Salis Care C.I.C.

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 key question has been rated requires improvement. This meant people’s needs were not always met. This is the first assessment for this service.

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

This service scored 54 (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 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. Relatives told us they felt improvements were starting to be made to people’s personalised care although this was a slow process as staff did not always have the skills and understanding to support people. One relative told us, “The staff are all lovely with [relative] but because so much has been lost already they need the skills to be able to pull it back and it’s going to take time.” The manager and director of care also acknowledged this was the case, they told us they spent a lot of time mentoring and guiding staff, “I’m very hands on and want staff to learn from how I do things and then we talk about it so they understand the theory.”

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. The manager told us they had held a number of meetings with professionals involved in people’s care to establish protocols. Whilst this had led to some positive changes in people’s care, the manager and director of care demonstrated a lack of understanding regarding their role in taking responsibility for leading on the recommendations. For example, the manager told us they believed it was the responsibility of the community team for people with learning disabilities to agree and compile people’s care plans and positive behaviour plans. This had led to some changes in the way people were supported and guidance for staff being delayed.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication plans lacked detail. The manager told us prior to changes in the management team people had not been supported and encouraged to use communication aids which had previously been effective in helping their understanding. We saw these aids were being re-introduced and people were beginning to use them in their communication. However, people’s support plans had not been updated to provide guidance regarding how to use the communication aids and how this could be increased over time.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The provider had a complaints policy in place which highlighted how complaints would be handled and gave timescales for responses. We reviewed details of one complaint which showed that although the response was provided in a timely manner, additional detail regarding the outcome of the investigation were required. This had led to the complainant needing to come back for further clarification. The manager assured us this was being dealt with and there was evidence of communication with the local authority to enable further information to be provided.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. There was no record to demonstrate people’s health care needs had been assessed and no health action plans or process to review people’s health were in place. The provider told us people had access to a range of healthcare professionals to support their health and well-being and relatives confirmed this was the case. The manager told us they were aware a more planned approach to ensuring people had access to all the health care support they required was needed and would be completed alongside changes being made to support plans. Whilst there was no evidence the lack of health action plans had resulted in poor health outcomes, there was a risk health concerns would not be effectively monitored.

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. Whilst staff spoke to people with kindness, they did not always demonstrate an understanding they were in people’s home. People received support on a one to one or two to one basis. This meant there were a large number of staff in the supported living setting. When people were spending time in their rooms we observed staff gathered together. This created an atmosphere of this being their work place rather than people’s home. Records of how people spent their time were often task focussed and lacked detail regarding how people communicated, what they enjoyed or what had worked well. This meant staff were unable to reflect and build people’s support in a more meaningful way.

The provider assured us people would be 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 the people supported by the service were young and in good health. The manager told us that should people’s needs change and decisions be required regarding their future needs such as the support they would like at the end of their life, they would support people and their families to work through this.