Archived: My Life Choice

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• 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 changed to inadequate. This meant services were not planned or delivered in ways that met people’s needs.

The provider was in breach of the legal regulations relating to person-centred care

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care was not person-centred. People’s potential, interests and skills were not being actively explored to promote meaningful, person-centred activities and minimise restrictions in people’s lives. Staff told us risks relating to people’s complex support needs had impacted on their level of engagement and activities. However, the provider was not able to demonstrate how they were promoting people’s personalised goals and wishes to support them to lead a full and active life.

For example, 1 person’s care plan for accessing the community included a goal to participate in activities they enjoy. The plan did not include any personalised information about what activities the person enjoyed, only detailing 2 scenarios, the first for ‘Walking around the drive’ and the second for ‘Going out in a vehicle’. There were no details about where the person would like to go in the vehicle. There was an action to look at hiring vehicles and finding a suitable car for the person to use. However, from October 2024 until the time of the inspection, there was no evidence of how this action was being progressed. This meant the provider was not able to demonstrate how the person was being supported to achieve their individual goal.

There were shortfalls in how the provider understood the diverse health and care needs of the people they supported. People’s care was not always joined-up, flexible or supportive of choice.

The provider was not always able to demonstrate how they worked in partnership with other health professionals to ensure people received prompt, appropriate health input and to ensure barriers to activities and integration were minimised. People did not always receive consistency in their support and staff were not always appropriately skilled in understanding people’s diverse needs.

The provider had not ensured all people received appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Where people used different methods of communication, the provider had not ensured all staff providing support were able to use this form of communication. People’s relatives told us staff did not appropriately adapt their communication style to suit people’s individual needs and preferences. They told us this impacted negatively on people’s experience of care.

Where people required different communication aids to facilitate their decision-making, the provider’s records did not demonstrate how these were aids being used effectively to support communication and promote choice.

The provider did not make it easy for people to share feedback or raise complaints about their care, treatment and support. Where people and their relatives had raised concerns or complaints, the provider had not always responded appropriately. People and their relatives did not feel listened to.

Comments from relatives included, “My friend raised the concerns because I was too scared”, “The company said lessons have been learned but they haven’t communicated anything”, “They see us as a nuisance”, “Nothing was resolved” and “Things don’t translate into action or good care.”

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

We received mixed feedback about whether people were supported to access the health services they required to meet their physical and mental health needs. Where appointments were arranged, relatives told us the provider had not always made reasonable adjustments to ensure people could attend their health appointments or receive visits from external health professionals.

People’s relatives told us the provider was not always easy to contact out of hours in case of an emergency. One relative said, “Come 5 o’clock on Friday, if there’s an emergency, there’s no one to contact. We have no on-call number.”

The provider did not ensure people’s care, treatment and support promoted their equality or empowered them to lead a full life. Barriers to people’s support had not been mitigated to improve people’s experience of care.

The provider could not demonstrate how they had explored supporting people to go out to places that were important to them or access local communities, in line with the principles of the 'Right support, right care, right culture' guidance. The provider was not able to evidence how they had reviewed people’s daily care to understand their quality of life. During the inspection, we found people were very limited in what they were doing and where they were going. People spent most of their time alone within the home or with staff. One relative told us, “[Person’s] world is the end of the road. They won’t take any positive risks.”

Relatives did not always feel the provider had removed barriers to ensure people were able to maintain their family relationships. Comments included, “They don’t give you any space when you visit. The staff are still sat there” “[Person] doesn’t need bodyguards with them”, “We don’t enjoy visiting because the atmosphere is not pleasant” and “They promised [person] would be brought home. They lied to me."

The provider was not able to demonstrate how they supported people to make decisions about their future care and support, including those relating to potential medical and psychological needs and their wishes for end of their life.

People’s care plans did not evidence how they were actively involved in planning for important life changes and future care. Staff were not always able to demonstrate how they promoted open conversations and supported people’s different communication methods to enable them to make decisions about their future cure.