Ascend Support (Ealing)

We assessed the service against Right support, right care, right culture guidance to determine whether it ensured people with a learning disability and autistic people received respect, equality, dignity, choice, independence and access to their local community. The service worked in line with the principles of Right support, right care, right culture. People were supported to exercise choice and control, maintain important relationships and participate in activities within their local community. We found no evidence of a closed culture.

People experienced personalised care that reflected their individual communication needs, preferences and routines. Staff knew people well and used this knowledge to provide consistent support. Feedback from people, relatives and professionals was positive and described improvements in wellbeing, stability and quality of life.

The service operated from a community-based setting that promoted inclusion and participation. Staff supported people to access healthcare, community activities and family relationships. Reasonable adjustments were made to meet people's communication and sensory needs, helping to reduce barriers and promote equality of experience.

There were sufficient numbers of trained and competent staff to meet people's needs safely. Staff demonstrated a good understanding of safeguarding and used person-centred approaches to support people safely while promoting independence. Medicines were managed safely, and staff used positive behaviour support and least restrictive approaches to reduce distress and avoid unnecessary use of medicines.

Care and support were generally effective and responsive to people's needs. Staff worked closely with healthcare professionals and relatives to support positive outcomes. People were involved in decisions about their care and future wishes, and care was adapted when needs changed.

The service demonstrated a caring culture. Staff treated people with kindness, dignity and respect and supported them to express their views using personalised communication approaches. Positive relationships between people and staff contributed to people feeling safe, valued and supported.

However, governance systems had not always identified inconsistencies in care records. We found shortfalls in emergency evacuation planning, assessment reviews, risk records, clinical guidance and some Mental Capacity Act 2005 records. Following our feedback, the provider updated the PEEP to clarify the people’s location, mobility aids, required staffing support, assembly point and daytime and night-time evacuation procedures. The provider also supplied a staff read-and-sign record showing relevant staff had read the revised plan. This provided assurance that the updated emergency information had been shared with staff and reduced the immediate risk associated with inaccurate or incomplete information.

Overall, the provider delivered good-quality, and person-centred care. People achieved positive outcomes and were supported to live meaningful lives with choices, independence and inclusion within their community. Leadership promoted an open culture and demonstrated a commitment to learning and continuous improvement.