Archived: Alderwood LLA Ltd Addington 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 outstanding. At this assessment the rating changed to requires improvement. This meant people’s needs were not always met.

This service scored 57 (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 choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.



People and their relatives were kept informed about changes but evidence of their involvement in developing and reviewing their care and support plans was limited.

Training records confirmed most staff had received the required induction and training about supporting people with a learning disability and autism. However, the provider was in the process of changing their positive behaviour support approach and the new ways of working had not been fully implemented or understood by staff. We were not fully assured people experienced a consistent approach to ensure people were supported safely. People’s known triggers including those caused by the environment were not always taken into account in the way day to day support was provided and this had resulted in distress. This did not meet the person’s needs. There was a lack of anticipation, consideration and planning to prevent these situations having a negative impact on the person.

Each person had a support plan in place which contained information about their physical, mental, emotional and social needs. However, new documentation had been introduced and was not yet fully embedded into ways of working.

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 were supported with their health needs because staff were provided with information about specific conditions people had and supported them to attend appointments. People’s health needs were considered at every key worker meeting. Staff understood people’s cultural needs. Where people wished, they were supported to access their faith.

People received care and support in line with their funding of commissioned care. People knew the staff team supporting them so experienced continuity and consistency of staff team.

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

The provider was meeting the accessible information standard. Information was available in easy read formats to support effective communication and communication care plans were in place to guide staff about people’s communication needs.

Written information was available in easy read formats. Social stories were used to increase people’s understanding of health appointments and other important events. Social stories are personalised stories used to support people to understand social situations.

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

People were asked if they had any complaints or concerns during key worker meetings. Relatives told us they had confidence in the Registered Manager and in staff but did not feel satisfied with responses and action taken by the senior management team which was at times delayed. For example, a relative complained about an unpleasant odour in one person’s bathroom caused by drainage, this concern had been going on for some time and while some action had been taken the issue remained unresolved. Another relative told us there were ongoing issues about maintenance of the premises.

The Registered Manager knew how to access advocacy services should people require this.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.



The provider did not always understand the barriers faced by autistic people and people with a learning disability because communication barriers had not been sufficiently addressed for one person, and this resulted in periods of distress.

The maintenance and design of the environment was having a negative effect on some people’s wellbeing. While this had been identified, action to improve had not always been taken or was delayed. There was no adapted vehicle available for a person with mobility issues. The Registered Manager told us this person would benefit from an ‘off road’ wheelchair to support better access to activities outside of the service.

There was no evidence of people accessing learning opportunities for skills or education. This meant people may not have access to these opportunities.

Relatives told us their family members had access to services including health services and to activities they enjoyed. A relative said, “They take [family member] out a lot, and if I had any issues I would speak with the manager or his key worker. Another relative said, “The on the ground team are excellent and provide good care for my family member and also provide excellent updates for the family.” The community visits have improved drastically over the last 12 months, we did raise concerns about the lack of visits out into the community, and once we did this, the manager was straight onto this.”

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.

People’s support plans did consider people’s protected characteristics. However, reasonable adjustments to support equity in experience were not always made or were delayed. Staff did not always effectively record or respond to incidents or periods of distress. The review of people’s emotional wellbeing did not always result in changes to reduce further distress or plan for improved outcomes. Key worker meetings used to evaluate outcomes did not sufficiently involve or understand the views and experience of the person or consider actions to improve. The introduction of positive behaviour support plans which included functional assessments may lead to improvements in this area but at the time of our site visits, these had not been fully embedded into working practice and did not sufficiently promote positive experiences and outcomes for people.

People were supported to access activities they enjoyed. However, risk assessments did not always sufficiently take into account people’s needs.

The provider had an Equality, Diversity and Inclusion Policy designed to eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Equality Act 2010. Staff had received equality, diversity and inclusion training.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

People’s future care preferences for greater independence were known and some action had been taken, however action plans were not in place about how or when these goals would be fully achieved.

People’s spiritual needs had been considered and factored into end-of-life planning.