Josh's Care Company Ltd

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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

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this service. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People and those close to them, were involved in planning and making shared decisions about how their care could meet their needs. As people’s needs changed, a review was held to ensure their care needs could still be safely delivered with any reasonable adjustments. One person’s relative told us the provider had supported them through a major change, the provider arranged and attended multi-disciplinary team meetings to support a transition process. Staff who knew the person and their family well were also involved. A professional who has worked with the provider told us, “I would say their [provider] strongest quality is their [person]-centred care approach which has been of great benefit to caring not only for the [person] but also the [family].”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People were supported by staff trained and assessed to be competent to meet their individual needs. The provider developed and delivered bespoke training packages to develop staff teams to be competent and confident to meet each person’s range of complex needs safely.

The provider identified the opportunity to offer training to family members and other carers in the community. The provider arranged opportunities to provide essential and clinical skills training to help others keep their loved ones safe. This also provided a network and support group opportunity in the local community.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication needs were assessed and met. The provider trained staff to implement a variety of communication methods, including sign language and eye pointing as well as using individual communication aides, to ensure information was shared with people in the way they preferred.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People were listened to and involved in regular opportunities to share feedback about their care. For example, people were encouraged to give feedback on the service they received, through discussion with their care staff, or with managers carrying out ‘spot checks’. Records identified where conversations had taken place and actions agreed to make improvements.

The provider involved stakeholders in a range of ways. Satisfaction surveys were carried out and where issues were identified, these were acted upon to improve the service people received. The provider shared a ‘You said, we did’ document to let people know what actions they planned to take in response to the feedback they received. For example, the provider improved the induction programme for all new staff to include educational and practical training to meet the care needs of individual packages.

The provider identified the opportunity for a new project to promote input from the people they supported. A person receiving support requested to be involved and volunteered to work with the provider to develop and run a client and family committee. This was in progress.

Where people had raised concerns and complaints these were dealt with promptly by the provider and the outcome shared with the people involved. One person told us, “When I did have a problem, I complained and they [the provider] listened and sorted it. Problems are not brushed under the carpet, problems are investigated.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People received person centred care which met their needs, this included flexible care when required. One person told us, “They [the provider] always manage to find some contingency hours, for example, to support a hospital appointment”. Another person told us, “The provider and staff were flexible to meet my urgent medical needs. Staff were available at short notice to support changes in my support.”

Staff understood their responsibilities to ensure people received an equitable service and had received training in Equality, diversity and human rights.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

The provider’s way of working ensured everyone received exceptional specialist care assessed and planned to meet their individual complex needs. A professional working with the provider told us, “I have overseen the implementation of two care packages and found [the provider] to be proactively responsive and innovative and highly effective and evidence-based in managing complex care packages.”

Where the provider identified potential barriers to people achieving outstanding outcomes, they took action to address this. For example, the provider responded to feedback from people who did not have access to a wet room at home and wanted to have a shower. The provider purchased a mobile shower and van, to transport the equipment, to offer people the opportunity and support to have a shower in their own homes. The person who first used the shower gave the following feedback demonstrating excellence. “The machine itself is rather compact and was easily manoeuvred around my bed. From start to finish the process did not take long and I felt really safe whilst using it. Even though my carers were using the shower for the first time the procedure was well managed all round. For quite a while I have been having bed baths, so it was a great privilege to be the first to use the shower. After using the shower, I felt invigorated and will definitely be using the service again.”

The provider attended community events and provided guidance to people wanting to manage their own packages of care. For example, the provider worked with a person and their family and health professionals to develop and provide training and clinical oversight of the care provision for a family member with complex needs. The person and family were able to have full control over how and who supported them.

The provider shared numerous examples of achieving outstanding outcomes for people and their families. For example, supporting people to plan and go on holidays independently from their families and working with people to provide support giving the opportunity for their family members to go on holiday.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were fully involved in making decisions about how their care was to be provided and care plans included any specific and person-centred details for future care.

People’s goals and aspirations were discussed with them, documented and included in the regular reviews of people’s care. People’s goals were individual to them and reflected their own circumstances. For some people this was to pursue sports activities or a range of social activities, for some people it was to offer them the comfort of providing opportunities for their family members to follow their own interests, for others this meant developing a bespoke support package to enable them to be able to fulfil their own family caring responsibilities. People achieved their individual goals with support from staff.