Voyage (DCA) London East

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 outstanding. At this assessment the rating has changed to good. This meant people’s needs were met.

This service scored 64 (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 always ensure people were fully at the centre of decisions about their care and support. Feedback about how well people’s support needs were met was mixed. Staff, healthcare professionals and relatives gave differing accounts of how well people’s care was delivered in line with their individual wishes and needs. We sought and received assurances from the provider that these concerns were being addressed.

People told us they were able to do the things they enjoyed. One person said, “Life is good,” and another told us they liked their home and the staff. Another person smiled and gave a thumbs up when asked about their activities. We observed person-centred practice throughout the inspection. Staff knew people well and interacted with them politely and respectfully. We saw warm, light-hearted conversations that reflected positive and trusting relationships between staff and people.

People received care and support from services that understood their diverse health and social care needs. There was evidence of joined up and flexible care to meet peoples assessed needs.

Processes were in place to promote community connections and opportunities, and staff rotas were designed around people’s activities and commitments. Feedback informed us people’s lives and wellbeing had been enhanced by these opportunities.People told us they were busy, and this was reflected in their daily notes.

The provider did not always ensure appropriate, accurate and up-to-date information was available in formats tailored to people’s individual communication needs. Staff were not always trained to use people’s preferred communication methods, including Makaton, as outlined in their care records. Makaton is a communication programme that combines signs, symbols and speech. Feedback from families and professionals indicated that guidance to support people’s essential communication methods was not always followed or accurately implemented. This included the use of social stories and Picture Exchange Communication Systems (PECS). We observed that information was available to people in easy-read formats, including topics such as men’s and women’s health. While this supported accessibility and understanding, some of the information was displayed in the lounge of 1 house, which did not reflect a homely environment. We sought and received assurances from the provider about the action they were taking to improve effective communication.

Communication assessments were part of people’s care planning pathway, and care plans reflected their individual communication needs. Some of the provider’s policies, such as the complaints procedure, were supported by pictorial symbols to aid people’s understanding.

The provider did not always make it easy for people or their representatives to share feedback or raise complaints about their care and support. Feedback from families and professionals indicated that concerns were not always sufficiently addressed. Some relatives told us they were unsure how to raise a complaint formally. Families consistently said that communication between the manager and relatives was an area that required improvement. The provider acknowledged these concerns and told us steps were being taken to strengthen communication and ensure families were confident in raising and resolving concerns.

People had opportunities to share their experiences of care and support, and a complaints procedure was available in an accessible format. People were involved in meetings about their care, and staff told us they sought people’s views and ideas through everyday conversations, keyworker discussions and engagement with people’s wider support networks. Feedback from people was used to identify improvements and enhance their care experiences. For example, a raised flower bed had been created in 1 house for a person who wanted to grow their own vegetables. In another example, where certain items of clothing worn by others caused a person to experience heightened anxiety, measures were in place to ensure staff and visitors avoided wearing these items.

The provider ensured people could access the care and support they needed when required. People’s care plans reflected input and advice from medical and healthcare professionals. Care records showed appropriate referrals had been made to specialist services, and people attended routine medical check-ups and annual health reviews.

Processes were in place to make sure people had timely access to healthcare and that important information was shared appropriately. Staff rotas were planned to ensure people were supported to attend appointments, and risk management plans considered people’s transport and accessibility needs. Care records demonstrated ongoing consultations and collaboration with professionals involved in people’s health and wellbeing.

Staff and leaders listened to information about people who may experience inequality in their care or outcomes and adapted support accordingly. People’s needs were met through a holistic approach to assessment, planning and delivery of care. Protected characteristics under the Equality Act 2010 were identified and recorded, and care plans reflected people’s abilities and the things they could do independently.

Staff treated people as individuals and provided support in a non-discriminatory way. They had completed training in equality and diversity and understood how to provide care that respected people’s abilities, choices and lifestyles.

People had opportunities to plan for important life changes, including at the end of their life. However, people’s cognitive abilities meant it was not always meaningful or appropriate for them to engage fully in discussions about future care. Some relatives told us they did not feel these conversations would be helpful for their loved one at this time. The manager told us that when the need arose, they would work with the person and their support network to ensure care was delivered in a dignified and respectful way. People’s cultural and spiritual beliefs were recorded in their care plans and considered as part of their ongoing support.