Choices Housing Association Limited - 1 William Street

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 as good. At this assessment, the rating has changed to 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.

Feedback from relatives consistently demonstrated an exceptionally caring culture where people were treated with genuine kindness, compassion, and dignity. One family member described staff as, “Special people,” and said, “Thank goodness for [registered manager’s name] and the lovely staff. I can go on holiday safe in the knowledge my relative will be looked after. They can be tricky at times, but the staff have boundaries, they are gentle and caring. We all make a great team and whenever there is a problem it is sorted quickly.” This demonstrated an exceptionally caring culture which fostered confidence, trust, and peace of mind for those closest to them.

Professionals consistently described staff as caring, compassionate, and respectful in their interactions with people. Professionals observed staff treating people with warmth, dignity, and genuine kindness. One professional said, “Without exception, I have observed staff treating residents with dignity and respect at all times. Interactions are kind, compassionate, and tailored to the individual, reflecting a strong, caring culture within the home.” Professionals described how they felt valued and respected by staff and spoke positively about their consistent approach which ensured people received the best possible support. This demonstrated a culture where kindness, compassion, and dignity were embedded in everyday practice and consistently experienced by both people and those involved in their care.

Staff demonstrated exceptional compassion and a strong commitment to preserving people’s dignity. Staff sensitively recognised one person's prescribed medication was affecting their physical wellbeing, confidence, and sense of dignity, preventing them from fully engaging in their community and the activities which were important to them. Staff worked closely with healthcare professionals to advocate how the person’s current treatment was negatively impacting their quality of life. Following changes made to the medication, the person's symptoms improved significantly. Staff described seeing a noticeable increase in the person's confidence, happiness, and willingness to socialise. The person was able to access opportunities which had previously been restricted by their symptoms, leading to a renewed sense of purpose and self-worth. This demonstrated a caring and compassionate culture where staff were dedicated to upholding the person’s dignity which had a significant impact on their quality of life.

People were supported to maintain and nurture relationships to enhance their lives. The provider recognised the importance of meaningful relationships in people's lives and proactively supported people to maintain and develop connections with those who mattered most to them. Staff demonstrated patience, empathy, and skill when supporting a person to reconnect with an important family member, ensuring the wishes and wellbeing of everyone involved remained central to the approach. As a result, the person was able to enjoy a valued relationship which had a positive impact on their emotional wellbeing and quality of life. This demonstrated an exceptionally caring culture where staff understood the importance of achieving an outcome which had a meaningful and lasting impact on the person's happiness and emotional wellbeing.

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.

The small and homely nature of the service enabled staff to develop strong, meaningful relationships with people, resulting in highly personalised support. One staff member told us, “I know people really well with being a small home. I understand what people prefer in all aspects of their life such as sensory and religious needs.” Staff were able to recognise subtle changes in people’s emotions, preferences, and wellbeing, enabling them to respond proactively and consistently in ways which reflected each person’s wishes. This culture of truly knowing people as individuals ensured support was personalised, meaningful and delivered in a way that maximised people's quality of life.

Staff showed an exceptional commitment to treating people as individuals, with care and support tailored around each person’s unique preferences, interests, history, and aspirations. Professionals described staff as knowing people exceptionally well and they used this knowledge to provide tailored support, centred on what mattered most to each person. One professional said, “Staff demonstrate a strong awareness of individual needs, and it is evident staff know the people they support very well and deliver truly person-centred care.” Staff took time to understand what was important to people and supported them to maintain meaningful lifestyles reflecting their individual choices and identities.

Staff demonstrated a strong understanding of the people they supported and actively sought opportunities to learn more about their lives, experiences, and achievements. Staff told us how completing life books with people had been a valuable way of understanding their personal histories and celebrating important milestones. One staff member explained, “Completing life books with people has been a great way to get to know their stories before they lived here and helps us to celebrate both past and present achievements with people.” This approach helped ensure care was embedded in an understanding of the whole person, not just their support needs.

There was a strong commitment to ensuring the environment met people's diverse needs. People's individual preferences and protected characteristics were carefully considered when planning improvements, with adaptations made throughout the home. The garden had been redesigned with people’s need in mind to ensure it was safe, welcoming, and accessible to everyone. We observed people accessing the garden throughout the day independently and with staff, sitting and chatting on the benches provided. People told us they had been actively involved in choosing how their home was decorated and proudly showed us the newly decorated lounge, which featured furnishings and décor they had chosen together from the local community. As a result, people felt a genuine sense of pride in their home and were supported to live in an environment that reflected their individuality, promoted inclusion, and was accessible to everyone who lived there.

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.

There was a strong culture of empowerment throughout the service, with staff focusing on what people could do rather than what they could not. One staff member explained, “There are no restrictions at all as people have choices in everything related to their lives.” Staff actively encouraged and worked alongside people to develop new skills, confidence, and independence. They described the sense of achievement shared when people reached personal goals, stating, “We support by teaching and developing skills too. It is wonderful when people achieve goals and learn new things.”

Staff recognised how promoting independence often meant knowing when to step back and giving people the space to make their own choices and build relationships on their own terms. One staff member said, “It is so important to give people space to promote independence, such as socialising at events. I don’t stand over people so they can be themselves with friends, but they know I am there if they need me.” This approach respected people’s autonomy while ensuring support was available when required. People were enabled to take part in community activities, develop friendships and make decisions about how they wished to spend their time, which resulted in a positive impact on people’s confidence and self-esteem.

The registered manager demonstrated a strong commitment to promoting independence by securing specialist funding and personalised assistive technology for a person whose needs were expected to change over time. They worked collaboratively with the person to plan for the future and ensure they would continue to communicate their views, preferences, and support needs independently. The person explained how the access to this technology was assisting them to prepare for future changes in their health and the positive impact this will have on their ability to continue expressing their preferences and needs. The person told us, “This technology is good for me because it suits my individual style of expressing my support needs and wellbeing." This proactive and person-centred approach helped the person maintain choice, control, and a sense of identity despite increasing health challenges.

People were supported to achieve exceptional outcomes by staff advocating strongly on behalf of people to ensure their wishes, wellbeing and quality of life was prioritised. Staff successfully supported 1 person to reduce their medicine by following the NHS STOMP (Stopping Over-Medication of People with a Learning Disability) initiative. This is a national program within the NHS England to reduce the inappropriate use of psychotropic medications in individuals with learning disabilities, autism, or both. By taking time to understand the reasons behind behaviours of distress, identifying triggers, and implementing proactive strategies, staff significantly reduced the need to administer as required medication. One staff member explained how they worked with the person to understand what caused the distress and what support was most effective. Through positive redirection, reassurance and developing strategies to manage frustration, the person experienced a significant reduction in their anxiety and distressed behaviours. As a result, this made a significant positive impact on the person’s communication, wellbeing, and ability to express choices in the support they wanted.

The provider consistently championed people's rights and empowered them to have their voices heard. On one occasion, a person was concerned about a proposed healthcare intervention and felt their views had not been fully recognised. The registered manager worked alongside the person to ensure they were supported to express their wishes and make informed decisions about their care. They advocated for the person's preferences to remain central to discussions with healthcare professionals, resulting in a care plan that reflected the person's wishes whilst maintaining appropriate oversight of their health needs. The person told us, “Eating is an enjoyment in my life, and I want to be able to eat myself for as long as possible. When [registered manager’s name] told me I didn’t have to have an [invasive physical intervention] yet, I felt very relieved and it means so much to me to have staff who understand me and listen to my feelings about things.” This person-centred approach ensured the individual remained in control of decisions affecting their life and demonstrated a strong commitment to promoting choice, autonomy, and self-determination.

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.

Relatives spoke with great confidence about the quality of support provided to their loved ones and the reassurance this gave them. One family member said, “[Person’s name] gets all that they need. We have a good relationship with the manager, and I know they have the best care that there is. I trust the staff to keep them safe and well.” This feedback reflected the high levels of trust people and their families had in the service and demonstrated the provider’s ability to consistently meet people's needs to an exceptional standard. Families told us they felt listened to and were confident any concerns or changes in needs would be addressed promptly and effectively.

Staff had developed a strong understanding of how each person communicated their needs, wishes and feelings, including when communication was non-verbal or unique to the individual. Staff explained, “We understand people’s various ways of communicating what they are feeling or need. It’s important to understand physical signs people communicate to us like body language and facial expressions so we can support them when needed.” They recognised subtle changes in behaviour, mood and presentation and responded proactively to ensure people remained comfortable and supported. This person-centred approach ensured people could express themselves in ways best suited to their needs and be understood by staff supporting them.

Staff created an environment where people felt safe and confident to discuss concerns or worries. One person told us, “I feel able to talk with staff if I need to, they are good at listening to me. They also respect my choice if I don’t feel like talking at the time and don’t pressure me.” One staff member told us, “People will tell us if they are unhappy. Some people like a quiet chat to discuss anything that is bothering them and we make time for them to feel able to tell us.” This culture of active listening and responsive support made people feel cared about, respected and enabled to have open discussions about their care.

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.

Staff consistently described a workplace where their wellbeing mattered, and the registered manager actively listened to and responded to their needs. One staff member told us, “The staff group are caring, and [registered manager’s name] is very supportive and makes changes to help staff if needed. We all treat each other well, have built good relationships and look out for each other.” This feedback reflected a strong team ethos where mutual support, kindness and respect were embedded throughout the service.

Staff wellbeing was promoted through recognition schemes, which included peer nominations where staff celebrated positive impacts and acts of support between colleagues. One nomination highlighted how a staff member had been supported by a senior carer and colleague during a training programme when they were struggling with confidence in the role. The nomination stated, “They had really brought me out of myself; I have never felt so comfortable in a training session, and that is down to them.” This demonstrated a culture where staff actively nurtured one another’s development and wellbeing, helping colleagues to thrive both personally and professionally.

The provider recognised the link between staff wellbeing and positive outcomes for people receiving support. Leaders actively invested in staff development, wellbeing, and recognition, resulting in a confident, skilled, and motivated workforce. Staff told us they felt appreciated for their contributions and empowered to deliver care which reflected people's individual needs and preferences. As a result, people benefited from support provided by staff who were engaged, highly motivated and committed to achieving the best possible outcomes.