Altogether Care - Care At Home Limited Beaminster

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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.

This is the first assessment for this newly registered service. This key question has been rated 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 90 (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.

Leaders had highly effective systems and processes in place to assure themselves that people were consistently treated with kindness, compassion and dignity. Through regular spot checks, audits of daily records and observations, supervision and appraisal processes, and reviews with people and their families, leaders maintained clear oversight of the quality of relationships and interactions being delivered. Feedback mechanisms, including surveys and ongoing engagement with people and relatives, enabled leaders to continuously evaluate and improve people's experiences of care.

The registered manager had created and sustained a strong, values-driven culture where kindness, respect and compassion were consistently prioritised. These values were clearly understood by staff and were evident throughout the service. Staff embraced the provider's guiding principles of privacy, dignity, rights, equality, diversity and inclusion, and translated these into meaningful day-to-day support. They demonstrated empathy, understanding and emotional intelligence when supporting people, resulting in strong, trusting relationships and highly personalised care.

People and relatives consistently described staff as exceptionally kind, caring and respectful. Feedback was overwhelmingly positive and demonstrated that people experienced care from staff who genuinely cared about their wellbeing and took time to understand what mattered most to them. Comments included, “I have had brilliant help and support from Altogether Care.”, “we are very happy with their reliable and cheerful care.”, and “My [Loved one] always tells me how friendly and caring they all are. Their neighbours who get to know some of them say how friendly they are too.”

The caring culture within the service extended beyond the delivery of planned care and support. One person told us how staff had gone above and beyond to support them through an extremely difficult and emotionally challenging period in their life. They described how staff recognised the impact of events on their emotional wellbeing and took additional time to provide reassurance and support, helping them navigate a particularly distressing experience. This demonstrated staff's commitment to seeing people as individuals and responding with compassion when they needed it most.

The registered manager and staff team spoke passionately about their roles and demonstrated a genuine commitment to improving people's lives. There was a clear focus on building meaningful relationships and creating opportunities for people to remain connected to their communities and interests. Staff shared examples of initiatives they had undertaken beyond their caring responsibilities, including organising bake sales to raise money for charities that were important to people using the service and volunteering their time to help older people improve their gardens so they could spend more time outdoors and enjoy activities that mattered to them.

We also heard how a manager had developed a strong and trusting relationship with a person living with dementia whose family were not always able to visit each day. Recognising the importance of social engagement and meaningful experiences, the manager arranged to accompany the person to a local community scarecrow festival. The outing provided an opportunity for the person to enjoy a shared experience, reminisce and engage with their local community. Staff told us the person greatly enjoyed identifying familiar displays and spending time outdoors. This demonstrated how staff consistently looked beyond people's assessed care needs and sought opportunities to enhance wellbeing, reduce social isolation and improve quality of life through personalised support.

Staff consistently spoke about people with warmth, affection and professionalism. They demonstrated a detailed understanding of people's histories, preferences, values and aspirations and used this knowledge to provide highly personalised support. Staff were skilled at promoting people's independence, choice and control in ways that enhanced rather than diminished their dignity. One staff member told us, “Promoting independence is so important as it promotes dignity and maintaining a positive sense of self. We can support this by supporting and encouraging people to do things for themselves..." They went on to describe numerous practical and creative ways they supported people to remain independent and maintain control over their daily lives, tailoring their approach to each person's individual abilities and preferences.

People consistently told us staff respected their privacy and dignity, particularly during personal care. Staff took time to ensure people felt comfortable, listened to and in control of the support they received. Staff demonstrated a compassionate and trauma-informed approach, adapting their communication and support to meet people's emotional as well as physical needs. These approaches helped people to feel valued, respected and understood, and contributed to the development of strong, trusting relationships.

Health and social care professionals also described Altogether Care as a service that placed people at the centre of care delivery. Professionals consistently highlighted the caring, responsive and collaborative approach of staff and leaders. They told us communication was effective; staff were proactive in responding to changing needs and worked in partnership with others to achieve the best possible outcomes for people. One health and social care professional said, “I have been working with altogether care for many years with clients I am involved with. I have always found them very helpful in terms of receiving up to date information on changes or difficulties they may have with changes to clients' circumstances and wanting to ensure they are giving them the best service/care they can.”

The feedback gathered demonstrated a deeply embedded culture of kindness, compassion and dignity. People experienced care from staff who consistently placed their wellbeing, preferences and emotional needs at the centre of support, resulting in exceptionally positive experiences and relationships that extended beyond task-focused care.
 

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 provider demonstrated a deeply embedded commitment to understanding each person as an individual and ensuring care was tailored around what mattered most to them. People's life experiences, personal histories, aspirations, cultural needs, communication preferences and protected characteristics were recognised and reflected in the planning and delivery of care. Care records contained detailed and meaningful information about people's routines, preferences, goals and desired outcomes, enabling staff to provide highly personalised support. The registered manager told us, “All care plans are built with the focal point being the individual and what matters the most to them.”

Staff demonstrated an exceptional knowledge of the people they supported and consistently adapted their approach to meet individual needs and preferences. Staff spoke about people as individuals and described how they tailored support based on what mattered most to each person rather than focusing solely on completing tasks. One staff member explained, “I support people in a person-centred way by not always following the tasks on the app to a ‘T’ but rather as a guideline.” They described how they began each visit by asking people what support they wanted and how they preferred things to be done. They told us, “I will first of all ask the client what they would like me to do for them, if there is a certain way they like things done.” This demonstrated a culture where people remained in control of how their care was delivered and staff adapted their support to people's preferences and choices.

Staff demonstrated a strong understanding of the diverse needs, backgrounds and life experiences of the people they supported. They recognised that people's lifestyles, beliefs, cultural needs and personal histories influenced how they wished to receive care and support. One staff member explained the importance of understanding that people have different lifestyles, beliefs, cultural backgrounds and life experiences and adapting support accordingly. Staff gave examples of respecting preferences around the gender of care staff, supporting people to continue caring for beloved pets, and ensuring support reflected individual wishes and circumstances. Staff also described adapting care to respect religious and cultural needs, including supporting dietary choices during religious festivals, providing time and privacy for prayer, facilitating attendance at places of worship and respecting visits from religious leaders. These approaches helped people maintain their identity, beliefs and lifestyle choices while receiving care.

People using the service and their relatives consistently told us staff listened to them, involved them in decisions and responded to their views. They described positive and trusting relationships with staff, which enabled care to be delivered in a way that reflected their individual circumstances and preferences, including for people with more complex care needs. One person told us, “Staff are professional with the human touch and understanding.”

Another person described the positive impact the service had made during a particularly challenging period for them and their family. They told us, “I have had brilliant help and support from Altogether Care.” They explained how staff had supported them while they were recovering from COVID-19 and relearning how to walk, whilst also providing support to their wife who was living with dementia. They said, “Altogether Care have been great for us and very well led by the registered manager, and nothing is too much trouble.” Their feedback demonstrated the provider's ability to adapt support to changing circumstances and provide personalised care that responded to the needs of both people and those important to them.

Staff looked beyond people's immediate care needs and supported them to maintain the lifestyles, relationships and activities that were important to them. Staff described supporting people to remain connected to family, friends and their local communities through practical and personalised support. One staff member told us about supporting a person to continue meeting friends for lunch by helping them choose suitable clothing, ensuring they had their mobility equipment, mobile phone and bank card, accompanying them safely to a local café and supporting them to spend meaningful time with their friends before returning home. The staff member reflected on the positive impact this had on the person's wellbeing and how rewarding it was to see the enjoyment these social connections brought. Staff also described supporting people to maintain independence in social relationships by helping with phone calls, correspondence and preparing for visits from friends and family in ways that reflected people's wishes and usual routines.

Care and support arrangements were regularly reviewed and updated in response to changes in people's circumstances, ensuring support remained responsive and reflective of their wishes. Staff demonstrated flexibility when people's needs changed and adapted their approaches to achieve outcomes that were important to them.

Health and social care professionals also highlighted the provider's exceptionally person-centred approach. They described staff as flexible, responsive and committed to achieving outcomes that mattered to people. Professionals provided examples of staff adapting support to enable people to remain independent and continue living in their own homes. One professional told us they believed a person would not have been able to remain living independently following a difficult hospital stay without the “flexibility of the Altogether team.” They also said, “I would and do recommend Altogether Care as a safe agency who have the patients’ best interests at heart.”

The provider actively supported people to be involved in decisions about their care and treatment. Staff took time to seek people's views, understand their preferences and adapt support where required. The registered manager told us, “All individuals are encouraged and supported to make decisions about their care needs wherever possible.” This approach helped ensure people remained at the centre of decisions affecting their lives and care.

The provider's approach to care planning, regular reviews and continuity of staffing supported the delivery of exceptionally personalised care. Staff understood the importance of seeing beyond a person's care needs and recognising them as individuals with unique histories, preferences, aspirations and experiences. As a result, people received care that was tailored, respectful and consistently focused on achieving the outcomes that mattered most to them.
 

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff supported people to have choice and control over their care and support wherever possible. People's needs, preferences and aspirations were recorded in care plans, enabling staff to understand and respond to their individual requirements. Care plans reflected people's routines, communication needs and preferences. The registered manager explained, “Not everyone likes to receive personal care in the mornings. Some people prefer to wash or shower in the evening or may be at lunch time when they are more awake and alert.” This demonstrated how care was tailored to people's individual preferences.

Staff encouraged people to express their views and preferences and adapted support accordingly. Care plans and risk assessments were reviewed when people's needs changed to help ensure care remained appropriate and responsive.

People were supported to maintain their independence and make decisions about their day-to-day lives. Staff provided support in a way that respected people's choices and promoted their autonomy. One staff member told us, “I encourage people to make their own choices wherever possible, such as choosing their clothes, meals, daily routines, and how they would like their support provided.” They also explained, “I encourage individuals to do as much as they can for themselves, providing assistance only when needed.”
The provider recognised the importance of maintaining relationships and social connections. Staff supported people to stay in contact with family, friends and others who were important to them and, where appropriate, helped people continue with activities and interests that contributed to their wellbeing.
 

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.

People and relatives told us staff were responsive, reliable and communicated well about any changes or delays.

Staff understood people’s risks and responded calmly and appropriately to changes in health or wellbeing, escalating concerns promptly when required. Professionals confirmed communication was timely and meaningful, enabling coordinated responses and positive outcomes, including reduced incidents and improved stability for people.
 

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.

Leaders had created an exceptionally positive and supportive culture where workforce wellbeing, engagement and development were recognised as fundamental to delivering high-quality care. Staff consistently described feeling valued, listened to and supported. One staff member said, “Management is supportive and communicates well with staff,” while another told us, “I couldn't ask for a more supportive manager.” Staff spoke positively about recognition schemes, regular opportunities to provide feedback and leaders who listened and acted on their views.

The provider had implemented a comprehensive wellbeing strategy which recognised that its people were its greatest strength. Wellbeing support was embedded through Mental Health First Aiders, Wellbeing Champions and Social Champions across the organisation. Staff had access to a range of wellbeing initiatives including yoga, breathing techniques, sound therapy and nature-based activities. The provider monitored workforce wellbeing through regular reporting and evaluation to ensure support remained responsive to staff needs.

The registered manager described one of the service's key strengths as “providing a safe space for staff to be able to speak freely and make suggestions to improve our service.” Staff feedback reflected this culture. Staff told us they felt able to raise concerns, contribute ideas and influence changes within the service. One manager described how staff feedback had informed discussions around recruitment processes and interview questions, demonstrating that staff views were valued and acted upon.

Leaders promoted an inclusive culture where diversity was recognised and celebrated. The registered manager explained how the service supported staff from different cultural and religious backgrounds, including recognising Sinhala New Year and putting “special measures” in place during Ramadan to support fasting and prayer. These approaches helped staff feel respected, included and supported.

There was a strong sense of teamwork, belonging and shared purpose. Staff described colleagues as caring, supportive and committed to achieving positive outcomes for people. The provider promoted team cohesion through social events, including an annual Christmas celebration that brought staff together outside of work. Staff also worked collaboratively to raise £2,500 for a local hospice through bake sales, a community raffle and a charity skydive. These initiatives strengthened relationships, promoted wellbeing and reflected the provider's values of teamwork and community engagement.

The provider demonstrated a strong commitment to staff development and progression. The registered manager shared how they had joined Altogether Care in 2013 as a part-time care worker before progressing through senior and coordinator roles to become Registered Manager. They explained that “Altogether Care is very good at investing in their employees, and the company has a lot of staff who have progressed within the company.” This demonstrated a commitment to nurturing talent and supporting career development.

Overall, the evidence demonstrated an empowering and inclusive culture where workforce wellbeing was embedded throughout the organisation. Staff felt valued, supported and motivated, enabling them to provide compassionate, high-quality and person-centred care.