Complete Care and Enablement Services

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 outstanding. At this assessment the rating has remained outstanding. This meant people’s needs were met through excellent organisation and delivery. Services were tailored to meet the needs of people and delivered in a way that ensured flexibility, choice and continuity of care.

This service scored 93 (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 excelled in 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.

Where people experienced barriers we saw excellent examples of staff navigating around these, working with advocates and external partners, for solutions and positive outcomes. People were able to achieve their goals as a result of this. During our visits to people in their own homes 2 people excitedly recounted to us about their recent indoor skydiving experience. They were proud to show us the mementos they had from the day, including photographs and a video of themselves floating in a vertical wind tunnel. Staff had gone to great lengths to arrange this with the venue to ensure both remained safe, whilst providing them with an unforgettable experience. Other examples included people choosing where they wanted to live, going on cruise holidays and learning to drive.

We saw examples of people having moved from placements that had hampered choice and independence now flourishing in their own homes with the person-centred approaches adopted by the whole staff team. Whilst incidents had occurred these were well managed and lessons were learned for the future.Newsletters and pictures in people’s homes recorded social gatherings people had enjoyed attending; get togethers at each other’s homes, in the community, or as part of a wider social network. People gained confidence and as a result were more able to say what they did and didn’t want to do; staff supported those decisions and advocated for the person to ensure their choices were respected.

Support plans were person centred, were written from the person’s perspective and contained information relating to past histories and relationships. They offered insight into how people’s personalities, likes and dislikes had been formed. For example, one-person disliked showering, but there was historical context as to why this was the case. As well as providing an insight into the person, support plans also provided staff with specific direction and instruction as to how best support a person; for example, one person preferred using plastic cutlery and food being provided in a bowl rather than on a plate.

Staff ensured care records had a support plan in relation to people’s daily routines and personal support. For people who communicated using Makaton, there were images of signs in their support plans which acted as a reminder to staff. People’s views on whether they wanted to vote, how they wanted to receive their post, who they wanted to hold their keys, whether they had access to a mobile phone and their internet safety were all included within people’s support plans.

The provider ensured support plans were reviewed with people, where their input was possible, and involved family and friends were warranted, to better understand people’s preferences. Support plans outlined how the person had been involved, the ways people had expressed their needs and preferences and how they had been helped to manage their own treatment. For one person, it stated, “[Person] has autonomy over [their] treatment and voices [their] own preferences well.”

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. People’s care records clearly outlined the amount of support hours they had available to them. Rota’s showed people’s hours of support matched what was in their care record.

The provider was working closely with community partners to increase people’s support hours when this was an identified need. For one person whose support needs had changed. we saw evidence the provider had liaised with social work professionals to increase the package of care and support.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People had communication and decision-making support plans within their care records. These were extremely detailed and contained peoples identified needs and the personalised support required to supporting these needs. Staff focused on these to ensure people felt empowered to make independent choices and be in full control of their care and support.

Staff supported people to communicate with them and others. Staff had developed communication dictionaries for people who required them. These documents stated what the person was saying, what it sounded like and what it meant to them. Staff had been trained in Makaton; Makaton is a communication system which uses signs, symbols, and speech to help people who struggle to communicate understand and express language. Staff provided choices to people who had limited communication skills, using pictures or mutually agreed and understood signs. A person who was non-verbal was presented with pictures to indicate their meal choices to staff, or whether they wanted a shave. This method worked perfectly for the individual and they were able to make their preferences known.

Assistive technology was used by a person to support their communication; they were able to engage well with staff and others. Staff took time to listen and respond, enabling the person to express their views and participate in conversations. Staff also supported the person with techniques they had developed to further aid communication; for example, we observed the person was able to answer ‘yes’ or ‘no’ to closed questions by staff holding up both hands and labelling them; the person was able to quickly communicate their answer by touch. This was a lovely display of communication based on a well-established relationship and trust.

Support plans for communication and decision-making provided excellent guidance for staff and outlined how staff should speak clearly, calmly and with simple terminology ensuring people were given time to process and respond to information.Information was shared in formats accessible to people; the service was fully inclusive. This included information relating to people’s achievements, people forums, care and support reviews and staff successes, with the management of information done in line with best practice.

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 totally involved and invested in the service, their care and support, both at a local level but also on a wider basis. People helped the company make decisions in how to drive service improvements forward at a national level. There were forums for people and staff to gauge opinions, ideas and share good practice. People living in the services were proud to be forum representatives. We saw lots of examples of positive engagement from the provider at all levels, with people, families, staff and professionals.

Key workers in most settings we visited completed monthly reports with the people they supported. These included a review of what was working well and what was not, any comments regarding their support plan, complaints or compliments and dreams and goals. We were unsure monthly reviews were being completed at all locations.

Staff supported people to complete surveys. We saw evidence of these at some of the locations we attended. In one of the surveys completed, the person had stated they had clear goals and targets which were reviewed regularly. Support staff worked well with others to provide support and involved them in planning their own support. The person told us they were consulted on changes and treated with respect by staff.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

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 provider ensured there was a document within people’s care records regarding people’s equality and human rights. This detailed if people’s gender, sexuality, religion, ethnicity and indicated any disabilities. There were details of the support and interventions required to support the person appropriately. For example, one form documented how a person needed staff to support and encourage participation in activities, as they were reluctant to ask to do things they enjoyed.

Staff considered reasonable adjustments which needed to be made to ensure people access healthcare. For example, 1 person was supported by a specialist dentist with experience of treating people with a learning disability. People’s preferred pronouns were discussed and recorded; staff respected people’s preferences and referred to them according to these.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.