Atholl 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 requires improvement. At this assessment the rating has changed to good.

The provider was previously in breach of the legal regulation in relation to person centredcare. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.

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.

The provider developed personalised care and support plans that reflected people’s views, preferences, routines, communication needs, strengths, and abilities, with easy‑read and accessible formats used where required to support involvement. A relative said, “They do the best they can for her… they work within the care plan.”

The provider reviewed and adapted care in response to changes in people’s needs, including health, mobility, and wellbeing. Staff worked in partnership with people and, where appropriate, families and professionals to agree how support should change. This supported people to remain in control of decisions about their care, maintain independence and confidence, and receive support that responded to what mattered to them as individuals within an extra care setting.

The provider understood the diverse health and care needs of people and their local communities, so care was flexible and supported choice and continuity.

The provider shared information about people’s needs through personalised care plans, risk assessments, health action plans, and hospital passports, which supported continuity when people experienced changes such as hospital admissions or increased health risks. Where people had needs outside the provider’s direct remit, staff adapted their support and worked with healthcare professionals, families, and housing partners to escalate concerns and coordinate responses.

Leaders told us they worked with partner agencies and escalated concerns when people’s needs fell outside the provider’s direct remit. However, people’s experiences and relative feedback showed that care was not always consistently joined‑up between services, with some gaps in communication and coordination between health, social care, and housing partners. As a result, while partnership working supported people on an individual basis, continuity of care sometimes relied on individual or family advocacy rather than fully seamless integration between services. A relative told us, “The issues are what happens in between the different services… that’s where issues arise.”

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

The provider presented support plans, risk assessments and records in ways that reflected people’s communication needs, including the use of easy‑read formats, visual prompts, and preferred‑language materials for people with learning disabilities.

We saw communication tools within care records that helped staff explain information clearly, check understanding and involve people in decisions about their care and risks.

This helped ensure people could understand information that affected them, participate meaningfully in decisions, and exercise choice and control in ways that reflected their individual needs and abilities.

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 had arrangements in place to support people and relatives to share their views and be involved, including tenant‑led meetings, direct access to staff and managers, and responsive handling of day‑to‑day requests.

People shared positive feedback about staff support, activities and responsiveness, and there was evidence that people’s views influenced aspects of daily life and engagement within the service.

Relatives described differing experiences. Front‑line staff were consistently responsive and supportive, while involvement and communication from management were more variable.

Overall, this showed that the provider listened to and involved people effectively at an individual level, although greater consistency in management communication and proactive engagement would strengthen this further across the service.

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

The provider supported people with a range of needs, including learning disabilities and multiple health needs, to access personal care and healthcare services, and did not restrict access based on disability, communication needs or level of support required. The provider identified and responded to barriers to access through reasonable adjustments, including accessible information, preferred‑language materials, communication guidance and the use of hospital passports and health action plans to support access to health services. This helped ensure people were able to access care and treatment equitably and in a way that met their individual needs. However, at times people needed to chase things themselves to get extra support or clear answers, rather than this happening automatically.

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.

Staff supported people with learning disabilities and multiple needs to access person‑centred care, activities and community engagement, and individual adjustments were made to support inclusion and wellbeing.

However, the provider did not consistently analyse or monitor differences in experience or outcomes, and relative feedback indicated that positive outcomes were sometimes reliant on individual family advocacy rather than equitable, system‑led approaches. As a result, while people could experience good outcomes, the provider did not always demonstrate assurance that experiences and outcomes were consistently equitable for all people using the service.

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.

The provider had some elements of future planning in place, including health action plans, hospital passports, and Mental Capacity Act assessments, which supported decision‑making where people experienced changes in health or care needs.

However, the provider did not consistently demonstrate a proactive or structured approach to planning ahead for significant life changes, including future health deterioration or end‑of‑life wishes, and it was not always clear that people were supported to revisit these discussions over time or in different ways where they were initially reluctant. As a result, future planning tended to be reactive to events rather than anticipatory, which limited assurance that people were always given sufficient time and support to make informed choices about their future care and treatment.