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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

At our last inspection this key question was rated requires improvement. At this assessment, the provider had improved, and this key question is now rated good. Staff understood people’s care needs well and supported people in line with their wishes and preferences. People were supported to live healthier lives and had choice and control over the activities they participated in. Staff and leaders ensured people were involved in decision making about their care and support, which was reflected in their care records. However, information was not always provided in formats tailored to people’s individual needs.

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.

People told us the care they received was individualised and in line with their choices and preferences. One person told us, “It's brilliant here. The carers are lovely. I get on well with everyone. This is the right place for me. They support me with all my personal care, and they do what I ask them.”

Leaders and staff told us how care and support was planned and reviewed with a person-centred approach. People were involved in the care planning and risk assessment process. A resident of the day programme was in place, but it was not being used effectively to give people opportunity to feedback. We reviewed a number of resident of the day documents but did not see any evidence of the person being involved in the process. The registered manager acknowledged this and said they would discuss with staff how this process could be improved.

Staff knew people’s preferences and provided care as people preferred. We saw staff offering choices and asking people what they would like to do. Staff also knew from observing people’s behaviours what they wanted, when they were not able to tell them. For example, one person stood in a certain place when they wanted support.

People felt supported and involved in their care provision and treatment. Where they were able to advocate for themselves, people told us that they were involved in planning their care and support. One person said, “It probably helps that I’m also able to explain the condition and the symptoms myself so if they’re not sure about anything they can ask me. I have a good relationship with our regular carers, so they’re comfortable to ask me things and I’m happy to tell them anything.”

Staff and leaders made sure people were supported to receive coordinated and appropriate care. The service worked with partners in health and social care to make sure people were, wherever possible, at the centre of coordinating their care. For example, one person was going to look at a house arranged by their social worker. Staff accompanied them to make sure they were fully supported and able to give their views. Staff told us that care and support was planned in conjunction with people and their families, where appropriate. One staff member told us, “Where residents are able, they are involved [in reviewing their care needs].” Staff also told us that input from other healthcare professionals was used to provide the most appropriate care and fed into the support provided by staff at the service. Another staff member told us, “If they’re having district nurse or doctor input we make sure that’s referenced in the care they need.”

Partners were assured that the service made sure people received the right support. They told us they had noted a significant improvement in the quality and personalisation of people’s care plans.

Processes were in place to make sure referrals were made, where appropriate, to health and social care professionals to support people in making sure their needs were met. Staff worked closely with partners to achieve good outcomes for people.

People told us, where possible, they were involved in reviewing their own support needs and that it was taken into account.

Staff told us they had worked with one person to produce a photographic guide for staff on how to meet this person’s moving and handling needs. This information had been produced using the person’s preferred font.

There had been some improvement in people’s records, but information was not always provided in formats tailored to people’s individual needs. The registered manager told us they had not yet produced care documentation in a format that would be helpful to people with a learning disability. However, they said they did have plans to start working on this.

People felt listened to and involved in the service. One person told us, “There isn't anything I would change. I love living here especially the manager and deputy. I can go to them if I have a problem.” People were involved in some aspects of auditing the service. For example, people accompanied the registered manager in their walk arounds to check the environment.

People’s involvement in the service had improved. For example, people were now involved in the interviewing of potential new staff and in managing their own meetings. Staff also involved people in decisions about their care and in other aspects of the service.

Processes were in place and being developed to make sure people had involvement in their own care and in the running of the service. People were encouraged to speak up during meetings and staff checked regularly with people about how they were feeling. People had also completed anonymous surveys about their experience of the service. The service had produced ‘you said, we did’ documents in response to the feedback.

People we spoke with did not report facing any barriers to accessing services. For example, appropriate swimming facilities had been sourced for one person and another person regularly attended a local gym. People were supported to visit appointments such as dentists and opticians, where they wished to do so.

Leaders told us people received the support they needed to make sure disabilities or communication difficulties were not a barrier to accessing services.

Commissioners had reported improved outcomes for people living at the service. They told us, “There has been a noted improvement in the activity offer, particularly individuals being supported to access the community.” One healthcare professional also told us about the work the service had undertaken to support a person to make their own decisions regarding external activities, which had previously been deemed too risky.

Assessments of people’s needs, and person-centred care planning considered the support people needed to overcome any potential barriers. For example, the provider had worked with a charity to support a person to make a trip abroad.

People were supported to overcome any difficulties they might encounter to make sure they experienced equality in care. For example, one person had been supported to start going out, when previously they had not left their house for several years. This person had also started an initiative in the home to make sure everyone was registered to vote.

People were supported to overcome any potential barriers to achieving their goals and aspirations. Advocacy services were involved as needed and one person was being supported to find employment in the mainstream workforce.

Processes were in place to make sure care was planned in an individualised way, that made sure people were supported to minimise any obstacles they may face because of their disability. For example, new chairs had been ordered for people to enable them to access the community. Another person had a document in place to show what font they preferred for their records to be produced in.

Where appropriate, people were supported in moving on from the service. For example, one person was being supported to look at independent living accommodation and another person was being supported to learn to cook, in readiness for living independently.

Leaders told us they worked with health and social care partners to support people in planning for the future.

Leaders had developed good working relationships with partners, to make sure they worked together effectively in supporting people plan for their futures. For example, one person was being supported to look for a property where they could live more independently.