Dickley Court

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 required improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

This service scored 62 (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

and they did not always work in partnership with people, to decide how to respond to

any relevant changes in people’s needs.

Care plans were not always detailed in relation to people’s care and support needs. For example, some care plans mentioned people lived with epilepsy but there was no information about how this impacted the person, how it was managed and what staff should do if the person had a seizure. There was no information about the types of seizures the person had. This meant staff did not have all the information they needed to provide care and support. Support plans for people who used hearing aids did not detail whether people could manage battery changes themselves or whether they needed staff support with this. There was no guidance for staff to detail how often the batteries should be checked/changed. A person’s care plan did not provide guidance for staff on how to support them when they were agitated, distressed and unsettled or challenging towards others. People’s care plans did not include goals and aspirations for people.

Care plans included individual preferences, likes, dislikes and favoured routines. For example, they detailed if people preferred baths or showers. Care plans were clear about oral care people needed. People told us, “I clean my teeth myself morning and night” and “I shower what I can, and they help me with the bits I can’t reach. I use [shampoo] on my hair and I do that myself.”

Relatives told us they had been involved with their loved ones in developing and reviewing care plans. Comments included, “They involve [person] with his care plans, he uses a voice machine. I do get invited to reviews” and “She is involved in reviews and so am I.”

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.

Information was shared with staff during handover regarding any changes to people’s health or care needs. The service worked with other health professionals involved in people’s care. Staff told us how they supported people. Relatives told us, they felt staff communicated well with them. Comments included, “They keep me in the loop, and they are good at communicating” and “They are very good at communicating.”

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

We observed communication was tailored to meet people’s needs. There were easy read documents in place if anyone needed them. We observed staff effectively communicating with people and supporting people to communicate with us. However, staff reported some people used Makaton sign language to communicate. Some staff reported they would benefit from Makaton training to help them support people more effectively as they had not received any training. A relative said, “Some staff struggle to understand what she is saying, and they don’t know the Makaton signs. [Person] can write her own conversation down on her own iPad.” A member of the management team told us that they are trying to resolve this for the person. They said, “We are communicating with SaLT (speech and language therapy) about a communication aid, she gets frustrated when staff don’t understand her.”

Other relatives told us communication met their loved ones needs. A relative said, “He has communication needs. He has not become dysregulated (out of sync) for years. Symbol have lots of insight, they have done very well. He's calm, he’s learnt to adapt, his language is improving all the time.”

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.

We observed good practice from staff in relation to listening and involving people with their care and making decisions. The registered manager told us that people gave feedback about their care and support during house meetings which took place regularly. A staff member told us, “We have a house meeting with clients every month, where we discuss outings, maintenance and to check if they are happy with their care and support.” A relative said, “Home meetings happen where they sit round and discuss things they would like.”

Relatives were provided with information about a homecare website which they could leave feedback and make comments about the service. Comments made on here included, ‘My cousin moved into supported living with Symbol, under the care of [registered manager] and her fantastic team. The change in him is just amazing, he settled in so well with their support and kindness’ and ‘Our son has just moved into supported living with Symbol in Kent after having a poor experience with another provider. [Registered manager] and her team are exceptional providing supported living how it should be done. Our son has gone from being depressed and unmotivated to smiling once again and eager to try new things. His self-esteem has improved and the team have been 110% dedicated.’

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

There was a clear access criteria for supported living and people’s needs were assessed before using the service. People would only not move to a supported living property if the provider had assessed that staff did not have the appropriate skills to provide safe care to an individual and if other tenants were not in agreement.

People were supported with emergency medical appointments and any routine or follow-up appointments that they required.

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 were made aware of the provider’s equality and diversity policy at induction. The management team were not aware of Right support, right care, right culture (RSRCRC). This applies to services for people with autism or people with a learning disability to ensure they receive the respect, equality, dignity, choices, independence and good access to local amenities that most people take for granted. We shared the guidance to RSRCRC with the management team to enable them to develop care plans further. However, people using the service were treated with respect, their choices and independence was promoted.

The provider’s website states, ‘We wholly subscribe to the nationally recognised Reach Standards for Supported Living, working at all times to progress the quality of what we do in line with these (I chose who I live with, I choose where I live, I have my own home, I chose how I am supported, I choose who supports me, I get good support, I choose my friends and relationships, I choose how to be healthy and safe, I choose how I am part of the community, I have the same rights and responsibilities as other citizens, I get help to make changes in my life).’ We observed that the providers aims for the service were being met.

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.

Discussions had not always taken place with people and their family members about the type of support they would like in the future including if and when they became unwell or at the end of their lives.However, a person was receiving treatment for a life limiting illness, the registered manager told us the service was working with the hospice in relation to care, support and treatment regarding the person. The registered manager also shared that the staff at 1 supported living house had been working with the community learning disability team to support a group of people who were older people with learning disabilities.

People were supported with important life changes. People were supported to plan for other future events. A person was working towards moving to a different supported living house. A relative commented that their loved one enjoyed going on holiday and that staff equally enjoyed the experience.