Home Instead Warrington & Lymm

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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 the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question 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.

People consistently experienced care that was kind, compassionate and respectful. Feedback from people was overwhelmingly positive and demonstrated strong, trusting relationships between people and their care professionals. People spoke warmly about the support they received and described staff as caring, respectful and willing to go above and beyond to support them.

The provider promoted compassionate care by ensuring people were introduced to new staff before they provided support independently. This helped people become familiar with staff, build trusting relationships. We spoke to one person who explained that their preferences were considered and they were able to have support provided by the people they built the best relationships with.

People reflected the impact of these valued and trusting relationships. One person told us, “I feel so much happier” and another said, “I feel safe and the staff support me well.” We reviewed feedback gathered by the provider in which one person stated their care team ‘do everything I want and more’, describing staff as respectful, friendly and supportive and saying ‘nothing is too much trouble’.

The provider recognised and valued compassionate care. This was promoted by sharing of feedback. We saw evidence of staff receiving thank-you cards, flowers and recognition for their support of people. Feedback gathered by the provider stated that a person described a member of staff as ‘lovely in her manner, her approach’ and ‘a lovely calming person’. The person said the staff member had ‘gone the extra mile’ and expressed how much this was valued.

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 were supported by staff who knew them well and understood what was important to them. We reviewed detailed support plans which included information about people's life histories, interests, goals, aspirations, relationships, preferred routines and the outcomes they wanted to achieve. This enabled care to be tailored around each person's individual circumstances rather than being task focused.

People consistently told us staff took the time to get to know them as individuals and respected their choices, routines and preferences. Staff described taking time to understand what was important to people and adapting their approach to meet individual preferences, which was reflected in people's feedback and care records.

The provider produced personalised photo sheets of care professionals for people who struggled to remember names, helping them recognise and build relationships with the staff supporting them. One person said, “The lady in charge of interviewing came to the house, met me, met my daughter and I was able to express to her what I thought my needs were and the style that I wanted. I wanted to be treated as an independent thinking individual and they have honoured that.”

We saw evidence of the provider identifying a culturally appropriate dementia support group for a person. The provider liaised with family members, shared information about the group and explained why they felt it may be of interest to the person, demonstrating they considered people's cultural backgrounds, interests and preferences when identifying opportunities for support. The person enjoys getting out and about, and staff facilitate these activities. Feedback showed people felt listened to and understood, and support was delivered in a way that respected who they were as individuals.

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 supported to maintain their independence and remain in control of decisions about their lives and care. Care planning focused on people's strengths, goals and aspirations, and people told us they were involved in decisions about how support was provided. One person told us they felt their wishes and preferences were respected. Another person said, “I’m the one that decides what we do,” and described being able to make decisions about their daily routines and support such as getting a shower or wash or going out with staff.

We saw evidence of the provider actively promoting independence and looking beyond people's immediate care needs to help them achieve outcomes that were important to them. For example, the provider supported one person to explore alternative accommodation due to an identified need. The provider worked alongside the person, family members and healthcare professionals to assess and manage risks, supported the person to visit the accommodation, and helped them make an informed decision about their future living arrangements. After this, the person did move to the new accommodation and expressed they were much happier there.

People told us staff encouraged them to remain active and continue participating in activities they enjoyed. One person described being encouraged to attend a local club, while others spoke positively about the support they received to access appointments, community activities and opportunities outside of the home. Staff understood the importance of promoting independence and described encouraging people to do as much as possible for themselves while providing support when needed, for example, one person who was not leaving their house was encouraged and supported to use walking aids and became confident enough to start going outside again.

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.

People received care and support that was highly responsive to changes in their needs and circumstances. We saw numerous examples of the provider identifying concerns promptly and taking timely action to ensure people received the support they required.

For example, staff identified concerns that a person may not have been taking their evening medication as prescribed. The concern was escalated to management, who worked with the person, their family and GP to arrange a medication review. As a result, the person's medication regime was reviewed and changed to better meet their needs.

We also saw evidence of staff recognising when people required additional support to maintain their wellbeing and comfort. In one example, staff quickly identified concerns that a person's clothing was no longer fitting appropriately and was causing discomfort. The provider supported the person to access a fitting appointment and obtain suitable clothing. In another example, staff identified concerns about a person's eyesight and promptly worked with the person and family members to ensure arrangements were made for an eye test and replacement glasses.

Staff told us they were encouraged to report changes in people's health, wellbeing or circumstances and were confident these would be acted upon. This was reflected in records we reviewed, which showed concerns being escalated promptly and appropriate action being taken. Relatives spoke positively about the provider's willingness to act quickly and advocate on behalf of people when concerns arose.

People consistently told us staff were easy to contact and responsive to their needs. They felt confident concerns would be listened to and acted upon.

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

The provider demonstrated a strong commitment to supporting staff wellbeing, development and professional growth. Staff consistently spoke positively about the support they received from leaders and described a culture where they felt valued, listened to and respected.

The provider had effective systems in place to support and develop staff. We saw evidence of regular staff meetings, supervision, support visits, spot checks and competency assessments. Meetings were held on different days and at different times to maximise attendance and ensure all staff had access to learning and development opportunities. Learning was reinforced through quizzes, refresher training and regular discussion of key topics, including safeguarding and whistleblowing.

Staff wellbeing was actively promoted. We reviewed evidence of wellbeing initiatives, including a menopause wellbeing café delivered by a qualified wellness coach, which the manager stated ‘Those who did attend found it enlightening and helpful.’ Practical support was offered by managers to individual staff members when needed.

Staff told us they had sufficient time to complete visits safely, were given dedicated time for training and felt supported to raise concerns. The registered manager promoted an open culture and regularly encouraged staff to speak up, including raising concerns about management where necessary. Exit interviews and staff feedback processes were used to gather staff views and identify opportunities for improvement.