The Old Red Lion

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 outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 93 (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 demonstrated outstanding practice in delivering truly person‑centred care. Staff had an exceptional understanding of how autistic people often rely on routines and predictable timing to reduce anxiety, support sensory regulation and make the world feel more manageable. They recognised that when routines were disrupted, this could create significant cognitive and emotional stress. The registered manager and staff team understood this deeply but also knew how to gently guide and support people to expand their routines in ways that felt safe, empowering and meaningful.

One excellent example was a person who previously only felt able to be away from the home for a very limited and predictable period of time. Staff worked patiently and consistently with them, using gradual exposure, reassurance and personalised planning. As a result, the person recently achieved their goal of spending six hours at a zoo, an achievement that represented a significant increase in confidence, independence and emotional resilience. Staff told us they were now supporting the person to build on this success at a pace that suited them.

Staff spoke passionately about the importance of recognising and valuing every individual goal. One staff member said, “Every goal someone has is important whether that’s tying their shoelace or going out for a meal, and we are given the time, support and funding to really help people achieve these.” This reflected a culture where progress was defined by the person, not by organisational expectations.

Professionals also recognised the strength of the service’s person‑centred approach. One professional told us, “I was an advocate for [name], however the staff know them so well and advocate for them so well they no longer need my services as much. This is always the desired outcome.” This demonstrated how staff’s deep understanding of people’s needs, communication styles and aspirations enabled them to champion individuals effectively and consistently.

The provider demonstrated outstanding practice in ensuring people received seamless, well‑coordinated and highly personalised care. Leaders and staff consistently advocated for people to access the funding, support and opportunities available to them, ensuring no one was disadvantaged or left without the resources they needed to live full and meaningful lives.

Staff worked proactively with external professionals and funding bodies to secure additional support for individuals. This included 4 people being supported to access funding for cars, enabling them to travel independently, pursue hobbies and expand their community involvement. Others were supported to access funding for education and night classes, opening up new learning opportunities and supporting personal development. These achievements reflected a strong culture of advocacy, ambition and belief in people’s potential.

The service also went above and beyond to help people access essential services they had previously feared or avoided. Staff invested time in preparing people gradually and sensitively, ensuring they felt safe and confident before attending appointments. This included supporting people to access sexual education, hairdressing services, dentists and chiropodists—services that had once caused significant anxiety. Staff used personalised strategies such as pre‑visits, visual tools, desensitisation sessions and consistent reassurance to build trust and familiarity. As a result, people successfully accessed services that were important for their health, wellbeing and self‑esteem.

Throughout the assessment, it was clear that care provision was integrated, continuous and centred around what mattered most to each person. Staff communicated effectively with external partners, shared learning across the team and ensured people experienced consistent support regardless of who was on shift.

The provider demonstrated exceptional commitment to delivering coordinated, proactive and empowering care. Their determination to remove barriers, advocate for people and tailor support to individual needs resulted in outstanding outcomes and significantly enhanced quality of life for the people living at the service.

The provider was exceptional at developing appropriate, accurate and up‑to‑date information in formats that were tailored to individual needs. During the assessment, we saw highly personalised approaches that ensured people could understand the information shared with them and make informed choices about their care, routines and future plans.

Staff used a range of communication methods to support people, including easy‑read documents, symbols, photographs, gestures and personalised communication tools. Key worker meetings were delivered in easy‑read formats, enabling people to follow discussions at their own pace. Staff also adapted their communication to match each person’s preferred style, using body language, signing, objects of reference or visual prompts to ensure information was meaningful and accessible.

Records showed how staff carefully documented people’s responses, including their gestures, facial expressions and body language, to evidence that information had been understood. This level of detail demonstrated a deep respect for each person’s communication style and ensured their views were accurately captured and acted upon.

Information was kept up to date and reviewed regularly, ensuring people always had access to clear, relevant and personalised guidance. This approach empowered people to participate fully in decisions about their care and promoted independence, confidence and choice.

Overall, the provider demonstrated outstanding practice in providing information. Their commitment to tailoring communication to each individual ensured people were genuinely informed, involved and able to shape their own support in ways that reflected their preferences and needs.

During the assessment, staff demonstrated an exceptional commitment to truly listening to people and involving them meaningfully in all aspects of their care. Staff took time to understand each person’s unique communication methods, including body language, gestures, facial expressions and individual communication aids. They also invested in learning about people’s life histories, preferences and routines, which enabled them to interpret subtle cues and respond to people’s needs, wants and aims with accuracy and sensitivity.

This deep understanding of each person’s communication style meant staff were able to recognise and act on people’s wishes, even when these were expressed non‑verbally. For example, one person had shown interest in trying Chinese food, and staff supported them to explore different dishes in a way that felt safe and enjoyable. Another person expressed through gestures and excitement that they wished to start swimming sessions, and staff worked with them to build confidence, plan visits and ensure the activity became a positive and regular part of their routine.

Relatives also told us they felt fully involved and listened to. One relative said, “Staff really do listen and want feedback. I call and update them about what we have done as a family during home leave, and we update [internal social media], which makes sure [name] always gets consistent care and any changes or concerns are spotted early.” This demonstrated a strong culture of partnership, where families were seen as experts in their loved one’s lives and their insights were valued.

Staff used all available information whether, verbal, non‑verbal or from relatives to ensure people’s care remained consistent, personalised and aligned with what mattered most to them. This approach strengthened trust, promoted independence and ensured people were active partners in shaping their own support.

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it. Care which was planned and delivered was highly proactive and a person‑centred approach that removed barriers, reduced anxiety and ensured people were fully included in opportunities that promoted their wellbeing, independence and quality of life.

People were supported to access education, day centre facilities and medical appointments in ways that felt safe, predictable and tailored to their individual needs. Staff invested significant time in preparing people for new environments or unfamiliar services. This included visiting settings with people in advance, gradually increasing the length of each visit and allowing individuals to explore at their own pace. These carefully planned introductions meant people were familiar with the surroundings, routines and staff before they needed to attend, reducing fear and building confidence.

This approach was particularly effective for people who had previously experienced anxiety or distress when accessing external services. Staff understood the importance of reducing uncertainty and used consistent reassurance, visual tools and personalised routines to help people feel secure. As a result, people were able to attend education sessions, day opportunities and health appointments with greater independence and comfort.

Where people were unable to access community‑based services safely, the provider took additional steps to ensure their needs were still met. For example, when attending a dental appointment would have caused significant distress, the provider sourced a dentist who could visit the home. This ensured the person received essential healthcare without unnecessary anxiety or disruption.

The provider demonstrated an outstanding commitment to equity in access. By anticipating barriers, adapting support and seeking creative solutions, staff ensured every person could receive the care, opportunities and experiences they needed to thrive.

Staff and leaders actively listened to information about people who were most likely to experience inequality in their experience or outcomes and tailored their care, support and treatment in response to this. During the assessment, we saw a strong commitment to ensuring every person had equitable opportunities to progress, participate and achieve their goals, regardless of their starting point or level of need.

Staff demonstrated a deep understanding of the individual factors that could place people at risk of unequal outcomes, such as communication barriers, sensory needs, past trauma or reduced confidence in decision‑making. They used this insight to adapt their approaches, remove obstacles and ensure people received support that was fair, personalised and empowering.

The registered manager described this ethos clearly, saying, “We consistently ensure everyone makes progress towards their goals. There isn’t a barrier we haven’t managed to overcome.” This mindset was reflected in practice. Staff worked creatively and collaboratively to ensure people had the same opportunities as others—whether this involved adapting communication tools, adjusting routines, increasing staffing support or introducing new sensory or behavioural strategies.

Leaders monitored outcomes closely to identify any emerging inequalities and acted quickly to address them. Staff shared learning across the team to ensure successful approaches were applied consistently, and people benefited from support that was responsive to their individual needs and aspirations.

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. During the assessment, we found that many people and relatives were initially reluctant to discuss end‑of‑life care. Despite this, the registered manager and staff approached these conversations sensitively, respectfully and at a pace that felt comfortable for each individual.

Staff ensured that people’s wishes were clearly documented, even when they preferred not to engage in detailed discussions about end‑of‑life planning. This included recording how people wished to be supported during periods of illness or in the event of an emergency. Staff used their knowledge of people’s communication styles, preferences and personal histories to capture what mattered most to them in a way that felt safe and non‑intrusive.

The registered manager promoted a culture where planning for the future was seen as an important part of personalised care, not a task to be avoided. Staff were supported to develop the confidence and skills needed to approach sensitive topics with empathy and clarity. As a result, people had plans in place that reflected their values, protected their rights and ensured their care would remain aligned with their wishes during times of uncertainty.