Foundation 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 Outstanding. At this assessment the rating has changed to Good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People received person-centred support that reflected their individual needs and preferences. Staff demonstrated a good understanding of people’s needs, personal goals and individual risks. However, opportunities remained to strengthen personalised records. Some daily notes were task-focused and did not consistently capture people’s wellbeing, experiences or personal preferences. In addition, some life history and ‘about me’ information had not been completed. One leader told us they had been working on a new project that would enhance the information gained and held about people. It aimed to change the way information was recorded and reviewed, further evidencing people’s progress and development and capturing their personal history, participation and future aspirations.

Right Support, Right Care, Right Culture is statutory guidance that sets out the standards and principles providers should follow when supporting autistic people and people with a learning disability. We found the provider had embedded these principles within service delivery, and managers and staff consistently demonstrated them in practice. However, staff were not always able to clearly articulate their understanding of the guidance itself.

Staff knew people well and adapted support to help people achieve outcomes that mattered to them. For example, people were supported to access assistive technology, maintain relationships, pursue hobbies and interests, and work towards greater independence. Individual keyworker arrangements helped ensure people’s preferences, goals and family involvement were understood and promoted. Leaders spoke about matching people with staff based on shared interests with one leader commenting, “We look at people’s skills and who they connect with, we wait until they are embedded before assigning keyworkers.”

Staff described supporting people to make decisions, take positive risks and maintain choice and control over their lives. People told us they were involved in decisions about their care. One person told us, “I can make changes any time. They [staff] ask me if I want to change my care plan once a month. One health and social care professional told us they could readily review information, such as when a person first reported pain, the treatment provided, and the outcome of the intervention.

One person had been supported to achieve a position within the organisation, supporting the delivery of learning disability and autism training to staff. This had included support through the interview process and undertaking their training for the role. This meant employees would benefit from training delivered by someone with lived experience and this person could have input into helping staff understand what was important in delivering their care.

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.

Effective systems were in place to promote continuity and integrated care, enabling staff and external professionals to work collaboratively to achieve positive outcomes for people. Relatives told us the service maintained open and transparent communication with them, keeping them informed and engaged. One relative told us, “They text me regarding dental appointments etc. When [person] was taken to hospital they provided continuity of care there.”

Professionals spoke favourably about the service and described successful partnership working, which promoted continuity of care and positive outcomes for people. One professional told us, “It's the best service environment and staff.”

The provider understood the importance of maintaining consistent care arrangements, which provided people with stability, reassurance and positive outcomes. We saw an example where staff had actively sought to maintain a person’s continuity of receiving the care they required. This had involved professionally challenging funding decisions, working collaboratively with other professionals and providing strong advocacy to ensure this person’s needs continued to be met safely in their chosen environment.

The principles of the Accessible Information Standard were not always met as the provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s experiences were mostly positive. One person told us, “The staff talk to you.” However, some people felt communication could be more consistent amongst the staff team. Feedback included comments that staff could communicate better at times or did not always give people their full attention.

A previous quality visit had identified a request for pictorial menus to support choice for people who could not read. This had not yet been acted upon at the time of our assessment.

The provider generally gave people information in ways they could understand and took account of individual communication needs. Communication care plans contained detailed guidance about how people communicated, how staff should interpret responses, and the support required to help people express their wishes and needs. The service also worked with speech and language therapy professionals and produced easy read information and social stories where required.

Staff understood the importance of adapting communication methods to the person. They described using simple language, visual aids, communication devices, providing enough time for responses, and ensuring information was given in accessible formats. One staff member said, “Adapt style of language to the individual’s needs. Face people so they can see your lips. Make sure the environment is quiet, speak slowly and clearly using simple language and short sentences. Be patient. If supporting someone who uses communication aid, give them enough time to use it, don’t jump in, trying to finish their sentences. Ensure you understand what they are saying.”

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 listened to people and created opportunities for them to be involved in decisions about the service. People were able to attend regular resident meetings where they discussed issues important to them, including safety, service improvements and activities. People were involved in choosing potential destinations for whole-home trips and voting on options to ensure everyone could be involved where able.

The service encouraged feedback from people, relatives and staff and reviewed this information to identify actions and improvements. Analysis of stakeholder feedback demonstrated the provider considered what people said and responded to issues raised. The service had received a range of compliments from relatives about the quality of care and support people received and leaders and staff were spoken of in high regard.

People knew how to raise concerns. Easy read complaints information was available and staff told us the complaints procedure was discussed with people. One person told us they had complained previously and the matter had been resolved quickly. Relatives also told us they knew who to contact if they needed to raise concerns commenting, “I know who to complain to if I need to” and “I’ve no complaints, but if I had I would contact the manager.”

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

The provider understood many of the barriers people could face and worked to reduce them. People were supported to access healthcare services, including local GPs, dentists and specialist professionals. The service had established relationships with community healthcare providers, which helped people receive ongoing support and treatment when needed.

Staff took steps to ensure activities and opportunities remained accessible. Where environmental barriers existed, such as the availability of suitable changing facilities during outings, staff researched options in advance and planned support so people could still participate in community activities.

People told us they were supported to access healthcare appointments. Comments included staff helping them arrange appointments and access nursing support when required. One person told us, “If I tell the nurse they make the appointment.” The provider’s approach helped people maintain access to healthcare, community opportunities and services that supported their wellbeing and independence.

Out of hours support was in place for staff should they need to seek advice about a person. The on call support was facilitated by senior leaders across the organisation. The provider’s business continuity plan detailed in an emergency the crisis management team could be contacted. This was a team of senior leaders that would collectively coordinate efforts to manage any significant incidents affecting service provision.

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 worked to ensure people had equitable opportunities to achieve positive outcomes and pursue goals that reflected their individual aspirations. Staff described setting bespoke goals with people and supporting them through keyworker meetings, assistive technology and personalised development plans. The service aimed to promote independence and maximise opportunities rather than simply provide care.

People benefitted from improvements designed to increase inclusion and independence. The premises were accessible for people of all abilities and needs. The kitchen had been recently refurbished to provide more accessibility, creating greater opportunities for people to prepare meals and take part in everyday living activities.

The provider promoted equality, inclusion and participation. Foundation House residents were involved in wider organisational and community initiatives, including contributing to discussions about disability benefits and meeting a government minister. These opportunities helped ensure people’s voices were heard and valued.

Staff spoke positively about equality and inclusion and told us people were treated fairly and supported as individuals. One staff member said, “We don’t discriminate and we are all treated equally, we feel part of a big family.”

People were not always supported to plan for all important life changes, so they could have enough time to make informed decisions about their future, including especially around thinking about future decisions relating to at the end of their life.

People had ReSPECT forms (Recommended Summary Plan for Emergency Care and Treatment) in place. However, records were not all complete.. One staff member said, “I haven't provided end of life care to anyone at Foundation House and honestly, I don't know people's end of life wishes.”

Leaders were mindful this was a sensitive subject and due to some people’s needs, this may be distressing to them. However, they said they would offer this conversation to people and if they did not want to discuss it would record this, and continue the conversation at another time. Staff had been provided with bereavement training so they could understand how best to support people at this time.

Staff worked collaboratively with people in planning future goals, focusing on their aspirations, preferences and any anticipated changes in support needs. People told us and interactions demonstrated people were active agents in making choices and decisions on goals they wanted to do short and longer term. One person told us their future plans included, “Hopefully still living here, volunteering at Star College. National Star is the best place in the world.”