South Street

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 good. At this assessment the rating has changed to 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, to decide how to respond to any relevant changes in people’s needs. Relatives did not feel people’s individual preferences were considered when activities were planned and people did not always have enough opportunities to go out with them expressing to their relatives, they were sometimes bored. Staff were mostly able to describe how people’s individual needs should be met. However, our observations and checks on daily records showed these plans were not consistently followed by staff. This meant people were not always receiving the person-centred care they needed. However, people told us they had support to maintain relationships which were important to them and did things during the week which they enjoyed as a group such as going to a local centre. We saw people’s bedrooms were personalised and care plans gave information about individual needs and preferences.

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. People did not always have continuity in their care and support. The lack of staff available, the use of agency staff and the conflicting information in peoples care plans meant people sometimes did not receive the support they needed. Staff were also not following not following the care plans in place to support people with their assessed needs, for example not providing the correct diet indicated in a person’s food and drinks care plans which meant they did not receive continuity of care. However, the provider had worked with local commissioners, and no concerns were identified by partners about the service.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People had their communication needs assessed, and plans were in place to guide staff in how to ensure people received information in a format they could understand. Staff were able to describe how they communicated with people effectively and staff were observed using the information they had to engage people effectively. The provider had systems in place to make information available in different formats. For example, easy read information was available, and images were used to aid understanding.

The provider did not always respond and act when concerns were raised about the service. A relative told us they had raised concerns multiple times over a 3-year period about the lack of opportunities for a person to continue with their hobbies and pastimes once they came into the service. However, effective action had not yet been taken to enable the person to do the things they enjoyed. Whilst the relative had not raised a complaint, they had raised these concerns with the manager and whilst they received a response, this was still not resolved. This meant improvements were needed to ensure learning was applied and effective actions were taken when concerns were raised about peoples care and support. However, there was a complaints policy in place, and the provider had a system to respond to formal concerns raised.

The provider made sure that people could access the care, support and treatment they needed when they needed it. Some people were not consistently enabled to access the community at a time of their choosing, to enjoy things that mattered to them. A relative told us, “I worry that on a weekend he is bored and I get the feeling he wants to do something, that would be an ideal time to take [person’s name] to [enjoy their preferred pastime]. When they first went in, we were promised allocated extra time to do this. I did sign up for regular payment for the activity, but they weren’t taking [person’s name] they have plenty of money for their activities. The only barrier is staffing.” Improvements were needed to ensure enough resources were available to support people to access the things they enjoyed and be a part of the local community. However, some people described being supported to do some of the things they enjoyed in the local community as part of a group. A person told us, “I love going there [a local centre] and playing bingo. I buy clothes from the centre and go with [person’s name] and [person’s name] with the staff.” We saw the provider had systems in place to ensure people had access to health care. Forn example, hospital passports were in place to ensure people received the support they needed when accessing hospital-based services.

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. People had mixed experiences with outcomes as there was insufficient staff to ensure people had equity in their experience. Where people were able to go out as a group with minimal staff support, they enjoyed the things they did and achieved positive outcomes. Where people needed individual support from staff to be enabled to go out, they were often left unable to do things they enjoyed. For example, we saw a person asking to go out in the morning of the inspection. The person remained in the service until staff were available during the late afternoon to go out. We saw this meant the person became distressed. Relatives told us people who needed support to go out were often unable to and they felt people were bored and left in the service. Whilst people had outcomes care plans where they had agreed things they wanted to achieve and goals in place to achieve them, improvements were needed to ensure people had equity in their experiences and the support they received for meeting their desired outcomes.

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. Nobody was receiving end of life care at the time of the inspection. However, people had their future wishes considered. Relatives confirmed they had been involved in these plans. We saw people had end of life and future wishes care plans in place where this was appropriate. The plans considered individual preferences for where people would receive care and the support they wanted at the end of their life. The plans were individual and where people expressed they wished to discuss this later, this was respected.