New Villas Office

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

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement.

Requires improvement: This meant people's needs were not always met.

The service was in breach of legal regulation in relation to person centred care. This was because the provider did not demonstrate they were always listening to and involving people in their care and support, and their care plans were not always updated as required.

This service scored 50 (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 andtreatment choices and they did not always work in partnership with people, to decide

how to respond to any relevant changes in people’s needs.

Although peoplegenerally receivedpersonalised, person-centred care and support that mettheir day-to-day needs, this was not provided within a cohesive framework that supported

people to aspire, reach their dreams and live their best lives.People’s care plans reflected their physical, emotional and community support needs, andincluded information about protected characteristics under the Equality Act and how these mightinfluence and shape people’s experiences to date as well as their need for support. However,we did not see these care plans translated effectively into a care and support model thatenabled and empowered people, with staff who were able totake into accounttheirbackgrounds and histories. For example, we saw several instances of documents that referredto people visiting their relatives as ‘home leave’,going out as ‘social leave’,and riskassessments for people ‘absconding’ from their home. It is not possible for a person to ‘abscond’from their home, nor do people leave their home on ‘home leave’ to visit their loved ones or on ‘social leave’ to go to the cinema or out for dinner. This failure to understand people’s rights as ordinary citizens living in their homes was also reflected in other documents we saw, that referred to their support as a ‘care home’ despite the tenancies they held. Notwithstanding this, individual staff supported people in ways thatdemonstratedthey understood people’s day-to-day needs relating to their autism or learning disability. Support plans were documented in a variety of formats people could understand, including easy read and pictorial. For one person, the service had developed a specific staff team that worked closely together to ensure the person’s needs were safely met, both at home and in the community. The staff team closelyfollowed a holistic PBS plan that enabled the person to access community facilities safely, and incidents of distress and frustration had significantly reduced since the team had consistently supported the person. We saw that the person hada number ofuseful communication enhancers that they used, including achoicemakerboard, ‘now and next’ chart and a visual timetable that used lots of pictures to support the person to understand and make day-to-day choices.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

We found managers were not always clear about the expectations of a supported living service. People told us they had limited choices, for example choice over some decisions was always present, but people told us they were not able to have input into decisions regarding the décor in communal areas. The provider told us they had plans to involve people in such decisions going forward. Although care plans and risk assessments contained details of people's needs and preferences and protected characteristics, only staff working directly with people knew of their present needs as these care plans were not updated with regularity.

The provider did not always supplyappropriate,accurateand up-to-date information in formats that were tailored to individual needs.

Atone addressinformationsuch as resident meeting minutes,was provided in easy to read and pictorial formats for those who needed this. It was also shared freely and without the need for it to be requested by people.However,information was not shared consistently across addressesand incontrast athomeaddressinformation was given only in textformatand relied on people asking toseethis rather than it being offered.

The provider did not always make it easy for people to understand actions taken in response to their feedback and ideas. It was not always evident that people were involved in decisions about their care or how it was shared what had changed as a result.

People were asked for their views using accessible feedback forms which they were supported to complete where necessary. There were regular meetings for people living at the service. At one address minutes from such meetings were shared in pictorial formats as well as text to ensure accessibility. The minutes detailed views of people and showed evidence of ideas being acted upon as well as updates from issues raised at previous meetings. This was not consistent across the whole service with one address having only text minutes which were only with people when they requested to see them. Relatives we spoke to told us they found communication with the service to be less frequent than they would like. Relatives also told us they were not approached by the service for the opportunity to provide feedback in the same way that people who lived there were.

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

Staffidentifiedwhen people needed support from healthcare professionals andfacilitatedaccess to these to ensure people’s healthcare needs were met. Each person had an annual health check and Health Action Plan, and a Hospital Passport and Communication Passport that were clear,up-to-dateand unique to the person and their needs.

However,the recording and responses to incidents which included comments from care staff that medication may need to be reviewed did not make it clear that input fromother professionals wassought.

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.

The inconsistencies we saw across addresses showed that not all people had equity in their experiences of the service. Although care staff knew the people they worked with well, their knowledge of individuals was not always translated into up to date and accurate care plans, risk assessments or was recorded in such a way that would allow others to provide the correct care in the absence of others. Support plans did not detail people's aspirations or how these could be met including specific details of approaches that individuals required dependent upon their own circumstances or behaviours. Blanket restrictions, such as specific visiting hours meant that people did not have equity in achieving their individual outcomes.

People were not always 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.

People’s care plans did not always clearlyrecord their wants andwishes,these were also not updatedregularly.Transition documents we saw were not comprehensiveand didnot always includethe voice of the personconcerned, making it difficult to see evidence that people were supported tobeinvolved.