Avon Reach

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 79 (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 worked in partnership with them to respond to changes in their needs. Staff consistently demonstrated a detailed understanding of people's individual preferences, aspirations, life histories and support needs and used this knowledge to deliver highly personalised care.

Staff demonstrated a strong commitment to person-centred care. People's care plans contained clear guidance about how they wished to be supported and provided detailed information about their individual needs, preferences and desired outcomes. Staff used this information to develop highly personalised approaches which reflected people's interests, aspirations and abilities. For example, 1 person had a particular interest in music and expressed a wish to learn to play the keyboard. Staff sourced a specialist keyboard which illuminated the keys as they were played, enabling the person to pursue their interest in a way that reflected their abilities and promoted enjoyment, learning and achievement. This demonstrated staff actively sought creative solutions that enabled people to continue pursuing interests that were important to them.

People's histories, relationships, preferences and aspirations were clearly documented and regularly reviewed. Care plans included personalised "This is Me" profiles and detailed monthly "All About Me" evaluations. These contained information about what was important to people, their routines, preferred activities, relationships, significant life experiences and future wishes. This enabled staff to understand people as individuals and ensured support continued to reflect what mattered most to them as their needs changed.

Staff demonstrated an exceptional understanding of the people they supported. During the inspection, we observed staff engaging people in meaningful conversations which reflected their knowledge of people's lives, interests and personal histories. For example, whilst supporting 1 person with their meal, a staff member encouraged them to participate as much as possible while engaging them in conversation about their past and using humour to make them laugh. The interaction was warm, natural and demonstrated a genuine relationship between the person and staff member. This showed staff saw people as individuals rather than focusing solely on their care needs.

The service consistently adapted support to reflect people's individual preferences, circumstances and changing needs. For example, 1 person experienced pain in their arms and legs and was concerned they were losing strength. The person preferred not to attend group activities and rarely chose to leave their room. Rather than expecting them to participate in a group exercise programme, staff worked in partnership with the person to develop a personalised approach based entirely around their preferences. Regular 1-to-1 movement sessions were provided in the person's room by a trained member of the companionship team using exercises recommended by physiotherapy professionals. The person told us, "I have this with [Staff member] in my room as I don't like joining groups or coming out of my room" and described the sessions as "really fun". They reported the exercises reduced pain in their hips and legs, improved their wellbeing and helped maintain their strength. Importantly, the person was supported to continue the exercises independently between sessions, enabling them to take an active role in maintaining their own health and independence. This demonstrated staff adapted support around the person rather than expecting the person to adapt to the service, resulting in improved wellbeing, greater independence and more meaningful engagement with support.

People consistently described feeling known, valued and involved in decisions about their care. One person told us, "They really do know me and know what I like." Another said, "The care is excellent and the best part of it is that they see me for who I am beyond my health problems." A further person told us, "The staff really do involve me in every aspect of my care." These comments reflected a culture where people were recognised as unique individuals, actively involved in decisions and supported in ways that reflected their personalities, preferences and aspirations.

Examples reviewed during the inspection demonstrated staff consistently looked beyond people's care needs to understand who they were, what was important to them and how they wished to live their lives. Support was tailored to people's individual goals, preferences, relationships and abilities, ensuring people remained at the centre of decisions about their care and treatment. This demonstrated an exceptionally person-centred culture where people experienced support that was shaped around them and achieved outcomes that were meaningful to their lives.

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 provider had effective systems in place to support continuity of care and ensure people's changing needs were identified and responded to promptly. Staff described how information was communicated through handovers and other communication systems, enabling them to remain informed about people's current needs, preferences and any changes in presentation. During the inspection, we observed staff demonstrating a clear understanding of changes in people's health and wellbeing, including when people had returned from hospital or experienced a change from their usual baseline. This demonstrated people received coordinated care which reflected their current needs and reduced the risk of delays in support or treatment.

The provider invested in helping staff develop a detailed understanding of the people they supported. Staff induction processes included creative and dynamic approaches designed to familiarise staff with people's health conditions, care needs and the service user group. This supported staff to provide personalised care and contributed to consistent support across the service. Staff also told us communication systems helped ensure continuity even when different members of staff were on duty. This meant people benefited from care that was informed, responsive and centred on their individual needs.

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

The provider had effective arrangements in place to ensure people, relatives and visitors had access to clear, relevant and accessible information. The service worked in line with accessible information standards and adapted information to meet individual needs. For example, some people used whiteboards with large print to support communication and understanding. People told us information could be provided in formats that suited their needs.

A range of information was readily available throughout the service to help people understand what was happening within the home and make informed choices about their day. Information regarding activities, events, menus and developments within the service was displayed in accessible formats throughout the home. This supported people to remain informed, participate in daily life and understand changes taking place within the service.

The provider also ensured information was shared openly with relatives and visitors. Relatives described receiving regular updates and newsletters from the service, with 1 relative telling us, "The staff send out email newsletters regularly." Overall, evidence demonstrated people, relatives and visitors had access to accurate and relevant information and were supported to remain informed and involved in care and daily life.

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 effective systems in place to encourage people, relatives and staff to share feedback, raise concerns and contribute to the development of the service. Complaints and concerns were logged, acknowledged and responded to in a timely manner, with records evidencing actions taken and outcomes achieved. Annual surveys were completed with people, relatives and staff, and leaders demonstrated how feedback had been used to inform improvements. This demonstrated people had opportunities to influence the service and leaders responded appropriately to concerns and suggestions.

The provider actively involved people in decisions about their care and the running of the service. Residents' meetings provided opportunities for people to share their views, discuss issues affecting them and contribute to developments within the home. Care records also evidenced people were involved in reviewing their care and support. A person told us, "They take the time to listen and change things if need be." This demonstrated people were encouraged to express their views and participate in decisions that affected their lives.

Feedback from relatives and staff reflected a culture where concerns were listened to and acted upon. A relative told us, "If I've ever got a concern I just ring up and they get resolved," whilst another said, "If there are ever any issues they get sorted. Overall, we're very pleased." Relatives and staff also provided examples where feedback had resulted in changes to practice. A staff member told us, "Any problems they solve it straight away and we feel valued not just a number." This demonstrated the provider listened to feedback, responded appropriately and used learning to improve people's experiences.

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

The provider promoted equitable access to care, treatment and support by removing barriers and supporting people to access services, relationships and opportunities that were important to them. Visiting arrangements were unrestricted and people, relatives and friends spoke positively about being welcomed into the service. This demonstrated people were supported to maintain important relationships and remain connected to others.

The provider supported people to access healthcare services when required and made reasonable adjustments to help ensure appointments and care remained accessible. Records demonstrated people were assisted to access healthcare professionals and services appropriate to their needs. People told us they were supported to attend appointments and had access to services such as hairdressers, podiatrists, dentists and opticians when required. This meant people were able to access the care, treatment and support necessary to maintain their health and wellbeing.

People and relatives were generally positive about the support provided to access services. One relative told us, "Specsavers do visit but they struggle to get her to cooperate, so she sticks to her old glasses." This reflected the provider's efforts to facilitate access to specialist services whilst recognising people's right to make decisions about their own care. Overall, evidence demonstrated people were supported to access the care, treatment and support they needed in a timely and person-centred way.

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 provider recognised people's individual backgrounds, interests, beliefs and circumstances and tailored support to help ensure positive experiences and outcomes. For example, 1 person who had previously enjoyed growing vegetables was supported to grow tomatoes within the home. During the inspection, we observed the person proudly tending to their plants and speaking enthusiastically about them. The person told us, "I had a plot of land so growing vegetables was something I always enjoyed doing. Being able to still do this whilst I'm here has made all the difference as it is very important to me. Just look at them! Aren't they gorgeous?!" This demonstrated staff adapted support to people's individual circumstances and enabled them to continue pursuing interests that were meaningful to them.

The provider supported people to maintain their identity, independence and personal choices. People were enabled to practise their faith in ways that were important to them and were supported to access activities, relationships and opportunities which reflected their preferences. One person told us, "You get what you ask for, it's fantastic. There're trips every day on the minibus," whilst another said, "I have a routine and an activity planner, and we are free to take part if we want to." This demonstrated people were supported in ways that reflected their individual choices, preferences and circumstances.

We observed staff spending meaningful time with people and adapting their approach to ensure people remained engaged and included. Staff and activity companions were seen having warm and meaningful conversations with people, including those receiving support in their bedrooms. Relatives also described how staff supported individual interests, beliefs and preferences. This demonstrated staff listened to what mattered to people and tailored support to promote inclusion, wellbeing and positive experiences.

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.

The provider supported people to plan for future decisions and ensured their wishes, preferences and choices were understood and respected. Records demonstrated people were involved in advance care planning, including decisions relating to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), refusal of treatment and hospital admission preferences. Advanced care plans were detailed and personalised, setting out people's priorities, wishes and preferences for future care. Records showed plans were developed and reviewed in partnership with people, relatives and healthcare professionals to ensure they remained reflective of people's circumstances and what mattered most to them. One relative told us, "We agreed DNACPR when she first came." This demonstrated people and those important to them were involved in planning future care and treatment and supported to make informed decisions about their future.

The provider recognised the importance of emotional, social and spiritual wellbeing when supporting people through significant life changes. Two volunteers attended the service regularly to offer companionship and emotional support, including spending time with people receiving palliative or end of life care and providing spiritual support where requested. One volunteer told us, "We tend to see people who are on the palliative or end-of-life pathway and we offer companionship." This demonstrated the provider took a holistic approach to future planning and end of life support by recognising people's emotional, spiritual and social needs alongside their healthcare wishes.