231 Brook Lane

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

Improvements had been made following our previous rated inspection and our rating for this key question had improved to good. Care plans had been reviewed with people’s relatives to ensure people’s planned care was person centred. The provider was meeting people’s communication needs. Support and training was in place to aid staff to communicate with people in their preferred method. People were provided with information on how to complain. Information was available to people in an easy read format. People had access to required health care professionals. Records showed people had good access to other primary care services as required. Staff told us how they treated people equally and without discrimination. People did not have end of life plans in place, we told the provider this is an area they needed to improve in.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us, they were involved in people’s care plans ensuring these were personalised. One relative told us, “We are working on the care plans together.” Another relative told us, “I’ve just had a personal care support plan through the post.”

Staff were able to describe what person centred care meant. Staff told us, they had time to spend with people listening to their views and wishes about their care and support. One staff member told us, “Person centred care is a collaborative approach focused on people and their individual needs. Creating with dignity and compassion their care plan and how we meet their needs. Involving them in the activities and tailoring care to them. It’s about working together to meet people’s daily needs.” The manager told us how they ensure people were involved in drafting their care plans and staff listened to people’s views and wishes. They gave us examples of when people were involved in reviewing their care. One related to staff using easy read information to help a person make a decision about night time support. The other related to a PBS practitioner visiting the service to review with them a functional analysis review. The manager told us, this was an area they intended to improve upon and were passionate about increasing people’s involvement moving forward.

Observations related to person centred care were mixed. We did not always see people being offered choices. For example, being given drinks with no option to choose a preferred drink and staff not acknowledging people for prolonged periods during mealtime. We spoke to the manager about this who took immediate action to improve the mealtime experience for people. We observed staff speaking to people in a person-centred way. Staff knew people and their support plans and provided support in line with people’s support plans. During our on-site assessment visits we observed people were going out undertaking lots of activities, which were varied and personalised.

We did not receive any concerns in relation to people's experience of this quality statement.

Staff told us, professionals were involved in people’s support. One staff member told us, “The GP is contacted and used whenever is needed. Relevant professionals are involved when needed in relation to people’s care.” The manager was able to describe the diverse health and care needs of the people they supported. They provided joined up, flexible working which supported choice and continuity for people. They told us, “We like to have good dialogue with the whole integrated support network, health professionals, relatives, local authority, sharing information where agreed, taking general data protection regulation (GDPR) into consideration, to ensure everyone has the most up to date information. Having good lines of communication and up to date support plans which are accessible to those who need to see them. That also works when we have new staff supporting people.”

A professional shared feedback on how the provider worked in partnership with them to ensure good outcomes for people. This evidenced the provider was working in an integrated way, sharing information to ensure continuity for people.

The manager had collaborated well with the local authority, safeguarding team, and GP to make improvements in the service following the last inspection. This joined up working improved the quality of life for people. There were systems and processes in place to review and update support plans when professional advice changed, or people developed new medical conditions.

We did not receive any concerns in relation to people's experience of this quality statement.

Information had been made following our previous rated inspection and the provider ensured staff were skilled in using personalised communication systems to engage with people and understand their needs. Staff told us people’s preferred communication methods were used and there were processes in place to support new staff members to communicate with people. They told us for one person, they made a text book of the signs the person used to aid new staff. The manager described a number of easy read documentation which was in place. They told us, “We have whistleblowing and complaints information in easy read format. We support people in MCA using easy read information to aid people’s understanding. We have easy read information around medicines. We have an easy read document format for our impact report 2024. Easy read information is also available for voting, choosing keyworkers and choosing meals.” We observed easy read documentation had been used to provide people with information to help enable them to make decisions.

Systems and processes were in place to review and monitor how information was provided and to assess if the information met the persons communication needs. Information was available to people in an easy read format. We observed easy read documents used to support a person in the MCA process to make decisions around, food and drink, photographs, consent to care and care planning, managing finances, safety in the house, medical treatment and night time checks.

Improvements had been made following our previous rated inspection and relatives had increased confidence in the provider’s complaints process. Relatives told us they knew how to raise a complaint and were confident they would do this if needed. They were confident the current manager would follow any complaints up correctly.

Staff confirmed advocacy was used within the home. They told us of a person who did not have any relatives, was supported by advocates. They told us, the advocate would visit the service to look at care plans, check the person’s health and general wellbeing. Staff confirmed people were encouraged to make complaints. One staff member told us there were posters around the house explaining the process of making a complaint. The manager described to us the opportunities people had to provide feedback. They told us, “At keyworker meetings. People have their 1:1 allocated staff member. People have an opportunity to feed back to myself as I make sure I greet and have a conversation with them. They can communicate with their relatives and advocates. There is an organisational annual survey.” There had not been a recent complaint made by a person, however the manager was able to detail the process and told us there is an easy read format complaints policy.

Formal processes were in place to seek feedback from people. We reviewed evidence of 2 people surveys. There was no formal documentation of people’s involvement in reviewing their care and support needs, however, we reviewed documents, for example, a person’s communication passport which included pictures of them using Makaton signs to aid staff in how to communicate with them. We reviewed easy read records which evidenced people’s involvement in MCA and how they had been listened to. We were assured people were involved and listened to, however, this could be improved upon. The manager was able to give examples of how they planned to achieve this.

We did not receive any concerns in relation to people's experience of this Quality Statement. Staff told us they had not encountered barriers to people accessing care, support, and treatment.

The manager was able to evidence people had access to the required healthcare professionals. They gave us a detailed list of the healthcare professional’s people had access to. When asked if people attended the opticians, the manager confirmed they did. We saw evidence which confirmed this.

Professionals told us the provider worked with healthcare professionals and they had reviewed evidence which confirmed this.

We were assured people had access to required health care professionals. Records showed people had good access to other primary care services as required. We reviewed people’s health action plans which detailed recent appointments to see GP’s, dentist, opticians, and chiropodist. We reviewed a person’s PBS plan which had involvement from a community learning disability nurse (CLDN ). We reviewed medicines records which evidenced consultation with a GP when changes to people’s medicines had occurred.

We did not receive any concerns in relation to people's experience of this quality statement. Staff told us, they were able to speak up and shared an example of when this had happened. They felt the workplace was free from discrimination, they told us, the staff team was a multicultural staff team, and opportunities were available to all staff.

The manager understood their responsibilities in ensuring people’s treatment and support promoted equality, removes barriers, or delays and protects their rights. They told us, “We have very good record keeping and information around people’s wishes, needs and health requirements. We are their voice so we should have the skills and resources available to identify the concerns they can’t. It is our job to advocate for them, to be their voice and take appropriate action if we feel they are not being heard.” The manager had a good understanding of the equality and human rights legislation and was able to describe how the principles of these were followed in practice.

The provider had policies, training and systems in place to encourage people and staff to speak up about equality. The provider had an equality and diversity policy which promoted equal opportunities for all. There was a whistleblowing policy in place encouraging people and staff to speak up. Staff completed equality and diversity training. Supervision’s sessions gave staff the opportunity to speak up.

The relatives we spoke to, told us their relatives did not have end of life plans in place. One relative told us, this was not needed as their relative was young and healthy. Another relative told us, there is not a plan in place, and they would like to make a plan sometime in the future.

The staff members we spoke to, told us people did not have end of life plans in place. The manager understood the process for supporting people to discuss their end of life plans, they told us, “We have information which is available to support end of life planning. We have organisational support in this area if we need it. It can be a topic which isn’t always considered due to the age of people. It is looked at in audits and governance. A person or their next of kin might not want to explore. It is a case by case basis.” We could not see evidence anyone living in the home had been offered an end of life plan and how the decision had been made not to draft one.

There were systems and processes in place to monitor the completion of end of life plans for people. These systems and processes had failed to ensure the requirements of this quality statement was fully met. We were not assured the provider had considered people’s future and end of life planning to ensure if people’s health was to deteriorate staff would know how people wanted to be cared for at the end of their lives.