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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.
At our last assessment we rated this key question good. At this assessment the rating has remained 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 received highly personalised care that reflected their histories, relationships, routines, interests and desired outcomes. Care plans described what mattered to people, including remaining in their own homes, maintaining independence, spending time with family, following their faith and continuing meaningful activities. Staff matched people with care professionals based on shared interests and personality. This helped people develop trusting and consistent relationships. For example, one person was matched with an active animal-loving Live-in Care Professional so they could safely keep their rescue dog central to their life. Another person who was fond of a particular skilful craft, was carefully matched to someone who shared the same hobby and skills, enabling them to complete projects together.
Staff adapted support creatively around people’s individual circumstances. One person who had previously been isolated resumed writing poetry and used positive affirmations after a care staff listened to them, developed personalised coping strategies and worked patiently to build their confidence. Another person who was living in unsafe conditions because of hoarding worked at their own pace with a trusted care professional. Their home became cleaner and safer, while the person retained control over decisions about their belongings. The impact on the person was immense and their anxiety reduced and their confidence increased as a direct result of staff taking a person led approach with them.
Relatives described staff as knowing people exceptionally well and changing their approach according to people’s mood, communication and dementia-related needs. Feedback from relatives confirmed staff used people’s favourite music, films, cafés, shopping and community activities to enrich people’s lives rather than focusing only on care tasks. Relatives said this improved people’s wellbeing, independence and quality of life.
 

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 received support from a small and consistent group of care professionals. Staff said rotas were prepared in advance, travel time was included, and managers tried to arrange a familiar care professional when sickness or an emergency affected planned visits. Relatives also described continuity as a strength and said regular staff knew people’s routines, health needs and preferences well.
The provider worked with families and health and social care professionals when people’s needs changed. A professional said managers were responsive, held detailed discussions about what would work well for people and put agreed support into practice. Inspection feedback also described staff contacting NHS 111, GPs and community services when people’s health deteriorated, and keeping relatives informed.
Care records showed people’s needs were reviewed and support changed when required. For example, staff increased overnight support after a person living with dementia left their home. Relatives said this prevented the event happening again whilst upholding and promoting the person’s rights. People and relatives were involved in reviews, and staff used care plans, daily records and an electronic system to maintain continuity.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
Staff used this information to explain choices and provide care in ways people understood. Records showed staff provided information about meals, clothing, personal care and daily activities in a way people understood which enabled effective decision making, Staff sought people’s agreement before providing support.
People and relatives could view current care information through an electronic app. Relatives said the app showed detailed care notes, who was due to visit and what support had been provided. The service also communicated through telephone calls, emails and online meetings, which helped relatives remain informed and involved.
Relatives consistently described communication as effective and transparent.
 

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 and relatives were involved in developing and reviewing care plans. Review records contained people’s views about their care professionals, progress and outcomes. Relatives said reviews were collaborative and allowed them to discuss what was working and what needed to change.
People and relatives knew how to contact the office and described managers as approachable and responsive. They said concerns were listened to and dealt with quickly. Staff also said they could report changes or concerns by telephone or email and managers adjusted support when required.
Feedback showed that listening led to action. Staff changed schedules, arranged additional support, responded to health concerns and adapted care around people’s wishes. One person wanted to remain at home at the end of their life. The service worked to bring them home from hospital and supported them there in line with their wishes.
 

The provider made sure that people could access the care, support and treatment they needed when they needed it.
The provider also promoted access to community and wellbeing opportunities. People received support to visit cafés, shop, join singing groups and maintain important relationships. Community partners described the provider as active locally and said it offered advice, dementia learning opportunities and inclusive social events that helped reduce isolation.
 

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.
Staff supported people to overcome barriers and achieve outcomes that mattered to them. Examples included reducing isolation, rebuilding confidence after bereavement, improving unsafe living conditions and helping people remain active in their communities. Relatives described improvements in people’s engagement, health, independence and enjoyment of life.
 

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 received support to discuss and act on decisions about future care. One staff member described how the service worked with a hospital to support a person to return home and receive care there until they died, in line with their expressed wish. A relative also said the service had begun discussions about resuscitation and end-of-life planning and that this supported them to consider difficult decisions.