Your Support

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• 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.

This is the first assessment for this service. This key question has been rated 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 provider was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Discussions with the management team, senior support workers, support workers and staff in training and other roles demonstrated that at every level the team treated people with exceptional kindness and compassion. We saw excellent interactions between staff and people. We saw a person who was distressed being supported with kindness, patience and understanding. We saw staff sharing laughter and jokes with people, speaking very positively to them. Staff knew about people’s interests and needs well and could engage them in enjoyable conversations. They knew how to support them if they were feeling worried or unhappy.

Care documentation gave staff guidance about how to understand when people were experiencing pain or discomfort. Records about people were written with care and respect and guidance always promoted people’s dignity. We received consistently positive feedback about the staff and managers from all relatives and professionals we spoke with. One relative told us, “[The staff] are excellent, they are very, very good. I cannot say anything bad about them; they have been so good with [my loved one].” One professional told us, “I wish they [service provider] had more services in [our city]. I have nothing but praise for them.” Another professional said, “When a service user is in crisis, the whole leadership team come out, they are really responsive and really involved.”

Staff interactions with people demonstrated strong bonds and trust had developed between them. The leadership team spoke with praise about the staff teams. One manager told us, “Each staff member brings their own bit of magic.” Another said, “They really do an excellent job day to day.” Staff also spoke very positively about the management team. A strong culture of warmth, empathy and person-centred practice was evident across the service. Throughout the inspection we saw positive person-centred interactions and the approach of staff was always to treat people with kindness and respect.

The provider treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The provider took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff teams were built around the interests and needs of the people they supported. A bespoke presentation had been created for each person requiring care. This was kept up to date and used to help new staff get to know about the person’s needs and wishes. People’s cultural heritage was also considered. Their staff teams included wherever possible staff who shared their culture. People were also matched with staff who shared their interests. For example, a manager explained they had thought about a person’s love of watching football. They realised the person would not just want to be supported to watch the football, but also to enjoy watching a match together with staff members who shared a passion for the sport. We then saw this in discussions with a person and their staff team. They spoke excitedly together about their plans to watch a match together later in the day. We also saw that a person had been supported by staff to learn to prepare their own culturally appropriate meals. A person was supported to visit a local place of worship, which they had been unable to do previously. Staff told us the person was in charge of how long they stayed, but they did find aspects of the experience calming. The relative of this person told us how much it meant to them that their loved one had been supported to be able to attend a place of worship.

One person showed us a piece of art they had created with a staff member. They were proud of the work they had done together and had clearly enjoyed the creative process. Staff told us about training they had received to provide ‘touch therapy’. They had learned techniques from a qualified therapist and told us about the effects for one particular person had been ‘remarkable.’ The managers explained that they had seen fantastic benefits for one person in particular from the touch therapy. They had realised how much happier the person would be if they could receive this support from all their staff team and not just when the therapist visited. The therapist had agreed to train the staff team. When we visited this person, we saw this therapy in use, and they were clearly very happy, content and relaxed. One staff member commented that since the therapy was introduced the person was, “living their best life.”

People were supported to decorate their homes in ways which reflected their interests and needs. People were surrounded by things they enjoyed or that meant something special to them. People’s sensory needs were taken into account. Some people who needed a calming and soothing sleep environment had lighting and sounds which supported this. One person who benefitted from interacting with different textures had pieces of various materials arranged on the walls for them to enjoy. Another person had flags and pictures, and a bespoke mural painted representing images from their cultural heritage which were important to them.

People’s care records reflected their strengths, interests and talents. Each person had a ‘my journey’ document which was updated to show in pictures their experiences since joining the service. These provided people with an accessible way of reflecting upon their individual experiences and achievements.

The provider was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. Each person we met was supported by staff who promoted their independence and offered them choices.

Relatives told us about how much people’s independence had developed during their time being supported by the service. One person had been supported to use simple equipment to help them move around their home more independently but safely. We saw detailed planning and records demonstrating the painstaking care taken by the staff team to support someone to help prepare their own food. Training had been provided. The tasks involved had been broken down step by step and each staff member understood what must be done in what order. The person being supported benefitted from consistency and had responded to this endeavour. Staff had learned more about the person from this exercise and the person had taken their first steps towards independently preparing food.

Where people had expressed a wish to expand their education and skills, they had been supported to do so. One person had learned new skills and enjoyed reflecting on their learning experiences with staff and with their family.

A person who had struggled to go out into the community safely was supported to do so frequently. Going out had become normalised for them and this had promoted their confidence in themselves. All people receiving care were supported to do what they could to maintain a clean and tidy home for themselves. Tasks were broken down into smaller tasks and staff were very positive and encouraging. Care documentation recorded what people had been able to achieve towards their own independence. One person had been supported to order their own meal at a favourite restaurant. This allowed them to communicate their own wishes and preferences without reliance upon staff. We also saw people’s achievements being celebrated.

Each person was supported to spend time with their families and people who were important to them. Relatives told us about how happy they were to be able to visit their loved ones when they wanted to. One relative told us, “I can visit any time, I come unannounced and it is never a problem…. [my loved one] now has 2 homes.”

People were supported to try a wide range of experiences to help promote their interests and wellbeing. Each person was supported to go out into their local community safely when they wanted to. This may be a simple trip to a local shop, or a day out enjoying a favourite activity. One person was being supported to attend college regularly and told us all about the different subjects they enjoyed. Some people had been supported to have their own vehicle to allow easier access to trips out. One staff member told us one of the best parts of their job was seeing the smile on the person’s face when they went out for a long drive.

The provider was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Guidance for supporting people when they were distressed was personalised and detailed. The staff team invested time in observing and talking with people to learn about early signs of immediate changes in needs. Records demonstrated over time a growing picture of understanding of the best ways for staff to respond to people’s urgent needs. Staff shared what worked well and what was not effective. This meant people were supported by a team who were learning with them. One relative told us, “At this point I actually think the team know [my loved one] better than I do.”

Some people received support from a psychologist who helped them learn about how to reduce feelings of distress in challenging situations. This meant for one person a clearer understanding that they could move away from older ways of responding to distress. They were empowered to find new strategies which enabled them to feel much calmer and safer.

When a person was showing signs of distress and the reasons were not known, the team worked hard to learn possible causes. One member of staff told us that when supporting a person who was distressed they, “would not rest until they could find out what the person needed.” Another staff member said, “When we can’t resolve [distress], we feel heartbroken for [the person] but the management are really good at getting to the bottom of it.” Professionals were consulted to help explore possible causes. A relative told us they were always consulted in such situations. This helped the managers understand how the person’s history could be impacting upon the present.

Staff were alert to any signs of physical pain or discomfort. They used strategies to try to anticipate and prevent distress and discomfort with very good results for people. When people needed urgent medical care, this was provided quickly. A professional told us, “If someone needs to go to hospital, they just do whatever is necessary, they don’t hesitate.” Relatives told us they felt assured that the staff teams knew their loved ones very well. They told us about the ways in which staff understand how to support them to feel calmer and less distressed. Detailed analysis was shared with relevant professionals and used to review strategies over time. This had led to reductions in medicines and in restrictions to people’s care and support. This ensured staff and managers could support people with confidence that interventions could be effective.

The provider always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care. People benefitted from support from staff who felt confident to share feedback and raise concerns. Staff told us they could suggest ways in which the quality of care could be improved. One staff member told us, “I feel very confident to escalate anything to my manager, they have an open door, and we can talk to managers, and we will be heard and listened to.” Staff told us about how the management team had supported them at times of personal difficulty. They also told us they were well supported when they had cared for people who were very distressed and the situation was challenging. One staff member told us, “When things are happening [the managers] are really on it with helping. We have a 24-hour line, there is always someone you can call. They are very reassuring and calming. We get a debrief straight away… we feel confident to come back into work.” Another staff member said, “When things happen, we get positive feedback and we feel appreciated. It makes us want to come back each day. We also have employee of the month which is really nice.” A staff member also described working at the service as like being part of “a beautiful little community.”

Staff told us about opportunities they had had to learn and develop in their careers and how this helped them to feel valued. Staff told us and records showed they received regular supervision. They told us they had access to support and guidance whenever they needed it. Staff felt appreciated and involved in the design and implementation of care and treatment. This contributed positively to the caring and consistent support people received.