Longlast

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 outstanding. At this assessment the rating has remained 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 89 (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 their needs. People were involved in planning and reviewing their support using accessible approaches.

Staff knew people exceptionally well and adapted support to help them achieve outcomes that mattered to them. For example, one person was supported to return to horse riding through a gradual, personalised approach. Another was supported to develop a relationship and spend time with their loved one outside the home. Due to the complexity of people’s needs, even minor changes to some people’s routines required meticulous planning, repeated reassurance and encouragement from staff. We observed staff doing this routinely and with affection.

Staff used a desensitisation approach to help people achieve goals such as holidays and new experiences. They talked through plans, used photographs and websites, and gradually built people's confidence. One person, who had not been on holiday for several years, was supported to take longer journeys over time and was eventually able to go on holiday. Staff recognised that past challenges should not limit future opportunities and focused on what people could achieve currently.

People were also supported to achieve goals linked to community participation and independent living skills, with progress regularly reviewed through keyworker meetings and outcome tracking.

Professionals spoke highly of the care provided. One told us, "They [staff] built a great understanding of the best ways to support [person] and took the time with her to find out what is important to her and the things she likes." Another said, “They worked in a very person-centred way which I identified in the training and during my observation”, and "I have observed some behaviours that challenge being handled exceptionally well by the care team. It is very obvious that all staff know the residents very well."

We saw people making choices throughout the inspection. People chose drinks using pictorial resources, while others were involved in shopping, meal preparation and household tasks. This demonstrated a strong person-centred culture where people were listened to, respected and supported to achieve what was important to them.

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. Records evidenced effective partnership working with GPs, social workers, speech and language therapists, occupational therapists, physiotherapists and learning disability teams. People had health action plans, hospital passports and accessible information to support continuity between services. Staff shared information appropriately and implemented professional advice into care planning and day-to-day support

A professional told us staff were, "Always knowledgeable about the people they care for. They are attentive and caring towards residents. They are collaborative and responsive to queries and requests."

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The provider ensured people received information in ways they could understand. Leaders developed a wide range of easy-read resources covering topics such as fire safety, handwashing, healthcare appointments, screening programmes, complaints procedures, safeguarding, food choices and daily living skills. Information was tailored to individual communication needs and reviewed regularly.

Where people found fire alarms distressing staff created easy-read guides and supported them to understand fire safety procedures, helping them become confident in participating in fire safety checks. One person expressed how proud they were when they had successfully completed fire checks. Staff were also looking to develop accessible guides for voting, so that people could better understand the offer from the different candidates and vote in a more informed way.

People were supported through a variety of communication methods including Makaton, social stories, hospital passports and health action plans. Staff received communication training and most staff had completed Makaton training. Staff learnt people’s unique method of signing and had access to a Makaton dictionary which they used on a frequent basis to refresh or expand their signing vocabulary.

The service demonstrated innovative approaches to helping people understand information and participate in decisions. For example, meetings and decision-making discussions were recorded and linked to password-protected QR codes so people could revisit information and demonstrate their involvement in decisions about their lives.

The provider understood the Accessible Information Standard and offered information in further formats, such as other languages, if these were required.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result. People were actively involved in decisions about their home, support and daily lives. Monthly resident meetings, keyworker reviews, surveys, decision-making records and informal discussions gave people regular opportunities to share their views and make choices. Feedback was acted on and used to improve people's experiences.

People made decisions about activities, menus, holidays, household routines and the environment they lived in. For example, residents voted on wallpaper choices when a lounge was redecorated and chose topics for discussion during meetings. People were also involved in recruiting new staff, helping to develop interview questions or taking part in interviews. They also had a say in which staff supported them with different activities.

Staff were skilled at ensuring everyone could take part in decisions. Staff tailored communication styles and enabled people to give feedback at a time and pace that suited them. Decision-making was a two-way process, with people, relatives and staff discussing options together. QR-coded recordings of discussions helped people remember conversations, track outcomes and share information with professionals.

Relatives gave positive feedback about how people were listened to. One relative said, "They have house meetings; they chose what to do." Another told us, "They ask [person] what she likes. They are very good at communicating."

The service was responsive to feedback and committed to continual improvement. Although there had been no recent formal complaints, feedback from people, relatives, staff and professionals was used to improve practice. People were supported to raise concerns through accessible complaints and safeguarding information. Learning from incidents and feedback was shared with staff, leading to improvements, including strengthened medicines and reporting processes.

Innovative approaches further promoted involvement and transparency. Relatives had access to a secure online portal containing photographs, daily updates and information about activities, helping them stay connected to their family member's life. These approaches showed people were genuinely listened to, their views mattered and they were supported to achieve the things that were important to them.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The provider recognised and responded to barriers that could affect people's access to services and opportunities. Staff advocated for people when local services were not readily available and challenged age-related restrictions that limited access to community services such as falls support.

People were supported to access healthcare appointments, health screening programmes, places of worship, community activities and specialist services. Accessible information, communication support and staff advocacy helped ensure people could access services in a way that met their needs.

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. The provider worked to ensure people had equitable opportunities to experience meaningful activities, develop skills and achieve outcomes that reflected their preferences and interests. People were supported to participate in community life, maintain relationships, practise faith and access activities based on their individual interests and goals.

Staff adapted support according to individual needs and preferences.The provider celebrated diversity and inclusion through activities linked to culture, religion and LGBTQ+ awareness and worked to ensure people received opportunities that were meaningful to them.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life. Care records included detailed information about future wishes, changing needs, important relationships, decision-making arrangements and plans for periods of ill health. Staff considered people's long-term goals and worked with them to achieve outcomes that improved their quality of life and independence. Examples included supporting people to return to activities they valued, planning holidays after long periods without travel, preparing people for significant life events and maintaining important relationships. Outcome records demonstrated that goals were monitored, reviewed and progressed over time. This reflected how people were supported to plan for and achieve outcomes that were important to them.

Staff helped people plan around ill health and respected their wishes if they wanted to be cared for at the home. For one person this meant adapting staff training to accommodate the person’s increased moving and handling needs. Planning was done in conjunction with professionals and family. Outcomes for this person were positive, staff compliance with instruction and the person’s swift recovery were praised by a professional involved.

The service demonstrated a particularly compassionate and person-centred approach to end-of-life care and bereavement support. Staff worked closely with one person and their family during a period of deteriorating health, maintaining regular contact and providing support both within the service and during the person’s hospital admission. Staff showed a strong commitment to ensuring continuity of care and undertook additional training and responsibilities to enable the person to return to the home for end-of-life care, reflecting the wishes of the person, their family, other people using the service and staff members.

The provider took a thoughtful and inclusive approach to supporting other people living in the home, helping them to understand and prepare for the person's declining health and subsequent death. Following the person's death, staff supported people to attend the funeral where appropriate and helped them process their bereavement in ways that reflected their individual needs, preferences and level of understanding.

Staff also continued to provide support to the person's family. With the family's permission, staff delivered a eulogy at the funeral and maintained contact with relatives during the bereavement period. This demonstrated a caring culture that extended beyond the delivery of care and reflected the strong relationships staff had developed with people and those important to them.In a letter to the provider, a relative wrote, “I will always remember fondly the attention, care and love from all the care providers. I am truly grateful.” This feedback reflected the positive impact the staff team had on both the person and their family during a significant and emotionally challenging period.