Cygnet Care (Devon) Limited

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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. 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 100 (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.

Care staff excelled in delivering kind and compassionate care. The service went the extra mile to improve people’s lives and staff recognised what was important to each individual. For example, a person was no longer able to walk their dog. The care staff recognised the impact this had on the person’s mental wellbeing. The registered manager arranged for care staff to walk the dog as part of the person’s daily care package. This meant the person was able to keep their much-loved pet and retain their relationship and emotional benefits.

The kindness of the agency and individual staff extended beyond their arranged care. For example, people gave us examples of staff collecting shopping or doing washing in their own time. One staff member told us they stayed longer to give a person some pamper time because they enjoyed it. A staff member told us when a person’s favourite glass broke, they found a nice glass, wrapped it up and gave it to them. They said they were so pleased and it really made them happy.

People consistently told us staff treated them with exceptional kindness, compassion and respect. One relative said, “Staff are open, jolly and happy, I am very impressed by how they are recruited.”

Each person had a small, consistent staff team who knew them well. Staff had established a genuine and deep connection with those they cared for and demonstrated real curiosity about what mattered to them and how to meet their needs. One relative told us, “The care team know us both very well indeed. We feel they are (husband’s) social life, they are friends as well as carers. He loves to talk to them” In addition to delivering care to people, relatives told us they appreciated the support staff offered them. For example, a relative described how the service was able to increase the care package to 24-hour care, so they were able to have regular breaks. They felt reassured when staff were caring for their loved one and therefore, also benefited from their respite time.

The service provided sufficient time for staff to develop trusting relationships with people. Staff told us, “Each client gets a good, allocated time allowance enabling you to provide a high level of person-centred care. You have time to talk to your client, to get to know them, to listen to what they have to say, to listen to their wants/needs and desires, which enables you to provide person-centred care. I feel very supported by my co-workers, colleagues, and management.

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.

People benefited from highly personalised care that reflected their unique needs and preferences. Care plans were detailed and person centred, capturing what mattered most to each individual, such as routines, personal histories, cultural and religious needs and interests. Staff used this information to tailor support for each person. A staff member told us the registered manager put a lot of effort into looking at which staff are suited to which person to ensure the best outcomes.

People’s communication needs were consistently met to enable them to engage in their care, treatment and support to maximise their experience and outcomes. For example, one relative told us about staff’s excellent understanding of their loved one’s communication needs. They said, “Staff continue to chat away and to reciprocate his signing, they have an excellent relationship with him, to the extent they have a two-way humour between them, and he clearly enjoys their company. “

A relative said, “The great thing is, the service really values my mother. They see the bigger picture, beyond just getting her up and dressed. I am a long distance away but can ring the office about anything. I can arrange for staff to be at mum’s if I’m uncomfortable about something, for example if there’s to be a tradesperson there. We recently had an alarm system installed, (Registered manager’s name) helped mum accept the idea and was involved in the arrangements for installation.” This ensured peace of mind.

Staff treated people as individuals and made sure their care met their needs whilst taking account of their abilities. For example, a staff member told us one person preferred a very specific routine with their personal care. They said, “I made sure to follow their preferences exactly and gave them time to feel comfortable rather than rushing. On one occasion, they seemed more unsettled than usual, so I slowed everything down, reassured them, and adjusted the approach to make them feel safe. I also communicated this to the team so we could provide more consistent support moving forward.” This meant the person benefited from high quality, consistent care that met their needs.

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.

People were actively supported to enhance their autonomy, have as much control over their lives as possible and develop new or existing skills. One person told us, “The staff encourage me to keep up exercises I’ve been set by the physio. I feel the care is helping me overall with recovering from back injury and getting back to greater independence.”

Staff offered positive encouragement to promote people’s independence. For example, a staff member told us a person who used the service expressed a desire to go to the gym. Staff supported this person to go to the gym, giving assistance with the equipment and providing encouragement. This helped the person both physically and mentally. Their motor skills improved which helped when they needed to stand up. They were also sleeping better at night.

Another staff member said, “We have a lady and we all encourage her up and out of her chair to walk around the house or to the kitchen with us and choose her dinner as it is very important to encourage that independence and choice.”

People were involved in decisions about their day to day care and support. For example, the registered manager told us how they had supported a person to obtain a profiling bed. This person had been struggling to get in and out of bed and this led to them sleeping in their recliner chair. The registered manager involved the person and discussed the options available to them. An occupational therapy home visit was organised with this person’s regular care staff present. This led to funding for a profiling bed being delivered by the local authority. This person benefited as they were more comfortable, their dignity was respected, and their risk of pressure sores was reduced.

People’s social needs were understood and appropriate choices were offered. A relative said, “Despite the challenges of her mental state, mum knows she can’t survive without the carers, and really they are her life, without them she would be totally isolated. I see them come into her bright and breezy, and offering her all sorts of choices.”

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.

One person said, “They are all excellent and what I like is that they show initiative. One has just collected my prescription from the pharmacy for me, because I couldn’t get downstairs to receive the delivery. That is typical of them going over and above.” This meant the person received their medicines without delay and reduced their anxiety.

People and their relatives were encouraged and actively supported to be active partners in their care, leading to exceptional levels of satisfaction. People and relatives described how staff quickly noticed when something changed and acted immediately to provide reassurance or support. For example, a relative told us how staff identified a health concern and the registered manager contacted them to discuss the best way forward. They described how the registered manager arranged an emergency prescription as a precaution. They said, “With the carers’ levels of knowledge and expertise, and the manager’s links with local services, I feel we can always make the best decisions.” This gave the relative peace of mind and ensured the best outcome for the person.

Staff described how they recently supported a person who was unwell. Whilst waiting for an ambulance, one staff member stayed with the person to try and calm their breathing down and get their medicines ready. Another staff member went out to meet the ambulance as the satellite navigation system would have taken them to the wrong address. This meant the person got medical attention quicker and the person’s anxiety was reduced.

The registered manager told us how they worked with health professionals and a relative to prevent a hospital admission for a health check and treatment. The person received a home visit and the registered manager ensured there was clear communication. This meant the person was able to receive the treatment they needed whilst in the comfort of their home and staff were able to provide reassurance and familiarity.

The service was committed to responding immediately to people and their relatives when circumstances changed. For example, a health professional thanked the service for stepping in to cover a person’s care at short notice to prevent a potential hospital admission. They described the joint working as going above and beyond to make sure the person was safe.

Staff told us communication at the service was highly effective. One staff member said, “Communication is brilliant we can always contact them and someone always has the out of hours phone.”

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 benefited from a culture of exceptional teamwork. There was a stable workforce with some staff members having many years of service. This continuity reflected a positive and supportive culture, underpinned by high morale, strong staff engagement and genuine commitment to delivering excellent care.Staff said, “I find the job very enjoyable and feel part of a team. It's a small private company, that feels more like a family, we encourage, help and support each other as well as the clients we care for” and “It’s a really positive and supportive place to work. I’ve felt welcomed from the start and part of a strong team. I’ve been working for the service for a good amount of time now, and during that time I’ve gained valuable experience and confidence in my role.” One person told us, “Staff seem very loyal to the company, if they leave they often come back.”

Staff felt valued and treated in a way which supported their own wellbeing. One staff member said, “I feel like we get a good amount of time with each client, I never feel rushed, I never feel overwhelmed or stressed with the workload or the care we have to provide.” Staff told us they had the same rota each month so they knew what they were working and people knew who was coming to visit them. This meant people benefited from staff who were well supported and enabled in their role.

Staff wellbeing was prioritised. The registered manager told us they were always available to support staff with work related or personal concerns. Staff said, “(Registered Manager’s name) really builds your confidence and I had some personal issues and I have had no problem going to her about anything” and “(Registered Manager’s name) is very supportive of staff and is a really good boss and she will listen to you and if she can help with either a work or personal issue, she will.”

The registered manager told us staff could access a pool car and electric bike at no cost for work and personal use. The service had enrolled in the local authority’s parking permit scheme so staff could park closer to people’s homes. This reduced stress for staff and meant people received a more efficient service.

The service arranged funded team events such as afternoon teas and gave each staff member an extra day of paid leave for their birthday.