No 36

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding.

This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The visible culture of kindness and respect was embedded into every interaction and part of the service. Staff, people using the service and relatives constantly referred to the service as “like a family” and the “LD Care family.” Staff demonstrated genuine affection when talking about and to people. They became emotional when discussing people’s successes and about the loss of a person.

The provider had developed a community where the families of people using the service and staff were an integral part of life at the service. They were invited to be part of activities, holidays and daily life at the home. People were connected through a wider community with the staff from and people living at the provider’s other care homes. They had developed friendships and shared new experiences together. A staff member explained how their children had grown up knowing each of the people using the service. Another staff member told us how people and relatives used an affectionate nickname for them. They said, “This is very special and shows the relationship of trust we have built over time. When we work with someone every day we become an important part of each other’s lives.”

Staff were exceptionally kind and thoughtful. When 1 person was admitted to hospital, staff stayed with them throughout. They took their favourite bedding and belongings to make the hospital environment feel safe and homely. A staff member explained, “They are not just ‘residents’ to us. We are attached to the people we support.”

Other comments from staff included, “Care is about patience, understanding, respect and treating the people we support as part of our family” and “One of the nicest things is seeing the people we support happy and comfortable around us. When they smile when they see you, want you to join their activity, or show that they trust you, it means a lot. Those things cannot really be measured on paper.”

Staff empowered people by meeting their individual needs and recognising the things that were important to them. They knew people exceptionally well. A staff member explained, “We know their personalities, their funny moments, their difficult days, their achievements and the little things that are important to them.”

Staff explained that 1 person’s family member had recently needed hospital treatment. They supported the person to prepare meals for their family so that they did not need to worry about this and had freshly prepared meals when they returned from hospital. They also supported the person to help keep their family member’s house clean. This not only demonstrated the caring nature of the service, but the recognition that the person they supported would want to be part of this care for the people they loved. The provider had received feedback from their family expressing their gratitude for this.

Staff valued people and supported them to express their personalities and take a pride in their appearance and home. Staff supported people to buy nice clothes for special occasions, to dress up and not feel restricted by any physical disabilities.

Staff found creative ways to ensure people could celebrate culture and the things that were important to them. One person found it difficult to attend their place of worship because they expressed themselves in a way members of the public sometimes found difficult to understand. Staff worked with them to reduce their anxieties and slowly familiarise themselves with the expected routines for the place of worship. As a result, the person started to attend and was able to celebrate religious festivals with their family and community. Staff supported people to prepare different cultural meals and celebrate special events. Some people had specialist diets because of their religion. A relative explained, “They have wonderful trips. They always celebrate each resident’s birthday with a lovely party and celebrate Halloween, Christmas and Easter too.”

Staff supported people to have the experiences that those without additional needs would expect as part of normal life. They found ways to overcome barriers and allow people to feel valued and enjoy life. A staff member told us, “I recently supported people on a holiday abroad. For me this was a special experience. Seeing people enjoying the holiday, going to different places and having the experiences many of us take for granted. It makes you realise how meaningful our jobs can be. We are here to help them enjoy their lives as much as possible.

Staff encouraged people to feel safe which enabled them to be more independent. There was an ethos that life outside the care home was as important as life inside. Staff recognised that problems arose when people did not understand situations or felt scared by them. They created exceptionally personalised care planning which considered small steps and celebrated all achievements. This enabled people to develop independence at a pace which was right for them and felt safe. The registered manager told us, “We use graded exposure, travel training, social stories, visual preparation, positive behaviour support and consistent staffing to build confidence.”

The service recognised that providing a range of experiences gave people responsibility, routines, social contacts, confidence and a sense they were making meaningful contributions. For example, staff supported people to volunteer with litter picking, supporting a local place of worship and in a community gardening project. People had taken part in charity events, raising money for charitable causes.

Staff supported people to have new experiences. They used careful planning and communication with people to overcome barriers and to support people to be independent. For example, staff had recently supported a person to go on holiday abroad. The person had previously found leaving the house challenging. Their responses to new situations had put themselves and others at risk. Photographs of the holiday showed them achieving things alongside staff, clearly enjoying their company. They had independently managed some of the trickier aspects of travel, including managing the different situations at the airport, being in a country where people did not speak English and unexpected delays. The registered manager told us, “For somebody who previously could not safely go into the community, holding their passport and boarding an aeroplane represents years of patient work and an enormous increase in independence and quality of life.”

Staff also supported people to be as independent with their own care as possible. People had developed cooking skills and independence in their own personal hygiene. One person was now independent with an aspect of their own selfcare. This was a significant milestone, and they took a pride in their achievements. Comments from staff included, “We encourage independence as much as possible, even with the small everyday things that many people may take for granted” and “Even small achievements are important to us because we can see how proud and happy people are.”

Staff responded to people’s immediate needs. The service was staffed throughout the day and night. People did not have to wait for care. There was a close network of managers and senior staff who were available on call when people or staff needed them. Staff understood people’s health needs exceptionally well and responded to any changes in their health or condition. Relatives confirmed this. They explained people were safe with staff. Relatives trusted them to ensure people had the help they always needed. A staff member commented, “We are always reminded that even a small change can be important. Especially when the person we are supporting may not be able to tell us clearly if they are in pain or unwell.”

The provider valued staff wellbeing as equally important as the wellbeing of people they supported. All staff told us they felt valued, respected, had opportunities to develop themselves and that their personal needs were met. Senior managers and managers welcomed staff families to be part of the LD Care community. They supported staff to bring their children on holiday with people living at the service, recognising this gave staff with caring responsibilities the opportunity to participate in the whole service. This also ensured staff families got to know people and promoted a culture of inclusivity and acceptance.

All managers within the service, at this and the provider’s other homes, had been promoted within the organisation. They had been given opportunities to take on new responsibilities and undertake management in care qualifications. This ethos continued with the current support workers, giving those that wanted opportunities to develop their careers.

Staff unanimously felt supported and that working at the service was an important part of their lives. Their comments included, “LD Care encourages staff to grow. If you are willing to learn and do your best, the management team notices and gives you opportunities”, “I feel valued and respected. My opinions matter” and “Managers saw potential in me. I was never made to feel I was just a support worker.”