Dorset Healthcare University NHS Foundation Trust

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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

This means we looked for evidence that the service met people’s needs.
At our last assessment we rated this key question good. At this assessment the rating has remained good.
Patients received person-centred care that reflected their individual needs, preferences and goals. Information was provided in accessible formats, and reasonable adjustments were made to support equitable access to services. Staff worked collaboratively with patients, carers and partner organisations to provide coordinated care and support continuity throughout the patient's journey. Patients and carers were actively involved in service development, and feedback was used to improve services. Staff supported patients to plan for the future, maintain community connections and access the care, treatment and support they needed.
 

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 service 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 young people’s needs.
The service placed people at the centre of their care, treatment and decision-making. Staff described a strong person-centred culture and demonstrated how care was tailored to individual preferences, goals and communication needs. The service used a My Wellbeing Plan to support collaborative care planning, bringing together information from patients, carers and professionals. Easy Read versions were available and care plans reflected people's strengths, aspirations and support needs.
Staff used a range of communication approaches to ensure people could express their views, including British Sign Language interpreters, language translation services and Talking Mats. Staff demonstrated creativity in adapting care to people's interests and preferences.
People were offered choice regarding how, where and when they received support. Staff described adapting appointment times, locations and methods of engagement to meet individual needs and preferences. One person chose to work with three different professionals to meet different aspects of their care and this preference was accommodated.
Carers consistently reported that staff took time to understand the people they supported and adapted care to meet their communication needs, routines, interests and preferences. Families described the service as highly personalised and responsive to individual circumstances.
 

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.
The service provided coordinated and joined-up care. People were usually allocated a named professional rather than being supported through a pooled caseload approach, helping to promote continuity of care and therapeutic relationships. Staff described examples where people returning to the service had been allocated the same clinician because of an existing trusted relationship.
The service worked collaboratively with social care, acute hospitals, community providers and specialist services to support care planning, transitions and ongoing support. Families consistently described positive partnership working and reported feeling involved in care planning, reviews and decision-making.
The service worked proactively with acute hospitals to support people with learning disabilities when they attended hospital. Systems were in place to alert Community Learning Disability Teams when a person with a learning disability attended the Emergency Department. This enabled staff to liaise with hospital colleagues, advocate for reasonable adjustments and support continuity of care. The service had also contributed to improvements within acute hospitals, including the introduction of Easy Read resources and support for reasonable adjustments.
Carers consistently described effective partnership working between the Community Learning Disability Teams, social care, hospitals and providers. Families valued the coordinated approach and reported that staff worked collaboratively to support transitions, independent living and ongoing care. Several carers described long-standing positive relationships with staff and valued the continuity of support they received.
 

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

People were provided with information in accessible formats. Easy Read information was routinely available, including care plans, surveys and patient information. Easy Read versions of the My Wellbeing Plan were available to support involvement in care planning.
Staff considered individual communication needs when planning care and treatment. British Sign Language interpreters and language translation services could be arranged where required. Speech and Language Therapists provided support and training in the use of Talking Mats to help people communicate their views and preferences.
An Easy Read Group facilitated by people with learning disabilities had contributed to redesigning sections of the Trust website and developing accessible patient resources. This demonstrated a commitment to ensuring information was understandable and accessible to the people using the service.
 

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Staff members ensured patients knew how to raise complaints and carers told us they were confident the service would ensure their concerns were dealt with appropriately.

Feedback from carers indicated a high level of satisfaction with the service, with most reporting that they had never needed to make a complaint about the Community Learning Disability Team (CLDT).

All carers stated that staff were approachable, responsive and dealt with concerns promptly when they were raised. Carers felt able to raise concerns and were confident that the service would respond appropriately, openly and constructively.

Families described positive relationships with team members and felt confident that their views would be listened to and acted upon. Where concerns were raised, these were generally related to external providers, transition arrangements or access to specific professionals rather than teams themselves. One carer described how concerns about provider staffing and consistency of care were escalated and responded to quickly by the CLDT, resulting in improvements being made. Another family reported making formal complaints regarding transition failings involving other agencies but spoke positively about the support received from the Learning Disability Team throughout the process.

The service made sure that people could access the care, support and treatment they needed when they needed it.
Staff ensured that people could access the care, support and treatment they needed when they required it. The service collected and monitored information relating to protected characteristics and used this information to understand the needs of the population it served and identify potential inequalities in access, experience and outcomes.
The service demonstrated a commitment to reducing health inequalities through groups, attended by healthcare professionals, patient representatives and carers. For example, the trust had implemented the NHS Patient and Carer Race Equality Framework (PCREF), a mandatory national programme designed to reduce racism and improve equity in mental health services. Action plans had been developed and were reviewed and actioned regularly.
Staff received equality, diversity and inclusion training to increase their understanding of health inequalities, protected characteristics and the impact of discrimination. This supported staff to provide inclusive care and identify barriers that may prevent people from accessing services.
Reasonable adjustments were made to support equal access for people using the service. For example, British Sign Language interpreters were arranged for Deaf people accessing talking therapies. Appointment times, locations and lengths could be adjusted to meet individual needs and preferences. Staff considered mobility and accessibility needs when arranging appointments and could provide appointments in accessible locations, including ground-floor environments for people who used wheelchairs.
The service operated from accessible premises with level access, accessible toilets and lift facilities. Staff also provided training and advice to partner organisations regarding reasonable adjustments to improve accessibility and inclusion.
The needs of carers and family members were considered when planning care and treatment. Carers were supported to attend appointments and meetings with their loved ones, and accessible facilities enabled their participation where required.
 

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.
Staff were trained in equality, diversity, inclusion and human rights with an average training level of 96% across the services.
The service sought to understand and respond to the diverse needs of people using services. Care was tailored to individual communication needs, cultural preferences, religious beliefs, physical health conditions, autism and mental health needs.
The staff team adapted communication methods, recognising religious preferences and providing specialist support for people with complex health needs. Staff worked with individuals and families to ensure care reflected personal preferences and goals. For example they used of British Sign Language interpreters, Talking Mats and Easy Read information to support people to understand and participate in decisions about their care.. Specialist support was provided for people with complex needs, including epilepsy, autism, severe mental illness, behaviours of concern and complex physical health conditions. Staff worked collaboratively with individuals, families and providers to develop personalised Positive Behaviour Support plans, establish routines, promote independence and tailor interventions around people's interests and preferences. They used a person's interest in rollercoasters to improve engagement with care planning, wearing Marvel-themed clothing to reduce anxiety during appointments and using music and dance to encourage participation in physiotherapy.

Carers described positive outcomes including improved wellbeing, greater stability, reduced incidents, increased independence and improved quality of life as a result of support from the service.
 

People were supported by planning 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 service supported people to develop independence and prepare for future transitions. Staff worked with people to develop practical skills including travel training, healthy living, managing routines and independent living skills.
The service worked alongside local authority social care to support adults transitioning from family homes into more independent living arrangements through dedicated transition houses. These services aimed to develop confidence and practical skills before individuals moved into longer-term accommodation.
Carers described positive experiences of transition support and highlighted the service's role in helping people establish routines, access day opportunities, engage in meaningful activities and remain connected to their communities and support networks.
Staff recognised there was not yet pathways for adults whose primary diagnosis was autism following diagnosis. A senior manager advised that this was being considered through wider system reviews and partnership work across Dorset