Webb House

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 82 (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 clearly put at the centre of any support and care. People were asked about the care and support they wanted and their views were included within the care documentation. People told us, “I can do anything and everything can be done.”

Individual person-centred care was reflected within support and care plans. Each person had tailored documentation to meet their needs and included preferences they had on the way support was to be provided. Care plans recorded specific health and emotional needs that were individual to them. However, we found some gaps within the care documentation that were rectified immediately when highlighted to the managers. These had not impacted on the care and support provided, although may have led to inconsistencies in staff approach.

Relatives were involved and consulted as appropriate and felt staff did everything possible to support people as they would want. One relative told us, “X has their routines that help with their autism. I know what is in the care plan and they discuss everything with me. They let me know of anything that has happened. They know about all her likes and dislikes, and they always include her in discussions and everything.”

Staff were able to describe people’s individual needs and preferences and were confident that people were always at the centre of care and support with regular consultation. A staff member said, “We have a personal approach to all, we never presume people don’t understand or do not want to be involved we always give time and re -explain if needed.”

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.

Staff maintained good links with a range of professionals that supported a joined-up approach to care. Health professionals had regular input into people’s care and provided advice and guidance when needed. For example, the district nursing team were involved in reducing the risk of skin damage.

People received support from a consistent staff team for continuity. Staff were involved and updated about changes in people’s care and support needs. Information was also available to share with relevant health and social care professionals when needed. Recent changes in allocated individual time for one person had supported more stable and planned outings of choice. This had improved this person’s emotional well-being.

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

People’s individual communication needs had been assessed and recorded within communication support plans. These were well known to staff who had a deep understanding of how people communicated. People were able to express themselves and staff took time to understand what they were communicating. For example, one person had a very quiet voice, and staff had to be patient and attentive to understand words. Other people rarely used words but could point, use sign language, gesture and draw when communicating. One staff member said, “We know when they are uncomfortable as they use vocalisation and we understand that they normally need the toilet or to be changed.”

Information was provided in various forms and used to engage with people and encourage individual decisions and choices. For example, there was a pictorial activity planner to support people when deciding what to do. Menus were discussed with people and pictures of the daily meal choices were displayed.

Care records were recorded within a computer system and staff accessed these on mobile devices. Staff experienced difficulties in accessing these devices to update and read records. This did not impact on care delivery at this time as staff knew people so well. This needs further attention and was raised with both the managers and operations manager during the assessment to ensure up to date information was available at all times.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

People were given the opportunity to share their views on a daily basis; staff encouraged them to share any feedback and views, in any way that they could. One person did not use words to communicate, and staff understood their feedback given in gestures and demonstrations. Staff communication skills were individually tailored and understood what they were communicating. This person was concerned another persons could not access the new bins and needed another pedal bin. Their views were recognised and responded to. There were regular meetings where people were actively encouraged to discuss what was happening at the service and make requests and suggestions. People’s feedback was responded to in a proactive and positive manner. For example, during a resident’s meeting the use of the communal lounge area was discussed, ideas and views were offered. Everyone was involved with deciding the layout and colour schemes. People were involved in shopping trips to purchase items including the new large TV with surround sound system. The revamped area now provides for different interest and activities and includes a gym, with different equipment to meet specific needs, a cinema area that includes facilities for party activities and also for sensory stimuli. Everyone’s preferred activity was considered and responded to. The decoration of communal hallways and stairways was also discussed with everyone, staff used photographs and pictures to stimulate thoughts. Themes and scenic ideas were raised by people and a way of incorporating everyone’s preferences was agreed. A colourful mural was now being painted. A person told us, “I really like the seascape it is coming on well.”

People and relatives were comfortable to raise a concern or to share a problem. They were also confident that they would be listened to and responded to. One person said, “I would speak to any staff member if I had a concern I can talk to anyone if there was anything.” Another said, “If I need to talk to someone, I know who I can talk to. I have no complaints.”

Relatives were very complimentary about how staff listened to them and people and ensured appropriate action was taken to respond to any concern. One said, “When I had a concern, they listened to me and dealt with it.” They were impressed that they took account of what people said and told us. “They believed what X was saying and they are a very good judge of character. In the past we have not been listened to or believed.”

There was a system to record any complaint digitally and there was evidence that complaints were recorded, taken seriously and responded to.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Managers and staff were fully aware of people’s health and care needs and recognised the need to support people to access services. They ensured they were not prevented from receiving the care and support they needed due to their health or disability. Webb House was purpose built and had been designed to support people with a disability. There were wide corridors and rooms were large with suitable adaptations, including equipment to move people safely when needed. People benefited from adapted bathing facilities and could have a bath or a shower when they wanted.

Facilities within the service had been improved and upgraded recently and this had promoted access to more group activity. For example, an extra dining table near cooking facilities enabled more people to be involved in group cooking activities. Accessible outside space was also available, and ongoing improvements had encouraged people to spend more time outside and to engage in outside activities and entertainment. For example, vegetable gardening and outside BBQ s and celebrations either in the garden or on the balconies. Garden furniture had been purchased along with pergolas to provide protection from the sun. People told us they enjoyed using the outside space. One said, “We had lovely BBQ and meals outside in the summer.”

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Staff were aware of the importance of ensuring people were not subject to inequality or discrimination due to autism, their health needs or any disability. People were not prevented from living a very full, active and meaningful life. Staff were proactive in promoting people’s well-being and listened to people and their families to understand how improved outcomes could be achieved. For example, staff noted that people were attending hairdressers as they were unable to wash their hair or remove hair dye in a sink comfortably due to their disabilities. Some people did not attend a hairdresser at all. In response a hairdressing room with adapted sink and a riser cushion was provided which was accessible to everyone who wished to use it. An effort was made to make this feel and look like a hairdressing salon making it an event to attend. People could have their own hairdresser to attend if they wished and some staff were skilled with hair care. Nail treatment and painting facilities were also provided for further ‘pampering’. Additional benefits from this facility have included people saving money that they had been able to spend on other activities or interests.

When listening and observing one person staff noticed that they exhibited frustration around their individual activity programme. Discussions took place with them and their family to plan more clearly a weekly tailored programme. A specific staff member was recruited to work with them to provide a consistent approach that could focus on them solely. A new structured daily timetable that was further financed from monies saved on hairdressing trips was developed. This was flexible and responded to changing choices and feelings. This had improved this person’s level of well-being and was now working well, the new staff member was looking forward to expanding their activities further. For example, contact with horses and cycling.

Staff were always looking for ways to support people in whatever they wanted to do that was important and meaningful to them, and to overcome any barriers. For example, one person was interested in becoming a’ trainer through experience’ this was to support staff on a learning disability training programme. They lacked confidence when reading presentations. Staff suggested pre-recording a presentation and they supported them to do this. This worked well and this individual has now regained their confidence and continues to work within this training programme to deliver valuable training.

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.

No one required end of life care at the time of this assessment. However, staff had provided support in the past to people at the end of their lives. Staff worked with people, family and professionals to ensure people’s care was appropriate and in line with their wishes. One staff member said, “They were able to stay with us, in their home and enjoy the things they liked, like Guinness.”

Some discussions had taken place around planning for the future and relatives were involved in these as appropriate. Some people had advanced directives with regards to an emergency medical situation and end stages of life, these had been recorded. However, some of these needed to be reviewed. This was raised with the managers during the assessment process. They took immediate action to ensure they were still appropriate and in line with people’s own wishes. The managers confirmed they plan to use ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) forms to initiate conversations with people and to ensure people’s personal wishes are recorded and followed.