Neptune House

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• 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.

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

This service scored 61 (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 all 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.

Care and support plans were in place but were not always up-to-date and clear about people’s care and support needs such as epilepsy, continence and constipation. Some people’s care and support needs had changed significantly. Care plans did not provide staff with the guidance of how to meet people’s care and support needs. People had been involved in developing their care plans in the past and additional easy to read personalised plans were in place. A person said, “I have a care plan I wrote.” However, people had not been supported to achieve their goals and wishes they had identified. For example, a person’s goal was to buy a white dressing table, have a guinea pig and to meet a famous actress. The person told us that none of the goals had been achieved. They told us that the plan was done a long time ago. The person’s wants and wishes had not changed as throughout the assessment they talked about wanting a dressing table.

After the assessment visit the registered managers told us that the person has now purchased a dressing table and explained that care plans were currently being reviewed.

People told us they received care and support with their personal care which met their needs. Relatives confirmed people were supported appropriately with their personal care needs. Comments included, “He can shower whenever he wants to, he is on a 2:1 with all personal care, staff assist accordingly”, “Staff do assist with his personal care, in particular showering, I am not aware of any restrictions as to how often this can happen” and “Staff assist with personal care (in particular showering in the morning). We are aware that she can shower whenever she likes to, and have no issues with staff assisting with this.”

Most relatives told us they had been involved with reviews or care and support. All relatives we spoke with said, they felt reviews were overdue as they had not happened for quite some time.

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.

People had support from staff that they knew well. Agency staffing was not used. People had allocated key workers who took on additional tasks and helped people to fulfil some of their wants and wishes including support to purchase items such as toiletries and maintaining contact with relatives. A relative said, “The relationship with his key worker is very good, although this can change due to different staff coming on board. Staff interaction is very good, always polite and informative, our son often says, “I am happy to live here.” A person told us they really liked their keyworker and they had missed them. Their keyworker had been off work on holiday.

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. A staff member said, “If there was changes in their care, it happened recently; 2 residents on new cream, they go to the doctors, when they get back staff fill out a form, this gets put in the communication book so we all know if there are any changes with their care, we are expected to read this every morning, I just make sure I do it every day.” Staff told us how they supported people and their relatives. Relatives told us they felt staff communicated well with them.

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 communicating with people with speech but also using flash cards, individualised communication systems with people as well as Makaton sign language. If staff did not know a word or sign they spent time to understand what a person was trying to communicate. A person used their mobile phone to look up on the internet what they were trying to communicate and then used this to show staff. We observed that the service had developed ‘Makaton sign of the week’, this helped people and staff practice their signs and use new signs. A person who used Makaton to sign told us they were involved in choosing the sign of the week. They enjoyed doing this.

Relatives told us communication met their loved ones needs. Comments included, “We do have a video call with her most nights, she is non-verbal, so staff do assist her in making this call, and staff do recognise her mannerisms in communication” and “Staff can understand my son and his requirements, he is totally deaf, and staff do read his body language and movements.”

There was easy read signage and way marking around the service to direct and orientate people around the service. People knew their way around their home well.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Although the provider supported people to share feedback and ideas, or raise complaints about their care, treatment and support; people’s feedback was not always acted on.

We observed that people were not always listened to. For example, a person frequently through the assessment visit days asked for a cup with a straw similar to the one that was in the registered manager’s office. The local authority had reported to us that the person had been asking about this cup the week before we visited. The person had not been listened to and had not been supported to purchase a cup. After the assessment the registered managers told us that the person had now been supported to buy the cup.

The provider had systems in place to support people and relatives to express their views. Relatives had been surveyed in 2025 to gain feedback about their loved one’s care and support, all of the feedback was positive. A relative said, “We receive an annual questionnaire asking us for our views and thoughts on the service, we also receive a quarterly newsletter in the post, providing up to date news, details of trips and events, which is very informative.” At the time of the assessment people were being supported to give feedback through surveys, these were in an easy to read format. Staff had also been sent surveys to have opportunities to feedback.

People told us they could complain if they needed to. People said, “If I was unhappy I would talk with [keyworker]” and “She (registered manager) listens to me.” A relative told us they had raised a concern. They explained, “This was rectified very quickly.” Relatives told us, “I have had no cause for complaint, but do believe that the managers would deal with any issues promptly” and “We have no issues or concerns in relation to the service the home provides, if we did we would approach the managers.”

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

There was a clear admissions criteria and people’s needs were assessed before using the service. People would only not be admitted if the provider had assessed that staff did not have the appropriate skills to provide safe care to an individual. There were no vacant rooms and no new admissions had taken place for quite a while.

People were supported with emergency medical appointments and any routine or follow-up appointments that needed to take place. There were processes in place to ensure that people could receive care, support and treatment when they needed it. The service utilised the local GP surgery, hospital or minor injuries unit if they required it.

We observed interactions between staff and people during our visit. We mainly saw safe practice whilst enabling people to maintain their routines and come and go around the service as they wanted. Some people were able to move about the home independently; some people used the stairlifts to move between floors in one part of the home. There was no passenger lift in the service.

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 were made aware of the provider’s equality and diversity policy at induction. The management team were 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. Despite the provider and management team being aware of the guidance, we observed the principles of the guidance were not fully embedded into practice within the service. For example, the language and terminology in care and support plans did not always shows that people had been treated with dignity and respect.

Each person had a Neptune Promise agreement. This detailed ‘The promises we both make to build a better life for you’. These were signed by people if they had understood and had capacity.

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.

A person had a funeral plan in place, this had been put in place with them and their relatives. No other work had been undertaken to discuss and document people’s future wishes in relation to future care and support should they become unwell or be at the end of their life. The age range of people living at Neptune House ranged from young adults to older people who were in their 70’s. We discussed this with the registered managers at the time of the assessment and shared some guidance and support with them. After the assessment the registered managers fed back that they had now started to work on this delicate subject. They were seeking support and guidance from the community learning disability team to help them.