Harp Place

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 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 rated requires improvement. This meant, people’s needs were not always met.
 

This service scored 54 (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, and they did not always work in partnership with people to respond to relevant changes in their needs.
Care plans were not always updated when people’s needs changed. This meant staff may not always have had current information to guide person-centred care. One person told us, “no review has taken place and not sure when it is meant to happen”. This meant the provider had not always checked whether the care plan continued to reflect the person’s current needs, preferences, goals and outcomes. This was important because the service supported people with learning disabilities, and reviews should have helped capture people’s views, communication needs, aspirations and quality of life outcomes over time.
Relatives gave mixed feedback. One relative told us the care was person-centred within the limits of what the service could access, but they felt the provider needed to better explore wider facilities to increase the person centered delivery of care.
However, people received support that reflected most of their preferences and routines. One person said staff were helpful and supportive of their needs and listened to them. One person told us they had been involved in their care plan. This showed the provider involved the person in some aspects of their care, but this approach was not consistent across the service.
 

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.
Relatives raised concerns about continuity in relation to meaningful community support. One relative told us their relative had been brought home early more often recently. The relative told us they would like to see the provider improve communication about what their relative did during the day and who oversees the package of care. This meant the provider had not always demonstrated that community support was fully planned, monitored or coordinated, and handovers were not communicated well enough or via different methods of communication to ensure transparency and understanding.
During feedback, the providers had already recognised that this was an issue. Leaders described using proactive planning, communication and escalation systems to reduce this risk of this happening again. However, feedback showed this had not fully resolved concerns about whether people consistently received support that was flexible, meaningful and linked to their funded outcomes.
However, people experienced reliable care. Feedback from people and their representatives demonstrated staff provided regular and consistent support, and staff called if there were any problems. This showed people received consistent day-to-day support, but oversight of continuity and activity planning needed strengthening.
 

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
Relatives raised concerns about the information shared with them. One relative said “the provider needs to better communicate what my relative does during the day and where the information about this is recorded. Handovers and communication books would improve information sharing.” Another relative said they wanted clearer information about what could be accessed through the care package. This meant the provider had not always ensured information was accurate, accessible and available to the people who needed it.
However, the provider identified people’s communication needs and developed guidance for staff. Care plans and feedback demonstrated how staff used simple language, visual prompts, extra processing time and individual communication profiles where needed. A person also said staff communicated in a way that worked for them and checked their understanding.
 

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.
The provider did not always actively seek feedback. One relative said the service had not provided a formal opportunity for feedback. One representative who wanted to provide some positive feedback said, “No not really, I would like to provide feedback though.” This showed the provider had not always created structured opportunities for people and representatives to share their views.
This was particularly important because the service supported people with learning disabilities. The provider needed to demonstrate how people were supported to share feedback in ways that worked for them, including where people did not communicate verbally.
However, people and representatives felt able to raise concerns informally. One person said they felt comfortable in giving ongoing feedback and raising any issues. Relatives and advocates also said they knew how to contact managers and felt confident raising concerns. This showed people could raise issues informally, but structured feedback systems were not embedded.
 

The provider did not always make sure people could access the care, support and treatment they needed when they needed it.
Relatives described barriers that affected people’s access to meaningful community opportunities. One relative said, “there’s limited resources available and the carer has struggled to find meaningful activities, community support is not always as meaningful as it could be.” This meant people did not always access a full range of opportunities that met their needs, interests and aspirations.
The provider recognised there were barriers to accessing meaningful activities and community facilities. During the assessment, leaders evidenced they had contacted partners and community representatives, including their local MP, to explore wider opportunities. However, this work was still in progress and had not yet resulted in consistent access to meaningful activities for people.
This was important because people with learning disabilities should be supported to access ordinary community life, build relationships, develop independence and take part in activities that matter to them. The provider had not yet demonstrated that barriers were consistently identified, planned for, reviewed or reduced. This meant people’s access to meaningful care, activities and community support was not always equitable or consistently tailored to their needs.
However, people did receive regular support from staff, and feedback showed staff helped people access appointments, some community activities and day-to-day care. One person said staff supported them with appointments and worked around their needs. This showed staff made some reasonable adjustments to help the person access support.
 

Staff and leaders listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.
The provider supported people with learning disabilities and mental health needs who were at risk of poorer experiences or outcomes without tailored support. Staff and leaders adapted care around people’s communication, routines, food preferences, community access needs and emotional wellbeing.
People and representatives described positive outcomes. One representative said staff made a person feel listened to and cared for. They said the person’s overall outlook and wellbeing had improved. This showed staff had tailored care in a way that improved the person’s experience and quality of life.
Staff tried many different avenues to support people to access activities that reflected their interests. Feedback showed staff supported people to attend experiences and visit places that mattered to them and maintain social routines. This helped reduce isolation and promoted inclusion.
 

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.
The provider did not consistently support people to plan longer-term goals, future care needs or important life changes. This was important because the service supported people with learning disabilities, and planning should have considered people’s aspirations, relationships, health needs, community opportunities and future independence.
The provider described care plans as living documents that reflected people’s goals, routines and what mattered to them. However, people and representatives told us reviews and feedback opportunities had not always taken place. This meant the provider could not demonstrate that future planning was regularly discussed, recorded or reviewed with people and those important to them.
We did not see evidence that future wishes, emergency planning or end-of-life preferences had been explored where appropriate. The provider also had not consistently evidenced how people were supported to build on their strengths, develop skills or plan for future independence.
However, people experienced some support to develop day-to-day independence and improve aspects of their wellbeing. This showed staff promoted some short-term outcomes, but the provider had not embedded a structured approach to future planning.