A & T (Salisbury) Ltd

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 71 (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 were complimentary about the service they received. They were at the centre of the service and always received person-centred support by staff who knew them well. People told us “They’re [staff] spot on” and “They are fun to be with. I look forward to them coming.” A relative told us “[Family member] sees them as friends not carers.”

However, care planning did not reflect the person-centred service provided. There was limited detail about people’s needs, the support they required and the impact of any health conditions. For example, one record stated, ‘Assist with washing and drying, maintaining as such independence as possible’ but there was no information about what support the person needed, their abilities or what they found difficult. Another record stated, “I wish to be supported to make the best use of my senses and maintaining or improving the way I communicate.” The information did not detail what this meant in practice or what staff needed to do to help the person.

Leaders told us they were aware more work was required to develop people’s care plans. However, due to knowing people well, this was a recording issue rather than shortfalls with people’s support.

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.

Leaders told us they ensured people’s care was joined up and a holistic approach was taken. They said this included working closely with people’s relatives and any involved health and social care professionals such as GPs, specialist nurses and wardens of sheltered accommodation where people lived. Leaders told us being a small service enabled consistency and established relationships with professionals to be built. They said this helped when making referrals or providing information about people to support a review or assessment of their needs.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Leaders told us they had recently moved from electronic care planning to paper care plans, as people found the electronic system difficult to use. They told us they would gain as much information as possible about a person’s communication needs, during their initial assessment. They would then follow the communication methods already in place and build on them accordingly through time.

Leaders told us in the past, they had used facial expressions to help communicate with a person and used their fingers to spell out letters on another person’s hand. This had enabled the person to identify the words being spelt. Leaders said they had also developed flash cards to demonstrate care interventions and used a whiteboard to write things down. However, whilst these strategies were successful in practice, information about people’s communication needs were not identified within care records. Leaders told us they would develop this alongside the overall development of the care planning system.

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. People told us they could discuss their support with leaders at any time. They said leaders were responsive and would quickly resolve any concerns raised. One person told us, “I have had survey forms, but if I wanted anything changed I would just ring and say and it would be done, I couldn’t have a better team to look after me.” Relatives confirmed this. One relative told us, “If we had a worry about anything we would tell [name of leader] and she would deal with it.”

Leaders told us they regularly asked people if they were happy with the service they received, but these conversations were not documented. This did not enable any themes, patterns or trends to be identified. Leaders had a complaint procedure, and each person had been given a copy. People were also sent surveys to formally give their views. Leaders told us no concerns or suggestions to improve practice had been received so there an action plan was not in place.

The provider made sure that people could access the care, support and treatment they needed when they needed it. Leaders told us they advocated for people where necessary to ensure they received what they needed. This included for example, making phone calls on a person’s behalf to resolve any problems with their medicines.

Leaders told us they would also call the GP surgery on a person’s behalf, if they had not been able to get through to make an appointment. They said they would also accompany a person to a hospital appointment, if it ensured they attended.

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. People and their relatives confirmed it was easy to discuss anything about care provision with leaders. One relative told us, “They make sure everyone is heard.” Another relative said, “I can speak and text them very easily and they always reply and are so helpful to [family member] and to me” Staff told us they had not seen any discrimination within the service. They said each person was always treated with respect and supported in an individual way dependent on their needs. Leaders confirmed this. They said there was a risk people were discriminated against within the general population due to their age, but this was not the case within the service. Leaders told us they would not tolerate any discrimination and would take steps to address any concerns where needed.

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. Leaders told us if an existing person being supported became very unwell, end of life of care would be provided. However, the service does not accept new end of life care packages.

Staff told us they had completed training but had never supported anyone at the end of their life. They said leaders would do this if needed. Leaders told us they would ensure they worked with other professionals to support a person at the end of their life. They said this would enable the person to be pain free, comfortable and reassured, hydrated and with healthy skin.

Although records demonstrated the training staff had completed, people’s wishes on resuscitation and where they would like to end their life were not clear. This did not ensure people’s end of life wishes were fulfilled.