ECHO Supported Living Services Limited

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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 remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 86 (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 was exceptional at making 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.A relative told us, “[Person’s name] has a care plan, I am happy with it, its varied for all they do, they go bowling, to the cinema, theatre, garden centre they eat out and attend parties and events they have a lovely life I can’t guess where they will say they have been today.” A relative told us, “I think it’s marvellous, [person’s name] has a real life, and they do all in their power to keep it.” Staff understood people’s individual needs and preferences and could describe in detail routines which were important to people. Staff shared examples of people’s interests, their friendships and how they were supported to maintain these and talked warmly about the relationships they had with people’s families. The registered manager told us they worked with people and their families to build a support plan which was designed to meet their individual needs and preferences. They shared examples of how they had supported people who had previous placements breakdown and how they had successfully designed support that had enabled people to live active lives in the community. The registered manager also told us how they worked with families to build trust and improve people’s quality of life. Relatives supported what we were told, also expressing stories of successful placements with the service. All the support plans and risk assessments were exceptionally individualised and detailed. The support plans considered the persons specific needs, their history and background, there was a focus on what was important to the person and relationships. Individual communication plans were included with detailed descriptions of how to support the person and what a good and bad day looked like. People’s aspirations were considered and we saw how the service engaged people in their care. For example, 1 person had set the interview questions for staff recruitment to their core team, these were focussed on the persons individual needs and preferences. The provider had worked with other professionals for 1 person to design their home to meet their individual physical needs and maxmise their opportunity for independence.

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. Partners told us the provider had systems in place to ensure they collaborated with other agencies involved in people’s care. A health professional told us, “The team are aware of who to contact and are very proactive in organising meetings to ensure they maintain collaboration with outside agencies.”The registered manager told us they worked positively with other agencies to ensure people had the care and support they needed. This included involving people in a multi-disciplinary approach to assessing communication needs and developing communication passports for people. Staff were aware of different professionals involved in peoples care and described relatives as partners in developing peoples support plans. Records we saw supported what we were told.

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Without exception everyone we spoke with told us the provider invested in ensuring people had detailed communication plans enabling clear information in tailored formats. Relatives told us staff followed clear communication plans for individuals. A relative told us, “The staff will do a social story if there is something new on the horizon for [person’s name].” A staff member said, “Everyone has an individual communication plan in place to show us how to communicate with them as individuals. We use this alongside their positive behaviour support plan, it works well.” The registered manager told us they had a range of tools and techniques available to support communication. Relatives confirmed people’s individual plans were shared with staff and staff received relevant training to ensure communication was effective. We saw people had specific communication aids in place. 1 person had a social story to explain a positive change of a reduction in staff support. We saw images on cards had been developed to help another person create their own shopping list. A social story was used to explain bereavement to another person. Tools had been created to support people with understanding the steps to take in doing tasks such as laundry. Another person used a picture exchange communication system which enabled them to express what they wanted using pictures. The providers focus on communication techniques had led to improved outcomes for individuals. For example, 1 person transition plan included a workshop for staff supported by the previous provider to share communication strategies and support a successful transition. In another example staff had put bespoke communication sheets in place to help a person make a note of things they wished to discuss in regular weekly sessions with key members of their core team. This led to a reduction in anxiety driven behaviour which occurred when people were not available to discuss things with the person. We saw multiple examples of communication aids which had successfully been used to support people to engage with a variety of health professionals, including undertaking specific procedures. These had led to improved health outcomes.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. Relatives felt able to share their ideas and raise any concerns about the service and were confident they would receive a response. A relative told us, “They do listen to me, they respond in good time and in a way that makes me feel they understand.” Another relative told us how systems were changed when something had gone wrong to prevent this from happening again. Staff told us they were able to involve people and relatives in all aspects of peoples care and support and would be able to raise any concerns people have with the management team. A staff member said, “If people wanted to make a complaint, I would be able to take notes of this and refer to the team leader and registered manager if needed.” The registered manager told us about the process for managing complaints and could describe in detail how complaints from relatives had been investigated and responded to.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The registered manager told us, they worked with other agencies to ensure people could access the support they needed through requesting reasonable adjustments. They described working with doctors and local hospitals to understand the needs of individuals ahead of their admission so people’s needs would be understood by the professionals who would support them. We saw people had access to services when they needed them.

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.Relatives without exception felt the provider made sure people had access to the support they needed. A relative said, “[Person’s name] rights and cultural needs are part of regular reviews, I feel these are listened to and acted on, and if I suggest something it happens really quickly.”Staff told us the company made reasonable adjustments to support people. A staff member gave the example, “We had a purpose-built bungalow for 1 person, maintenance is good with making any updates with the environment as needed.” Partners told us the provider worked to identify adjustments required. One professional told us, “The team are very good in working with our Occupational Lead in ensuring the environment meets the person’s needs. This is evident both during a discharge and when someone’s needs change during their stay at ECHO.”Staff proactively considered the potential for discrimination and inequality people may face. Support plans were then tailored to ensure all barriers were considered, plans put in place to reduce and remove them with a view to improving outcomes for people. For example, 1 person had a specific tailored plan in place to support any unplanned urgent visits to a hospital setting. The plan outlined the adjustments which would be needed to ensure the person could access support with their health needs including considering receiving treatment in settings other than a hospital to minimise distress. In another example, staff proactively advocate on behalf of 1 person to access care in a way that works for them. They request reasonable adjustments, including home visits and appointment times that coincide with their established routines. This has led to better engagement with health services and improved health outcomes. All staff and leaders understood the challenges people may could face and proactively took steps to address these.

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. Relatives told us people made future plans and staff supported them with this. A relative told us, “I hope we have future proofed; no one can know, they [staff] do plan for progression though.” Staff told us they made plans with people for their future care and support. A staff member said, “We plan for the future with people all the time in terms of what they need to do, and we make sure care plans are updated to show their progress.” The registered manager told us there was nobody in receipt of end-of-life care but there were systems in place to plan for this if there was a need.