Saint Andrews Limited Also known as Home Instead Oxford

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 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 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 always treated people with kindness, empathy and compassion and respectedtheir privacy and dignity. Staff treated colleagues from other organisations with kindness andrespect.

Staff consistently demonstrated exceptional kindness, compassion and respect for people’s dignity. People and their relatives gave consistently positive feedback about how staff treated them with dignity and respect. One relative told us, “The carers are very respectful, caring and kind. They provide personal care observing [relative’s] privacy and dignity.” Another relative told us, “The carers [person] has are absolutely brilliant, showing her respect and kindness in every aspect of their care. She has various carers and gets on with them very well. They are polite and friendly, always cheerful and supportive.” People told us they were consistently treated with respect. Comments included, “The carer provided is very respectful, kind and caring,” and “They are respectful and kind when they do my personal care.”

Records demonstrated the exceptionally caring nature of the staff team and the strong relationships they developed with people. One person had formed a close relationship with one of their regular staff over a prolonged period. Whilst the staff member was on annual leave, the person's health deteriorated significantly. When the staff member became aware of the person's deteriorating condition, they made the personal decision to cut short their annual leave and return to work so they could support the person during the final stages of their life. This demonstrated the compassion, commitment and dedication staff showed towards the people they supported.

The provider shared examples which demonstrated the positive impact of the support provided, not only on the people receiving care but also on their relatives' ability to maintain meaningful family relationships. The support helped reduce pressures on family members, enabling them to spend more quality time together and focus on maintaining positive relationships rather than solely undertaking caring responsibilities. One relative told us, “This is an excellent company; all staff are dedicated to providing a great service to their clients and their family members.” This demonstrated how the provider's person-centred approach benefited both people using the service and those important to them.

Staff consistently had an awareness of the importance of protecting people’s dignity, particularly when supporting with personal care. One staff member told us, “I would always make sure [person’s] privacy is respected. If they have a physical ability to do something I would always encourage them to do it, for example brushing their teeth or eating. I always knock on the door before entering the room and make sure they are covered with a towel when supporting with personal care.” Another staff member told us, “I make sure curtains are closed, doors are closed, I always give people the option if they want me to stay in the bathroom with them, or if they would like me to wait outside the door for privacy.”

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 truly at the heart of the care being provided. Care packages were designed around people’s individual needs, likes and preferences. When new care packages were started, people were matched to a team of care workers. One person told us, “When I started, the first carer I had, I didn’t really get on with her one to one. This was no reflection on her care, but our personalities didn’t click. I spoke to the office, and they dealt with it straight away. My carers now are lovely, and I get on with them all well.”

The provider ensured staff had sufficient time to deliver high-quality, person-centred care. Care visits were scheduled with enough time not only to complete required care tasks, but also to enable staff to build meaningful relationships with people, understand what was important to them and support them to engage in activities that were important to them. The care manager told us, "We take a holistic approach [to care]. We are in the business of delivering more than medicines and breakfast. A direct care need may only be 30 minutes, but the other 30 minutes may be home help or companionship." This approach helped ensure care was tailored to people's individual needs and preferences, while promoting social engagement, emotional wellbeing and positive relationships between people and staff.

Care plans were highly personalised and provided staff with a detailed understanding of each person before they met them.These included not only care needs but also social interests, lifestyle preferences, and important personal information.For example, 1 person’s care plan contained information on what television programmes they enjoyed watching, another person’s care plan informed staff of a person’s specific breakfast routine, including specific cutlery they preferred to use, how they liked their cereal and how it was to be presented. One staff member told us, “I have good relationships with all of my clients and know them all very well, when I first meet a client. I always make sure they are comfortable and they know they can tell me if I am doing something they don’t like or do like so I know what’s preferred. For example, 1 of my clients has always had porridge for breakfast, she likes it made a specific way and told me how, I made sure to make a note of it so every visit it is made the same. It may seem little, but she really appreciates it. Another client I have always, asks for carers to fill his bird bath in the morning and evening. It has become part of his routine, and I make sure to do this every visit without him having to ask.”

Staff demonstrated a strong understanding of each person’s individual needs, this included their cultural background, religious beliefs, dietary preferences, communication methods, and personal routines. The provider showed flexibility and responsiveness in how care was delivered. For example, staff recognised that some people preferred a structured routine, while others preferred greater spontaneity and autonomy to decide how to spend their time. One staff member told us, “My care is always client led, never rushed and never forced. Some clients are easy going and don’t have a routine and some are strict with day-to-day activities; I learn these as I go and always check in.”

The provider also recognised the importance of maintaining relationships and social connections. There was a strong emphasis on building meaningful rapport not only with people using the service but also with their families and relatives. Staff actively engaged with relatives, valued their knowledge and insights to better understand people’s histories, preferences, and personalities. This collaborative approach enhanced the quality of care and helped ensure continuity and consistency.

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.

The care manager explained the service used a strengths-based assessment approach, which focused on identifying and building on people's existing skills, strengths and abilities. This helped staff understand what a person can do for themselves and supported the promotion and maintenance of their independence. The care manager highlighted when a person's abilities are clearly understood, support can be tailored to avoid unnecessary assistance and encourage independence wherever possible. For example, they described 1 person who received support with completing their food shopping. However, the person continued to enjoy preparing and cooking their own meals. Staff therefore did not assist with cooking, as the person was able to do this independently and gained enjoyment from it. This approach ensured the person's skills were maintained, promoted their independence and avoided taking away abilities they can continue to use for themselves.

The provider and staff understood the importance of people having maximum choice and control of their lives. Staff told us how they encouraged people to increase their independence. One staff member told us, “One of my clients had a fall recently, and has been given exercises to help him gain strength, he is always reluctant to do these exercises, so I have started doingthem every morning during his visit. I never mention to him to do them, but he always ends up joining in with me. I like to think that this will help him reach his goal of getting more mobile again.” Another staff member told us, “I would offer people choice, for example I will ask people what they would like to wear, we go to the wardrobe and look at what they would like to wear. If I’m preparing a meal, I will ask them what they would like, for example what they would like in their sandwich. If someone has dementia I would give them 2 choices, so I don’t overwhelm them, and they can still make a choice. One person told us, “My independence is encouraged by them, but they are still always there to support me when necessary.”

One person frequently spoke about wanting to visit a friend who they had not seen for some time. A staff member discussed this with the person's relative and the friend, and arrangements were made to support the visit. The staff member drove the person to their friend's home, remained available to provide support during the visit, and then drove them home afterwards. This enabled the person to maintain an important relationship and achieve something which was meaningful to them.

Staff demonstrated a strong commitment to enabling people to do as much as possible for themselves, with a focus on maintaining independence and supporting people to remain living in their own homes for as long as possible. One person had received support following two operations. After the second operation, staff worked closely with the person to rebuild their confidence, skills and independence. Through consistent encouragement and tailored support, the person's abilities gradually increased over time. As a result, they became able to manage independently and no longer required care and support services, achieving an outcome which was important to them.

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 their relatives told us staff knew them well and were responsive to any changes in their health and wellbeing. Relatives told us when their family member was unwell, staff responded promptly and sought medical advice. For example,1 person had a fall before the staff member arrived. When the staff member arrived at the property, they promptly called the emergency services and stayed with them until they had been assessed. One person told us, “In our experience all the staff across the board are responsive according to their job role.” A person’s relative told us, “The company as a whole are always very responsive to questions, queries or requests. I cannot fault them at all.”

During the inspection we heard office staff responding to people’s needs when they called the office. For example, 1 person had called the office and asked for an additional care visit the same day. Office staff responded to this by phoning staff members and arranging an additional care visit.

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.

The provider demonstrated a strong commitment to staff wellbeing and had implemented a range of initiatives to support employees both personally and professionally. Staff had access to a wide range of wellbeing resources through the provider's dedicated wellbeing hub. This resource offered advice, guidance and signposting to additional information to support staff with living and working well.

The provider had also developed and delivered a stress and wellbeing workshop to help staff recognise and manage factors that may impact their wellbeing. Additional support was available through a trained Menopause Champion, who provided guidance, understanding and signposting for staff experiencing menopause. This helped to promote an open and supportive workplace culture where staff felt valued and able to discuss issues affecting them. The provider also had a Mental Health First Aider, who had received specialist training to recognise the early signs of mental health concerns, provide confidential support and help staff access appropriate services when needed.

The provider shared records which demonstrated how they had successfully supported a staff member to improve their attendance at work. This involved managers taking time to understand the challenges the individual was experiencing and implementing supportive measures to help them remain in employment. The provider also worked closely with an NHS employment support programme, which provided training to managers to enhance their understanding of workplace adjustments and how to support staff with additional needs. This helped ensure staff were supported to remain in work and thrive within their roles, whilst fostering a positive and inclusive working environment.

Staff consistently spoke positively about the support they received and told us they felt their wellbeing was valued. Comments included, “I do believe my wellbeing is valued. I have had regular chats with [manager] who just checks in with me to see if there is anything they can do for me or that I need.” And “I know that I have the full support of the office when needed and especially my manager, who has been an absolute godsend just recently and given me the support and reassurance that I needed.”

Staff consistently told us they felt supported during periods of ill health and their wellbeing was valued by managers. Feedback from staff indicated there was a positive and supportive culture which encouraged people to seek help when needed and promoted staff wellbeing. Comments included, “Last year I was off for a few days due to being unwell. They were very supportive, checking in on how I was and offered me support. We have a mental health wellbeing platform.” Another staff member told us, “I feel my wellbeing is valued. I have turned up to do office duties in the past not feeling well and have been sent home to recover.” One staff member told us they were offered a phased return when they returned to work following a period of illness. These examples demonstrated management recognised the importance of staff wellbeing and took practical steps to support staff during periods of ill health, helping to promote a positive working environment where staff felt cared for and valued.