Aylestone

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 as 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 mostly 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.

Care plans were mostly person centred to ensure care was provided in accordance with people’s individual needs and preferences. For example, people were supported with personal care in a way and at a time of their choosing to help reduce their anxieties. As we have detailed previously, people’s care plans did not always include meaningful goals and outcomes. The provider was aware of this and was introducing a new system across their services at the time of this assessment.

We observed many examples of staff providing personalised care, including respecting people’s personal space, tolerances and recognising responses. However, we also observed there was a lack of reflective practice to ensure everyone was receiving truly person-centred care. We received mixed responses from relatives as to whether staff provided truly person-centred care. Comments included, “Yes definitely, [Name] is a totally different person, happy and confident in themselves now with no anxiety” and “I would say it is mixed due to staff turnover; some do not know [Name] so well. I think some staff could be more responsive, try new things and new approaches to help [Name] achieve more.”

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’s care plans included information about their diverse needs. Care workers had received training in people’s diverse needs including equality and diversity, dementia, learning disability, mental health and autism. Staff understood the needs of autistic people and people with a learning disability and worked hard to ensure that typical barriers faced by people were removed or mitigated against. They recognised when people were at risk from poorer experiences and worked to ensure everyone was included and provided advocacy where needed. For example, staff worked with health professionals to make adaptations and use flexible approaches to enable people to access medical appointments and healthcare where this was a trigger for people’s distress.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People had communication aids, including objects of reference. Easy read documents were available, and these were used to support people to make choices and decisions. For other people, where easy read documentation was not helpful, staff who understood their specific communication style were available to aid them. This meant people could make their needs and wishes known to staff.

The provider had systems in place 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.

Staff were able to describe how they recognised if a person was unhappy about something. A staff member told us, “Everything is on [Name’s] terms. They clearly indicate when they have had enough or are unhappy. We do things at their pace and respond quickly when they show us they want a change or want something to stop.” Relatives told us their concerns were mostly listened to and acted on. Comments included, “We have raised minor concerns with previous managers, and it was sorted but there has been so many changes in managers; they start and then seem to disappear. It makes it difficult to build a relationship with them,” and “I have telephone numbers of manager. Any issues are sorted out quickly.” A relative felt their concerns had not been listened to or acted on. They had submitted a formal complaint which was being managed at the time of our assessment.

The provider made sure that people could access the care, support and treatment they needed when they needed it. Staff had good working relationships with local health professionals and knew how to contact the appropriate teams to support people when the need arose. Staff were quick to respond to changes in people’s needs and support people to contact routine and specialist services when required. Staff worked with health professionals to understand people’s tolerances and experiences to enable them to access routine and specialist services. The home was adapted so people could access all areas and utilise the environment to meet their individual needs, although we identified it was not always utilised well and there were plans to improve the environment.

Staff and leaders actively listened to information about people most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff understood the needs of autistic people and people with a learning disability and worked hard to ensure typical barriers faced by people were removed or reduced. For example, each person had a hospital passport. These included people’s individual risks and health conditions. They could be shared with other professionals to reduce potential barriers to care within the health and social care system. Staff treated people as individuals and made reasonable adjustments for anyone who needed them. This meant people were less likely to experience discrimination.

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. Care plans showed people and those important to them were given the opportunity to discuss their end of life wishes and care plans reflected their wishes where they had made decisions. For example, people were supported through pictorial and adapted information to make informed choices about their end-of-life care with their relatives. This enabled end of life planning to be very personalised and included objects and practices that were important to the individual person.