Asher 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.

This is the first assessment for this service. This key question has been rated 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 made sure people were at the centre of their care and treatment choices. Comprehensive assessments had been completed taking into account people’s needs, preferences and risks. People, their relatives and professionals were involved in care planning, and staff demonstrated a good understanding of people's individual needs, enabling them to provide safe, consistent and person-centred support. A relative told us, “I am involved in my [Person’s] care plan. It is individualised and tailored to their needs”.People’s care plans contained relevant information about their physical, mental, emotional and social needs. These also reflected people’s long-term aspirations, and short-term goals to be achieved, including learning new skills and ensuring targets were meaningful to the person. Each person had an individualised (PBS) grab sheet which provided a good overall description of their needs and the support they needed from staff to live well. People’s needs were regularly reviewed, and where needed, reasonable adjustments were made to ensure people were supported in the most appropriate and least restrictive way.

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’s support was tailored accordingly, including recognising and responding to the needs of those with protected equality characteristics and those most at risk of experiencing poorer care or facing barriers to accessing care. The service worked collaboratively and flexibly with others, including commissioners, local advocacy groups and other professionals to ensure people experienced continuity of care, support and treatment. The registered manager told us, “This partnership approach has ensured people have benefited from a coordinated, multidisciplinary network of support, which has improved communication, better health outcomes, increased independence, reduced incidents and a more confident, skilled workforce able to deliver specialist informed care.”

The provider supplied information in formats tailored to people's individual communication needs, ensuring they could understand information, express their views and make informed decisions about their care. People's preferred communication methods were clearly documented in their care records, communication passports and hospital passports. Staff used a range of accessible communication tools, including easy-read documents and pictures to maximise people's understanding and participation. As a result, people were supported to communicate their wishes, exercise choice and maintain greater control over their daily lives and care. This person-centred approach helped reduce barriers to communication, promoted independence and ensured people's voices were heard in decisions that affected them.

The provider made it easy for people, relatives and others to share feedback, raise concerns and make complaints about the care and support provided. Complaints were managed by the provider's compliance team and records showed concerns were investigated, responded to appropriately and used to improve the service. A complaints and lessons learned log demonstrated learning was identified and shared to support continuous improvement. The registered manager and staff worked collaboratively with the Positive Behaviour Support (PBS) team, compliance officers and quality improvement teams to respond positively to feedback and concerns. For example, following concerns raised by neighbours about noise levels, the service organised a community barbecue to promote positive relationships with the local community. This provided an opportunity for neighbours to learn more about the service and meet people and staff. A neighbour had posted a thankyou card, congratulating staff for a delightful afternoon, commenting, “It was a very informative experience for those who attended, I had a lovely time chatting to everyone and enjoyed a very tasty buffet.”

The provider ensured people had access to a range of ways to give feedback about their experience of care. Results of quality assurance surveys carried out annually to obtain feedback from people, their relatives and staff about their experiences had been used to develop the service and communicated through a ‘You Said, We Did’ approach. This was displayed on the notice board in the communal area for people to see. People had access to independent advocacy services. An advocate visited the service weekly giving people the opportunity to give their feedback, share ideas or make a complaint. Another advocate had been involved in a person’s transition to the service. Both advocates provided complimentary feedback about the registered manager and staff. Comments included, “Staff are really helpful and appear to fully understand [Person’s] needs,” and “This is a lovely service, they have a lovely staff team, I always get a handover when I come. Registered manager is very good.”
 

The provider made sure that people could access the care, support and treatment they needed when they needed it. The service worked collaboratively to achieve equity for people. The registered manager and staff understood people’s diverse needs and tailored support to meet their individual circumstances, including recognising and responding to protected characteristics and factors that could place them at greater risk of poorer outcomes. Staff were aware of potential inequalities and discrimination within the wider health and social care system and acted as effective advocates for people. They worked proactively with healthcare professionals and other agencies to ensure people received timely access to the support and treatment they needed. Where barriers or delays were identified, the registered manager and staff took appropriate action to challenge these and seek solutions. For example, where a person experienced delays in accessing an urgent review due to deterioration in their mental and physical health, the registered manager raised a safeguarding alert with the local authority.

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. The registered manager and staff demonstrated a good understanding of people’s human rights and how to uphold them in practice. The principles of fairness, respect, equality, dignity and autonomy were embedded in care planning, risk management and decision-making. This supported people to maintain choice, control and independence and enabled them to live meaningful lives. Staff recognised the importance of ensuring people had the same opportunities as others and supported them to access their local community, pursue their interests and take part in activities that reflected their individual needs and preferences. Activities were adapted to ensure they were inclusive and took account of people’s age, abilities, cultural backgrounds and personal interests enabling them to engage in meaningful activities.The service had appointed 2 diversity, equality and inclusion leads, whose roles were to champion inclusive practice, support staff with advice and guidance, and ensure people’s protected characteristics were recognised and respected in their daily care. The registered manager told us, “The appointment of the diversity, equality and inclusion leads had increased awareness amongst staff and contributed to people feeling accepted, valued and comfortable being themselves.”
 

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. At the time of our inspection, no one was nearing the end of their life. There was minimal evidence in people’s care plans about how they were actively involved in planning for or discussing their future care needs regarding end of life. Improvements were needed in this area, including having difficult conversations with people or their representative to express their views, priorities, preferences and wishes about their care so that these can be considered, if at that time they are unable to make their own decisions and in case something unexpected happens.