Axis Care Group Ltd

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

This service scored 57 (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. Care records were not consistently person-centred and did not always provide sufficient detail to ensure safe, individualised care.

Providers are expected to follow CQC’s ‘Right support, right care, right culture’ framework. As part of this, CQC encourage services to meet the best practice REACH standards which include principles like choosing where you live and how you are supported. Despite requesting information for the 2 people receiving support from the supported living service, we were not provided with documentation regarding whether people were happy to live alone, whether the person came to choose where they lived, whether people had been involved in the recruitment process, what was in place to minimise loneliness, plans for people to develop friendships and relationships or their health action plan. This lack of documentation risked leaving the person isolated, without a real say in their care, and ultimately could compromise their safety, wellbeing and overall quality of life.

A person’s personal care risk assessment and care plan did not indicate how often the person preferred to have a shower. On a review of January 2026’s daily notes, it was clear the person only had 3 showers; however, they did have 10 strip washes. The daily notes also revealed the person had not been asked to brush their teeth twice a day, despite this being documented in their care record. The person had consistently refused the times when staff had asked but this did not appear this had been escalated.

People’s risk assessments and care plans differed in terms of how person-centred and detailed they were. We observed some good examples, including a person’s communication risk assessment which indicated how specific gestures the person made, meant they needed a drink. This same risk assessment explained the person’s vocalisation patterns and reflected their sensory impairments well. However, other risk assessments and sections of care plans needed more detail. For example, for the same person mentioned above, their personal care risk assessment did not provide sufficient detail for staff on how to support the person effectively in the shower.

Following the inspection, the provider submitted revised care plans and risk assessments which were more detailed and person-centred, demonstrating that action had been taken in response to feedback.

For one person we visited, it was evident they had not participated in many activities since living in their new home and spent much of their day and night asleep. I asked staff about this, and they said the provider had requested more community hours to ensure a safe number of staff can support them when outdoors as they required 2 staff members.

However, staff had a good understanding of the primary diagnoses of the people they supported. A staff member was able to list the key diagnoses of the person; they predominantly supported and was able to explain the treatment for said conditions. Staff were also aware of the signs and symptoms which would indicate a lapse or relapse in their mental or physical health of the people they supported.

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.

People’s homes were located close to their local communities. For example, both people were located closely to large supermarkets and one person lived close to a shopping centre. There were good links to Manchester city centre as there were bus stops and tram stops located nearby.

The nominated individual and registered manager were knowledgeable about people’s health needs and knew which services were available if people required a referral to other services, to address any changes to their needs.

The provider evidenced that people were receiving care from a team of staff which ensured continuity of care. This continuity of care supports safer, more effective, and more compassionate healthcare by ensuring care is connected over time.

The provider had submitted a request to the local authority for more community hours for a person, who had been identified as requiring 2 staff members to support them.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. However, we did see some examples of good practice.

The service user guide which is a key source of information for people who use the service did not describe what services were provided, what services were not provided, how reviews happened and how often. The guide was not tailored to supported living as it did not contain clear explanations about people’s tenancy rights, independence, housing arrangements, and community participation expectations. The name of the registered manager, initially in the document, was incorrect. Some of the wording, such as “delivering skilled care to enable optimum health and wellbeing” was professional but not very service user friendly. There was no information about how personal data was stored, who it was shared with and how someone can access their records. The fees section was brief and did not indicate how invoices were issued. Although the document mentions alternative formats, the layout, length and density of the document may be challenging for autistic people and people with learning disabilities. It is recommended service user guides contain plain language and visual aids for accessibility.

We saw no evidence of documentation, including people’s feedback surveys, being adapted for people to help them read, understand and respond to questions.

The communication needs risk assessments for people using the service were detailed. In one person’s risk assessment it clearly indicated the person’s communication difficulties, the risks associated with the person potentially not being understood, non-verbal cues in which the person communicated by and what verbal cues meant, including them showing excitement or discomfort. The communication needs risk assessment clearly outlined how to reduce the risks associated, including comments around staff tone, the necessity of using gestures and providing one choice at a time.

Leaders ensured reasonable adjustments were made for people whose vocal communication was restricted. For example, staff used a pictorial exchange communication system (PECS) with a person. PECS are a simple way to help someone communicate using pictures instead of speech.

The provider did not always make it easy for people to share feedback and ideas, however people/relatives felt they would feel comfortable raising concerns or complaints.

The provider failed to evidence regular minuted meetings with the person or their representatives regarding their care. Given that people had recently moved into their accommodation, we would have expected regular communications and meetings with them, their relatives or professionals.

The provider evidenced a questionnaire had been sent and completed by one person, but we did not receive evidence anyone else’s feedback had been requested.

However, people/relatives were confident they could raise concerns and complaints, and the provider had a complaints and concerns log which they evidenced appropriate oversight.

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

People were supported to access external healthcare services in a timely manner. This included support to register with GPs and dentists and attend specialist appointments.

Staff had received training in equality, diversity and inclusion and demonstrated a good understanding of promoting people’s rights.

Staff seemed knowledgeable about reasonable adjustments which needed to be made to promote equal access, but this was not documented effectively within care records.

Peoples care was not always tailored for those who are likely to experience inequality in experience and outcomes.

Although, the leaders had a good knowledge of the types of discrimination and inequality people who were accessing the service may face, the care plans did not always detail how people’s health needs presented for them or what adjustments staff needed to make to adapt the care they provided. We did not find evidence of impact, but this meant people could receive care with variable outcomes which could lead to inequalities.

People’s daily notes evidenced disparity in experiences for the 2 people supported. For one person their quality of life and everyday experiences, such as choice of activities, choice of meals and opportunities to go out, fell short of the experience that many people take for granted.

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’s preferences and wishes in relation to end of life care had not been considered or documented within care plans or risk assessments. This meant there was limited evidence to demonstrate how people’s choices would be respected if their needs changed. However, people using the service were newly admitted and were not assessed as being close to the end of their life at the time of the inspection.