Top4Care Services Ltd

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.

This is the first assessment for this newly registered service. This key question has been rated good.

This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 70 (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 treated people with kindness, empathy and compassion and respected their privacy and dignity.

Staff developed positive, meaningful relationships with people and demonstrated a clear understanding of what mattered to them. We observed staff communicating with people in a way that met their individual needs. One staff member told us, “To provide the right care, we follow details of the care plan, respecting the persons’ human rights, and make sure we provide them with dignity.”

People told us staff listened to them and respected their decisions. Policies such as equality and diversity further reinforced respect for people’s values.

People were supported to maintain relationships with family members and those important to them. Feedback from relatives was positive, one told us, “From what I have heard and seen the staff have been very helpful and caring.”

The provider generally treated people as individuals and supported care, treatment and support that reflected their needs and preferences. This was not always reflected in people’s living environments or documentation.

However, the provider had not consistently supported people to create personalised living spaces. We found that two bedrooms were only furnished with a bed. There was limited evidence to demonstrate people had been actively supported to make choices about how their rooms were decorated. This meant that opportunities to promote individuality within these spaces had not been fully realised. Since the assessment, the provider has contacted family members to discuss ways to personalise people’s bedrooms.

We also found examples where records of meetings contained language that did not consistently demonstrate how people’s individual views and preferences had been considered. Statements included, “cautioned about taking food without support worker watching and giving them permission” and “prompted to lower gadgets by 10pm for them to sleep.” The provider acknowledged language was not person-centred. They advised this was not representative of the care people received. Feedback from people, relatives and our observations indicated staff knew people well and supported them in a personalised way.

Staff demonstrated a good understanding of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Care plans contained information about people’s backgrounds, interests, life experiences, routines and outcomes they wanted to achieve. Staff knew people well and demonstrated a good understanding of what was important to them. People were supported to make choices about their daily lives, including how they wished to spend their time. Care plans included information about people’s religious preferences where relevant and staff supported people to practice their faith in ways that were meaningful to them.

The provider promoted people's independence and supported people to have choice and control over their care, treatment and wellbeing.

Care plans outlined how people wished to maintain independence, including managing aspects of their care and making day-to-day decisions. Staff supported this through offering choices and respecting preferences. One staff member told us, “We focus on their strengths and look at what they are good at, what they do best and then how they can be more successful. We encourage them or prompt them to do tasks, we don’t do everything for them.”

The provider encouraged people to pursue interests and achieve personal goals. We found people were supported to attend college, develop life skills and participate in hobbies that met their interests.

People told us they felt involved in decisions about their lives and supported in a way that reflected their preferences. Relatives also provided positive feedback and told us, “Staff have made him more independent. They show him how to do something if he has struggled with something” and “They support him with shopping. He has choices of what he wants.”

The provider 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.

Staff were observant and attentive to people’s wellbeing. We observed that people moved around the service freely and approached staff when they required support. Staff were consistently available and responded to people’s needs.

Care plans contained information on people’s mental health needs, including early warning signs of anxiety or distress. These included support strategies staff should use to provide reassurance and were individual to each person.

The provider promoted the wellbeing of their staff, and supported and enabled staff to deliver person-centred care.

The provider used staff surveys to seek feedback from staff and identify areas for improvement. Survey responses were positive, although we found staff surveys were not completed anonymously, which may have limited the provider’s assurance that staff felt able to provide honest feedback. Despite these concerns, staff told us they felt supported by leaders and able to raise concerns.

Staff had regular supervision and opportunities to discuss their performance and wellbeing. We found records demonstrated supervisions also provided opportunities for staff to discuss their wellbeing and any personal circumstances that may be affecting them outside of work.

Leaders held regular team meetings where staff could share feedback, raise concerns and contribute ideas. Staff told us they felt listened to and leaders were approachable.

Staff had access to policies and guidance to help them carry out their roles effectively. There was a stable staff team who understood people’s needs and preferences.