skills in supporting people to break down wider ambitions into manageable steps, while maintaining a clear focus on the person’s overall goals. They took time to understand what motivated each individual, regularly checked how they were feeling and adjusted goals sensitively in response to people’s mood, engagement or capacity at the time. This ensured the process remained positive, supportive and encouraging rather than overwhelming.

People told us they felt valued and motivated because they were actively involved in setting their own goals, rather than having goals imposed on them. One person said, “I don’t want to live anywhere else, it’s good here, staff are good.” Staff recognised and celebrated achievements, regardless of how small, which helped to build people’s independence and self‑confidence. Over time, this approach contributed to positive outcomes, including improved confidence, development of daily living skills and increased optimism about the future.

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

Staff worked hard to reduce barriers and support people to ensure they were not discriminated against due to their disabilities. People had access to support that promoted equality, removed barriers or delays, and protected their rights. The provider complied with legal equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments. The provider prioritised resources and created opportunities to tackle inequalities and achieve equity of access.

External stakeholders provided positive feedback about the care provided and found the staff team communicated well with them and responded to any information request promptly.

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

People were actively encouraged and supported to take part in new, meaningful and enriching experiences that reflected their interests, preferences and aspirations.

Staff and leaders demonstrated an innovative and reflective approach to understanding the needs of people who may be at increased risk of inequality in experiences or outcomes. They actively gathered and used this information to provide exceptionally tailored care, support and treatment, ensuring responses were individualised and responsive to people’s circumstances. For example, staff supported one person to access social environments from which they would otherwise have been excluded in a way that respected their identity and promoted comfort and trust. Staff ensured they felt valued, understood and at ease in their chosen community.

The provider had an equality and diversity policy and statement in place, which clearly reflected and reinforced their core values of kindness, commitment and creativity. These values were evident in staff interactions and in the way, support was personalised to minimise the risk of unequal outcomes. Staff told us they felt supported to use their skills confidently, without fear of discrimination, harassment or unfair treatment. This contributed to a positive, inclusive working culture and enabled staff to focus on delivering compassionate, person‑centred care.

Leaders ensured that equity was embedded not only in policy but as an integral part of service development and day‑to‑day practice. Staff were encouraged to share their experiences, perspectives and ideas for improvement. This collaborative approach ensured that support remained relevant, meaningful and impactful, and helped create an environment where Carlton House was inclusive and equitable for everyone. Staff members used their own life stories to support people with addressing any bias they may receive due to their protected characteristics.

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.

Support plans clearly captured significant life changes, including transitions in care and people’s wishes and preferences around end‑of‑life support.

The management team approached discussions about end‑of‑life care and funeral planning sensitively and at an appropriate pace, working closely with people and their representatives. They explained that these conversations were intended to understand and respect people’s wishes, as well as those of their family and loved ones, to provide reassurance, reduce potential stress at a difficult time and ensure decisions reflected what was most important to the person.

People were also continually supported to plan and look forward to positive life events, such as holidays, birthdays and other celebrations. Staff encouraged people to explore new experiences and maintain meaningful routines, supporting them to enjoy life and create positive memories at every stage.