Futures

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 good. At this assessment the rating has remained good.

This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 75 (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 made 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.

People were supported to express their identity and could have their rooms decorated as they wished. We saw that different themes had been adopted by people in their rooms, for example posters of sports teams and athletes, and family photos were on the walls, which made the environment personal to that individual. Family told us, “We had input to the bedroom.” People’s family involvement was acknowledged as an important part of the routine and the home had ensured that all people had access to family support if they wished. The registered manager supported and encouraged involvement of people important to the people they supported.

Documentation detailed the preferred ways to assist people with things such as moving and handling, eating and drinking, plus various activities. One person enjoyed activities that were technology based and staff were aware this was their area of interest, another liked sports and followed a particular football team. From the admission process throughout the time spent at Futures people had any changes to their needs or preferences updated according to what they or their families expressed and communicated to staff. Mixed teams of support staff worked in the bungalows so there was always a choice of preferred gender available for people when being supported with personal care or intimate interventions. Personal wishes were respected during people’s care routine and when being assisted with daily tasks or activities, and we saw staff giving people time to respond and make choices.

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 required complex care. Some tasks were suitable to be delegated healthcare tasks and were delegated to trained care staff. NHS nurses provided training and oversight and retained the overall responsibility for management of these elements of care. The interaction of staff across the Chailey site was impressive with staff from the different services, children and young people, being flexible and able to change between residences offering the same skilled support to people and providing a continuity of care that maintained standards. The same information was available to the support staff in all residences, for example medicines, allowing staff to become familiar with everyone’s individual requirements throughout the foundation. Staff rota’s evidenced familiar staffing within the Futures bungalows.

People were supported to go out into the community whenever possible and take part in a variety of experiences. Up to date information on health and care needs was taken with them to ensure any unforeseen circumstances could be safely managed and that the required information was to hand should medical assistance be required. Off-site risk assessments were reviewed annually and consisted of 3 main areas, “health and nutrition, on the bus and in the community” People were encouraged to have regular visits home with family. One person’s relative told us they struggled with transport but now, “We have them home once a month…. they bring them to us.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s care plans and relating documents included pictures and photos as well as writing so the information was clear and more easily understood. At times larger print was used, and bullet points rather than longer sentences supporting people to follow what was recorded about them. There were picture signage and symbols within the bungalows, and personal rooms, for example locating emergency exits and fire signage. People could recognise themselves in photos on the walls of the communal lounge area. Information could be delivered in an audible format, and people were seen to be using digital screens to access information, such as audible books or recordings of programmes. Staff supported people to communicate via text messages and video calls. Staff were patient when explaining things to people and ensured that they understood the information correctly and understood any response being given. A relative told us they had a system in place whereby they received a report from the night staff by 7am every morning. They said night staff were, “brilliant,” and they felt reassured by this and valued the measures to let them know their relative was safe.

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.

Support staff had regular opportunities to offer feedback and share ideas at supervisions, appraisals or team meetings. There was a clear feedback pathway from the different departments that contributed to the running of the service. Staff told us that management and senior staff were approachable and said, “Recently I have seen more of the registered manager as they are in their office more and they come in quite a lot.” People and their families were always made welcome and involved in any changes to routine or decision making. Relatives told us they had no problem raising concerns and would happily approach the team manager or the registered manager if needed. Families felt confident in discussing issues and told us that any concerns or queries they had raised were addressed promptly. We were told, “If I ever had a complaint I have called and they have picked up the phone.” and “Will always get a call back if we raise an issue.” The service had a complaints policy and followed specific guidance and procedures for any grievances or complaints received.

The provider made sure people could access the care, support and treatment they needed when they needed it.

The facilities and support at Chailey Heritage Foundation were substantial and people at Futures benefitted from being able to easily access support from across the foundation including clinical services providing nursing and therapist support, and activity areas. Regarding changes with a person’s care that were addressed in a day, a family told us that “They are responsive and it’s so important and incredibly reassuring and that is consistent behaviour by the staff.” Where people were supported by off-site medical staff, arrangements were flexible for appointments with one professional saying, “We make reasonable adjustments to ensure the best possible outcomes for individuals under our care” and “We offer alternatives to face to face appointments.” We observed staff supporting a person returning from a hospital visit after having a procedure. This had been arranged in a couple of days and the process went smoothly. Activities were easily accessible with specialist equipment being in place to aid any mobility needs that people had in the different areas of the foundation, for example the swimming pool. Staff told us, “Everyone has opportunities to go the hydro pool every week. Staff go in the pool too to support.”

The environment at Futures and over the whole of the Foundation site was easily accessible with wide doorways in and out of rooms and bungalows, and ramps to address any varying levels, so wheelchairs and mobility aids could be used outside with minimal effort. A professional told us, “All areas accommodate all access,” People had support arrangements in place for out of hours emergencies with onsite nursing staff, and an on-call managers rota so advice and guidance could always be obtained day and night. Repairs within the home were addressed quickly; regarding broken equipment a family member told us, “They arranged for it to be fixed the same day.”

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.

People had good outcomes with their experience of living at Futures and received a package of care that was tailored to their individual needs and requirements. Staff understood and appreciated the level of vulnerability people with complex needs experienced and managed to offer reassurance and encouragement to enable them to live full and confident lives.

A professional told us, “The young people at Chailey all appear happy, clean and cared for.” The culture of the service was to challenge any barriers that were in place preventing people from experiencing day to day events and activities. Staff did not accept the stereotype that people with disabilities had a low quality of life and made sure that varied opportunities were promoted each day, for example some people had been out to Brighton to have a bowling afternoon, the previous day they had been to a local activity centre, one person we observed in the kitchen being included in the preparation of their meal, one person was outside having fresh air and looking at nature, and some people were in the outside doorways of their rooms with various instruments playing along to music. Staff were well tuned in to people’s usual presentation and anticipated their needs, making judgment calls as to whether people were well enough to manage off site trips and visits. Staff were instrumental in driving the quality care that ensured people remained stable enough to participate in daily activities. Although other resources were quickly accessible, the support staff at Futures were the ones who were delivering the immediate care and assistance to people and maintaining the stability of complex health needs, enabling an assortment of experiences to be facilitated. The increased levels of confidence and enjoyment that came from people’s involvement in varied activities provided a significant improvement in their quality of life.

Support was given in managing everyone’s needs for them to participate and be accepted within the community, with personal behaviour plans and distress management guidance detailing the best ways to support people when having time out away from the home. Local community interaction was supported by the management team with facilities within Chailey Heritage Foundation being shared and available for public use, for example, the registered manager told us the on-site church had been used by the local community for services and children’s swimming lessons were held in the pool twice weekly. The service facilitated people to travel and spend time away on holidays throughout the year and ensured that the prospective environments would safely meet all their needs.

Within the bungalows everyone had an individual photo on the walls helping to establish a homely atmosphere and promoting everyone as equal.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future.

The provider accommodates people up to the age of 25 so there is always the knowledge that people will be moving on to a different care provider once they reach the age threshold. Plans for moving on, started well in advance and involved a process incorporating various partners and healthcare professionals, as well as families and the people themselves. Keyworkers contributed information obtained by knowing that person so well and being responsible for much of their care plan and support. Moving on was not something that came as a surprise as it was a consideration at every annual review to ensure families were prepared and involved in decision making. Families confirmed this and told us they were fully involved in the transition process. They said this was discussed regularly at the annual review meetings, with the moving on plans started well in advance to ensure there was enough time to source and arrange the best new home for their loved one. The process could be lengthy with added involvement from other partners such as ICB and local authorities who regulate funding. Families told us they found it worrying thinking about where their loved one would be moving on to, but the service supported relatives with the various stages of transition to make the experience as positive as possible. The registered manager described a thorough process to ensure the next placement is the best possible choice for the person. Whether a new admission to the service or moving on, information is shared between parties to enable a smooth transition, and people are supported to visit and spend time with new staff who can get to know the best ways to support that individual. Transitions are documented in greater detail in the safe key question.

Planning is in place for hospital admissions and surgical procedures should they be required so that the experience is as positive as possible. End of life care is not supported at Futures, but the team work with the local hospice to plan support for anyone whose health is deteriorating and needs specialist provision. Some people had a DNAR (Do not attempt resuscitation – this is a medical directive not to attempt resuscitation) in place.