55 Sandwich Road

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 remained Good. This meant people’s needs were met through good organisation and delivery.

This service scored 82 (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 made 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 people’s needs.

People had detailed care plans that reflected their physical and social needs and wishes and were clearly understood by the staff who supported them. These were regularly reviewed alongside people and their representatives. They were closely linked to people’s goals and ambitions, which set out clear actions of how people could be supported to have the best possible quality of life. One person was known to become significantly distressed by shoelaces, however their staff worked with them to reduce this sensitivity which in turn would allow them to visit locations where there would be more people. Some staff were now able to wear laced up shoes again which demonstrated the significant progress that had been made.

The provider had a good understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People were supported by a small and consistent team of staff who knew them exceptionally well and had a clear understanding of how to support them safely. We identified the service had a stable staffing team, who were occasionally supported by staff from a neighbouring service who also knew them well. This meant people received continuity and consistency in their care at all times.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff were knowledgeable about how to communicate with people in a way that was accessible, and how people may express that they were happy or unhappy. This included use of structured tools to assess if a person might be in pain or uncomfortable. ‘Easy Read’ information was available on a wide range of topics including safeguarding, advocacy and the role of CQC. Easy Read is a form of written communication using plain English and pictures to communicate information in a way that is accessible and easy to understand. Staff had received appropriate training in how to communicate with people, and how people’s body language or facial expressions may reflect a support need.

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.

There were regular opportunities for people and their loved ones to be involved in their own care, to ensure it was shaped around their wishes and preferences. People had monthly meetings called ‘My Meetings’ with their key workers. Although people could not communicate verbally, staff described how they would support people in making choices about their own care using visual aids. For example, staff were working with them to arrange holidays and described how they would show them pictures of potential destinations using their body language and visual expressions to gauge their reactions. This supported people to be included in the process and give an opportunity to communicate their preferences. There were regular reviews of people’s care involving their representatives, and surveys to give them a chance to share feedback. One relative told us, “We have regular weekly calls. They do send me a survey asking how things are going, but they always put people first.”

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

There were robust systems in place to ensure people received the care they needed, when they needed without barriers. The service worked collaboratively with partners to ensure people received health and care support in a way that was accessible to them, for example arranging home visits for appointments where appropriate. People were given an active opportunity to have their voice heard and used to underpin the care they received. The provider had created a “Your Voice” network of representatives from each of their services, where they would have a chance to share their voice collectively and use this to promote ongoing quality improvement. One of the people living at Sandwich Road was being supported to participate in the network to represent the service they lived in. People were also actively involved in the interviewing of staff including being part of one interview taking place in the week of the inspection. This meant they were valued participants in recruiting the staff who would be supporting them.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

The provider had a detailed understanding of the barriers faced by people with a learning disability or who are autistic and worked creatively and proactively to support people in having empowered and positive lives. People living at Sandwich Road were active participants in their own community, and staff worked tirelessly in supporting them to have the experiences others take for granted. One person had recently taken part in a charity walk and their medal for participating was displayed with pride at the service. Staff and relatives described how this person was cheered across the finishing line by a large crowd of spectators, and the person had taken clear delight and pride in their achievement. Staff were now working with this person to take part in another similar event. Another person could become easily overstimulated in large crowds however staff were working with them around the factors they caused them to become distressed. They recognised this could pose a barrier to this person in going on holiday, so were working them to plan this in a way that allowed this person to have a holiday in a way that was safe and accessible to them. The provider understood the importance of people’s relationships with the families, and supported to have regular contact including helping them to travel to meet their family or take part in activities together. For example one person had an interest in the theatre so staff supported them to book tickets to a musical performance in London.

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.

There were detailed plans of what was important to people, and they were actively supported to plan meaningful and positive life events such as holidays. Where people did not have the mental capacity to make certain decisions such as discuss wishes for end of life, people’s representatives were involved in these discussions on their behalf. Although some information around end of life care was documented, this was an opportunity for further improvement to ensure people had detailed plans in the event their health deteriorated.