City and South Cambridgeshire Learning Disability Partnership

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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

This means we looked for evidence that the service met people’s needs.

Staff supported people with activities outside the service, such as work, education and family relationships. The service met the needs of all people – including those with a protected characteristic. Staff helped people with communication, advocacy and cultural and spiritual support.

At our last assessment we rated this key question requires improvement. At this assessment the rating has improved to good.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

We scored the service as 4. The evidence showed an exceptional standard. The service 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 people’s needs.

People received the most appropriate care and treatment for them as the service made reasonable adjustments where necessary. For example, the staff offered flexible appointments in terms of length, time and location.

Many people using the service experienced communication difficulties, which meant they were not always able to express their needs or discomfort verbally. Staff demonstrated a person-centred approach by using a range of alternative methods to ensure care was appropriate and responsive to individual needs. This included observing non-verbal cues such as facial expressions, body language, withdrawal behaviours, and any noticeable changes in behaviour that may indicate pain or distress.

Staff showed an understanding of each person’s usual presentation and were able to recognise subtle changes, enabling them to respond promptly and adapt care accordingly. This approach helped ensure people received safe, effective, and compassionate care tailored to their communication needs.

For example, using simple language, avoiding medical terms, using demonstration to minimise verbal communication, written words, pictures, symbols and videos.

We observed the nurse allocation meeting and heard of many examples of positive and person-centred work to address people’s needs. Staff told us how they used accessible letters, leaflets and pictures with individuals preferred communication style.

The art therapists described how they would run individual or group sessions based on people's needs. They could support with bereavement support, anxiety, transitions from children to adult services, and trauma. The service would tailor the support to the individual.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

Quality Statement Score: 4

We scored the service as 4. The evidence showed an exceptional standard. The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported by choice and continuity.

We observed through care records that the continuity and flexibility of the interventions undertaken by the LDP allowed people to have choice and control in their care and support. For example, structured desensitisation support enabled 1 person to successfully tolerate blood tests which had previously not been possible. When appropriate, staff ensured that people had access to education and work opportunities.

Care records and observation of meetings demonstrated how MDT staff worked in partnership discussing individual cases, problem solving and allocating the most appropriate discipline to provide the intervention.

Staff told us how the demographic of people from different parts of the county presented with differing needs.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information governance systems included confidentiality of people's records. The service complied with the Accessible Information Standard. Staff ensured that people could obtain information on treatments, local services, people’s rights and how to complain. The information provided was in a form accessible to the people using the service. For example, in easy-read or pictorial formats. One person who used the service told us that the community nurse had made them a passport which documented their needs. They took this to the hospital, doctors and dentist.

However, in some reception areas, leaflets on display had not been regularly refreshed and due to so many documents on arrival to the reception area, it was hard to identify which ones would be relevant to the people using the service. Other departments also used the building therefore the documents were also on display for various other services.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information governance systems included confidentiality of people's records. The service complied with the Accessible Information Standard. Staff ensured that people could obtain information on treatments, local services, people’s rights and how to complain. The information provided was in a form accessible to the people using the service. For example, in easy-read or pictorial formats. One person who used the service told us that the community nurse had made them a passport which documented their needs. They took this to the hospital, doctors and dentist.

However, in some reception areas, leaflets on display had not been regularly refreshed and due to so many documents on arrival to the reception area, it was hard to identify which ones would be relevant to the people using the service. Other departments also used the building therefore the documents were also on display for various other services.

We make sure that everyone can access the care, support and treatment they need when they need it.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

Staff made reasonable adjustments for people. For example, when appointments were not effective, they would reschedule and consider another approach.

We saw that the multi-disciplinary team (MDT) had implemented a range of reasonable adjustments for a person who was using the service. They did this in line with their duties under the Equality Act 2010, to ensure the people were not placed at a substantial disadvantage in accessing rehabilitation due to psychological, sensory, and environmental barriers.

Physiotherapy input was modified to a slower, highly individualised, tolerated approach. Sessions incorporated familiar and engaging activities such as singing nursery rhymes and ball-based tasks to support emotional regulation, engagement, and participation.

A collaborative approach with music therapy was also planned to use sensory and auditory stimulation to increase movement through increasing motivation and reducing anxiety. This demonstrated an adjustment to both the content and delivery of therapy. Other therapies were also involved such as occupational therapy, and psychiatry with adjustments made within those too. Additionally, environmental and organisational adjustments had also been implemented. Staff were liaising with a person's care home to ensure consistency of approach, appropriate preparation prior to sessions, and continuity of therapeutic strategies.

These measures ensured equitable access to rehabilitation, in line with people’s needs. They reflected a coordinated MDT approach aimed at reducing distress, improving participation, and enabling safe and meaningful engagement in therapy. An ongoing review was planned to evaluate effectiveness and inform further adjustment as required.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service had a health inequalities action plan in place. People with learning disabilities consistently experience poorer health outcomes compared to the general population. The plan was structured in a way to identify, reduce, and monitor those inequalities while improving overall care quality and access.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views.

Staff were trained in equality, diversity, inclusion and human rights. Compliance with this was 98.5%

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

We scored the service as 3. The evidence showed a good standard. 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.

Staff created personalised care plans to account for people’s needs, wishes and feelings. Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs.

Staff told us nurses worked in collaboration with the Integrated Care Board (ICB) to support the transition process from children’s services to the adult service. They also worked with them to ensure Section117 aftercare was provided seamlessly.

Staff told us about the Castle School pilot. The aim of this was to prevent health inequalities. The LDP would gather information on people who were at school and would eventually move to support them from the LDP instead of the children’s service. Information on people could be gathered from schools from the age of 17. This meant an access assessment would not be required.