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 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 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 data was recorded and reviewed, further evidencing people’s progress and development and capturing their personal history, participation and future aspirations.

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. Care plans took account of people’s emotional wellbeing and to offer familiar staff support, so people felt comfortable to talk if they wanted.

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.

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.

At times there was a lack of recognition by staff to recognise and separate the home care part of the service from the care home. One person explained they had experienced staff saying during care provision that was how it was undertaken in the care home or staff may run late as they were supporting someone in the care home. This person told us, “Time management can be hard as staff working around the care home and sometimes care is delayed.” This person went on to say however, this had never left them feeling in an unsafe position. We followed this up with leaders to discuss supporting staff to understand the home care was not an extension of the care home but a separate provision.

The provider understood the importance of maintaining consistent care arrangements, which provided people with stability, reassurance and positive outcomes. The provider worked alongside people and their families to include health and social care partners in on-going care and support, and care plans contained details of people’s health conditions. Professionals spoke favourably about the service and described successful partnership working, which promoted continuity of care and positive outcomes for people.

Although the provider mostly met the principles of the Accessible Information Standard as they had identified communication needs, and provided appropriate communication materials, including easy read documentation, people told us staff communication was not always effective.

People were mostly complimentary of the staff however; it was raised that communication could be more consistent amongst the staff team. One person said, “With some [staff] there is a communication barrier.” We shared this feedback with leaders to take forward.

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.

Staff we spoke with 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. 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.

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, “I know how to raise a complaint, and they know I’m not frightened to do this.” This person knew all the leaders by their name and told us they could speak to them at any time.
 

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. One person told us they were supported on trips they chose to make and were able to request particular staff they preferred to be supported by at these times.

Out of hours management 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 that in the event of 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 that could affect core service provision. One person told us they could reach staff in times outside of their care delivery commenting, “Here they know me and are here 24/7.”

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. The service aimed to promote independence and maximise opportunities rather than simply provide care. One person told us, “The service is flexible to my care needs.

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 important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People had ReSPECT forms (Recommended Summary Plan for Emergency Care and Treatment). However, information about the individual care and support and wishes people may have if they became poorly or were nearing the end stages of their life, had not been obtained or recorded and this part of the care plan was incomplete.

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, they would record this, and continue to revisit 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.