Sturbridge

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.

This is the first assessment for this service. This key question has been ratedRequires Improvement.

Thismeant people’s needs were not always met.

This service scored 57 (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 and treatment choices. The level of detail in people’s care plans was inconsistent; while some plans contained good information that could support personalised care, others were much less detailed. This meant staff did not always have clear guidance on people’s preferences, routines or how best to support them safely and individually.

Staff told us they relied heavily on their own knowledge of people rather than on written guidance. Although this familiarity helped staff provide responsive day-to-day support, it also meant people’s care was dependent on individual staff insight rather than consistent, documented information that all staff could follow.

There was little evidence that people were meaningfully involved in shaping their care or making decisions about their day-to-day lives. For example, one relative told us the person did not get to make decisions at home, and staff relied on relatives to tell them how to support the person. This reduced opportunities for people to express their own wishes or develop independence and decision making skills. The management told us about strategies they used to involve people and the importance of this. However, this was not evidenced in people’s documentation.

The provider understood the diverse health and care needs of people and delivered care in a way that supported continuity, consistency and a joined up approach. Staff worked in a coordinated manner to ensure people received the support they needed when they needed it, helping to promote smooth and reliable care provision.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication needs were not documented in their care plans, despite one person being unable to communicate verbally. This meant staff did not have clear or consistent guidance on how best to share information or support people to understand their care.

We did not see any evidence that information had been provided to people in formats that were accessible to them, such as visual prompts, simplified language, or alternative communication tools. Staff gave us examples of techniques they personally used to communicate with people, telling us, “I use alternative communication methods such as gestures, visual aids or communication tools, and rely on my knowledge of the individual.” While these approaches were positive, they were not reflected in care plans or in any structured guidance for the wider staff team. The management team could not describe the accessible information standard.

There was a reliance on staff getting to know people well, rather than on clear, accessible information and documented communication strategies. This created a risk of inconsistent care and meant people were not always supported to understand or participate in decisions about their care.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Whilst relatives told us they had opportunities to share feedback informally and through satisfaction surveys, there was no evidence that people receiving care were enabled to do the same. People were not supported to share their views, raise concerns or contribute to shaping their care in ways that were meaningful or accessible to them. As a result, the provider could not demonstrate that people were routinely listened to or involved in decisions about their care and support.

The provider made sure that people could access the care, support and treatment they needed when they needed it. There were no concerns identified in this area. Staff worked in a coordinated way to ensure people received consistent support, and relatives told us they had not experienced any delays or barriers to accessing care. This meant people were able to receive the right support at the right time.

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.

It was not clear that the provider had embedded the CQC’s guidance on supporting autistic people and people with a learning disability into everyday practice. There was no evidence that steps had been taken to ensure that people who are most likely to experience inequality in experience or outcomes were treated as equal partners in the planning and delivery of their care.

The service relied heavily on relatives to explain how people should be supported, and there was limited evidence that people themselves were asked about their preferences, aspirations or what mattered most to them. This created a risk that care was shaped around what relatives wanted, rather than what people themselves desired. As a result, the provider could not demonstrate that people consistently experienced equitable outcomes or that their voices were central to decisions about their care.

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.

Whilst a previous manager had been supporting one person's relatives to explore respite options, it was not clear that consideration had been given to what the person themselves wanted for their future. There was no evidence that people had been supported to express their wishes, preferences or aspirations, and no attempts had been made to establish what was important to them when planning ahead.

People did not have advance care plans in place, meaning the service would not know what people would want to happen should they suddenly become unwell or require urgent decision making. Without clear, person-centred future planning, the service could not demonstrate that people were enabled to make informed choices about important life changes or that their wishes would be respected in the event of a health emergency.