United Support Services

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 good. This meant people’s needs were met through good organisation and delivery.
 

This service scored 82 (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 was exceptional at making 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.

Care was person-centred and staff were flexible in their approach. This meant they were able to adapt their approaches in the moment to help ensure meaningful outcomes. As a result people’s experiences had widened and they had more control over their daily lives. An external professional commented, “There was evidence of a genuine person-centred culture, with people being viewed as individuals with their own aspirations rather than simply in terms of their care needs or diagnoses.”
Staff told us they were focused on supporting people to develop their independence in all areas of their lives. This included practical independent living skills, choice and decision making and being part of their local community.
Staff described how important it was to people that they had ownership of their personal spaces. Comments included, “This is [Name’s] home and everybody respects that” and “Staff don't put their belongings in the flat it's most definitely their own home.” The registered manager told us staff had morning ‘huddles’ to plan the day using an app on their phones. They explained, “Staff can do it from their car before they go into the home, making sure no-one is encroaching on people’s space.”
The service was creative when supporting people to make meaningful choices. One person had difficulties expressing where they wanted to go. Staff had provided them with a model train with various stops on the tracks which represented places the person had visited. The person was starting to use this to indicate where they wanted to go. Staff were gradually introducing more ‘stops’ to widen their opportunities.
The service took a holistic approach to care. Staff worked with people to try and understand their needs and take action to improve outcomes. For example, 1 person’s actions could be detrimental to their health. This had been identified as a behavioural issue and ‘just what they did.’ The deputy manager had carefully monitored when the behaviour happened. They had subsequently introduced changes to routines, continually monitoring the impact, using observation and recording to adapt how support was provided. This approach led to a reduction in the behaviour. Staff continue to monitor and review. An internal document created to evaluate the success stated the work had ‘created a culture where staff ask ‘why?’ rather than accepting ‘[Name’s] always done it’.’

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.

Staff understood the different health and social needs of the people they supported. They used this knowledge to tailor care and respond to the person’s needs. Staff worked closely with relatives and other services and shared information appropriately so care could be delivered in a consistent way.
People were familiar with the local community. One person attended church regularly as this was important to them.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff used pictures, easy read information and objects of reference to support people’s understanding. A member of staff had a lanyard with several basic pictures on it to support people with some daily decisions. Monthly reviews were recorded with the use of pictures so they were available as a tool to talk with people about what they had achieved over the month.

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.

There was a clear focus on putting people at the centre of their care. Records such as daily records, forms used to record behaviour and incident reports were regularly reviewed to identify if the people were settled and happy.
Relatives and friends had frequent contact with the service, visiting and phoning regularly.

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

The service worked with other health care agencies to make sure people had access to external care and support as needed. People sometimes found attending health appointments stressful and staff worked with them to overcome this. For example, one person had been provided with a story book about visiting the dentist. Staff had encouraged them to use a reclining armchair and used mirrors to prepare them for the experience. They had given them a photo of the dentist and, at the initial visit, had agreed with the dentist to have examinations standing up. This had been successful and, over time, they had also started attending GP appointments. If, at any time, the person had become upset staff would tell them, “That’s fine, you are in control, we can go.” The person was now able to have regular health screenings, including blood tests.

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.

Staff did not assume any health issues were directly related to people’s learning disability or autism. They understood the additional barriers people might face during their lives and were alert to any factors which could impact on them.
 

People were 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.

Future planning focused on building people’s independence and broadening their experiences. No work had been completed on end of life care planning. The registered manager agreed this was an area they would explore.