Lilias Gillies House

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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

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure people were at the centre of their care and treatment choices and they worked in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff supported a resident who was in a wheelchair and referred them to a physiotherapist for their physical health needs upon their request.

The service provided life skills to support residents in building confidence and developing skills so they can carry on with them after leaving the service. Residents could access a weekly budgeting group, support with cooking and have opportunities to co-facilitate meetings. The service brochure also said that presentation skills, project planning and decision making, and creative thinking was also on offer, but we did not see this offered to the current group of residents. One resident commented that more could be done to support their emotional wellbeing, but most said that staff supported their emotional needs.

Relationships with other services were active and evidenced. Staff supported residents to maintain contact with their families and carers. Records showed that staff had attempted to engage with resident’s family or supported visits from the family.

Staff had supported 2 residents to visit the local job centre to try and access work opportunities in the local community.

The service did not always provide appropriate, accurate and up-to-date information to residents. The service did work to identify and meet residents’ different communication needs.

There was a resident’s handbook which detailed information about the service, the recovery journey and mutual expectations between the service and residents. However, all 4 residents we spoke with said they did not receive a copy of the handbook upon their admission. During our visit we did not see information about local services for residents to access.

Residents were asked to sign a tenancy agreement and agree to certain rules to live in the house. There was no clear consideration of a resident’s mental capacity to sign this agreement. This had been identified by the provider, and they had an improvement plan in place around this. One of the rules of the agreement was that residents were not to cause violence to oneself or to others. The service model to address these behaviours was through a relational approach to accountability and key-working. One resident’s behaviour had resulted in a formal notice, and their care team were sourcing an alternative placement for them, which could more safely meet their needs.

The service appropriately identified resident’s individual communication needs to make sure information is always provided in an accessible way. One resident had a sensory needs care plan, detailing how to meet their sensory needs.

The service ensured that residents received up to date information about the service in the daily planning meeting and the weekly community meeting.

Information governance systems included confidentiality of resident records.

The service had some processes in place for people to share feedback or raise complaints about their care, but these needed strengthening to be more effective.

Staff knew how to handle complaints appropriately. We could see that complaints were reviewed in the monthly service manager meetings, and outcomes recorded, such as implementing a new complaints board to the service. However, we could not see that the wider staff group received information about outcomes or learning from complaints, such as in their weekly staff business meetings.

The service had a complaints policy in place, which outlined the process and stages of making a complaint, including asking residents to bring their complaint to the community meeting as the first stage of addressing the complaint. However, the complaints process was not listed in the resident’s handbook and the one displayed on the noticeboard was dated from 2023.

Three residents said they knew how to complain or raise concerns and felt comfortable raising concerns directly with staff if they felt unhappy about something, although 1 resident commented that they did not receive feedback on concerns they had raised, so they were not aware of what the outcome was.

We requested the number of complaints within the last 12 months but were not provided with this information.

Residents were able to share feedback in the weekly community meeting, including raising concerns about their care, treatment and support. For example, residents reported in the January community meeting that the house seemed quite chaotic at the time due to shouting in the house. We reviewed 5 sets of community meeting minutes, however only one set of minutes had clear actions that were followed up after the meeting. Managers had recognised that there was no system in place to capture feedback from community meetings and this was part of their service improvement action plan that was sent to us after our visit.

The services accepted feedback as an opportunity to improve the service and the quality-of care people received. Residents had fed back that staff were unable to turn off the fire alarm in December, and a resident had to direct them on how to do this. Managers ensured that staff subsequently received a refresher for their fire alarm training.

The service made sure that people could access the service when they needed it. The service accepted referrals from external professionals and self-referrals.

The service assessed people on an individual basis to see whether they were appropriate for this service. The service brochure specified that they supported adults with a diagnosis of mental health conditions, including personality disorder, psychosis, eating disorder, PTSD, depression and schizophrenia. They also supported people with histories of childhood trauma, self-harm and substance use and people leaving hospital or those who otherwise might be in hospital. We were not assured that this service had the required environment or staff with the required qualifications and skills to support people who had an eating disorder.

The service environment met the accessibility needs of its current clients. The service was based across two floors with ground floor ensuite bedrooms to ensure residents with mobility issues had equity in access.

Staff told us that they contacted the emergency services in the event of a medical emergency and they were very responsive. There was no medical cover in the service, due to the service being a community high supported living service but all four residents told us they could access a doctor quickly in the community when required.

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.

The service recognised as part of its ethos that certain groups of people were marginalised and there is not a ‘one size fits all’ treatment approach. Staff were trained in equality, diversity, inclusion and human rights.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Residents were encouraged to participate and share their views in weekly community meetings, weekly therapy groups and weekly reflective groups.

The service had a lived expert by experience programme. This encouraged residents who had direct experience of using the service to get involved with the design and delivery of the service, including communication, training, fundraising and organising events. Two residents were currently active in working groups. Progress was reviewed in the monthly management meetings.

The service planned for residents to be involved in discussions surrounding future policy development, such as reviewing the drug and alcohol policy with staff. It also planned for residents to co-facilitate future staff training on neurodiversity and train the trainer training.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

The service had considered its practice around discharge planning, and this was based on clinical readiness. Where a resident was considered clinically ready to consider discharge, staff discussed this with them and created a discharge plan record.

For the resident with a discharge plan in place, staff had liaised with care managers and coordinators to facilitate this.

We saw evidence of professional meetings being held as required.