Saint Andrews Limited Also known as Home Instead Oxford

On this page

• 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 Outstanding. At this assessment the rating has remained Outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (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 making 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.

Care plans were detailed, robust and provided a clear profile of who people were, what was important to them, and how they wanted to be supported. Care staff knew people and their needs well and went out of their way to provide the highest standard of care for them.

Care plans contained meaningful information about people's lives, backgrounds and what was important to them. This included details of significant relationships, previous occupations and educational achievements, helping staff to gain a greater understanding of people's histories and identities.

Staff had access to clear guidance on people's preferred daily routines, including the times they preferred to get up and go to bed, as well as the order in which they liked to receive support with their care. Information about people's pets was also included within care plans, recognising their importance to people's wellbeing and daily lives.

Staff knew people’s preferences, daily routines and how they communicated which helped to deliver personalised and compassionate care. One staff member told us, “I know them [people] really well. I’ve formed really strong bonds with the people I support. We support a person who has quite severe Alzheimer’s, I know his routine, so I stick to the same thing every day. I know he likes to have a coffee, have lunch and then likes to have a walk.”

People's dietary preferences were clearly documented, including their preferred foods, portion sizes and any preferences relating to cutlery and crockery. This helped ensure support was personalised and reflected people's individual choices and preferences, enabling staff to provide care in a way that promoted dignity, comfort and independence.

Staff received specialist training relevant to the health conditions of the people they supported. The provider ensured all staff completed condition specific training before providing care to a person with particular healthcare needs. This helped ensure staff had the knowledge, skills and confidence to understand people's conditions, recognise potential risks, and provide safe, personalised and effective support. The approach helped care was delivered in line with individual needs.

Records demonstrated the provider's commitment to delivering person centred care. One person transitioned from another care provider and told staff it was important for their family to remain actively involved in their care. They specifically requested that a family member continued to support them alongside care staff during moving and handling tasks. To support this preference, the provider arranged a meeting at the person's home involving the person, their family and an occupational therapist. The provider completed risk assessments, identified any potential risks associated with the arrangement and took responsibility for ensuring family members received the appropriate moving and handling training required to support the person safely alongside care staff. By delivering this training, the provider enabled family members to continue to be actively involved in the person's care while ensuring safe working practices were maintained.

Staff consistently told us, when a person's needs changed, or when they were required to use new or additional equipment, the management team ensured staff received the necessary training before they next provided support. This helped ensure staff had the knowledge, skills and confidence to meet people's changing needs safely and effectively. As a result, care remained person centred, and staff were equipped with the most up to date guidance and best practice to support people in accordance with their individual needs and preferences.

People’s preferences of preferred gender of staff was respected. One person told us, “The carer is always a male which is really important as he does personal care.”

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The management team spoke passionately about their commitment to helping people understand the range of care and support options available to them, enabling them to make informed decisions about the services most suited to their individual needs. Their approach focused on ensuring people received the right support, rather than simply promoting their own service.

The care manager worked closely with an external professional who visited people in their own homes. Together, they provided information about available health and social care services and explained how the care system operated, helping people and their families to navigate what can often be a complex process. Where the provider was not the most appropriate service to meet a person's needs, they continued to offer support and guidance to help people access suitable care. For example, 1 relative contacted the provider to arrange an assessment. Following the assessment, it was identified the provider was not best placed to meet the person's needs. Despite this, the care manager maintained regular contact with the family and continued to support them in accessing the appropriate care and support by working with other external professionals. This demonstrated a person-centred approach that prioritised positive outcomes for people over organisational interests.

The provider had also introduced 'Location Champions'. These were dedicated staff members assigned to specific geographical areas to become familiar and consistent points of contact within local communities. The initiative aimed to strengthen local relationships, improve continuity of care and provide additional support to new staff working within those areas. This helped ensure people and their families knew who they could contact to discuss care needs and access support.

People and their relatives consistently described the provider as flexible and responsive to their needs. One person told us, “The office and management will always respond immediately if we need to switch appointments or call time.” This reflected the provider's commitment to working in partnership with people and adapting support in line with their changing circumstances and preferences.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider supplied information to people in a range of accessible formats to meet individual needs such as, easy read documents, large print, simplified language and visual communication tools.

People’s preferred communication methods were respected. For example, 1 person preferred to receive information via text message due to being hard of hearing.

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 their relatives understood how to provide feedback, share ideas and raise concerns or complaints about the care, support and treatment they received. The provider had systems in place to actively seek and act upon feedback. Annual surveys were distributed to people using the service and their relatives to gather their views and experiences. Responses were analysed, and action was taken where required to address identified concerns or areas for improvement, demonstrating a commitment to learning and service development.

The provider had a complaints policy in place, and people and their relatives were aware of how to raise a complaint if they wished to do so. This helped to ensure concerns could be raised openly and that people felt their views were listened to and acted upon.

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

The provider was aware of people who may face inequality and tailored care and support in response to this. They demonstrated an understanding of individual circumstances and took steps to ensure people received equitable and personalised support.

The provider identified some people experienced difficulties accessing appropriate nail care services within the community, particularly those who were unable to leave their homes. In response, they took steps to address this unmet need and improve people's access to services that supported their wellbeing. The provider trained 2 members of staff to deliver nail care and was subsequently able to offer a regular nail care service to people within their own homes. This helped people access a service they valued without the need to travel and promoted their wellbeing. The nominated individual told us, "For people who can't leave the house, it can give them a sense of self again, it's such a treat for people. We identified a need as it was really difficult for people to access nail care." This demonstrated the provider was responsive to the needs of people using the service and proactively sought solutions to barriers that could impact their wellbeing and quality of life. By identifying gaps in local provision and developing an in-house service to address them, the provider helped promote people's ability to access services.

The care manager worked in partnership with a range of external professionals to help ensure people and their relatives fully understood the health and social care system and the services available to them. This included hosting community events members of the public could attend, aimed at raising awareness of health and social care topics and helping people make informed decisions about their care and support options. The care manager also visited people in their own homes to provide personalised information and guidance on accessing different care services. This included explaining the types of support available, discussing associated costs and providing information about funding options and how to access financial support where appropriate. This support was not limited to people who had made enquiries about the provider's services. Information, advice and guidance were offered more widely within the local community to help people access relevant information and better understand the care and support options available to them, regardless of whether they went on to use the provider's service.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

The provider carried out robust assessments, engaged with relevant professionals and leaders, and arranged tailored training for staff to help ensure people did not experience disadvantage or discrimination because of their individual needs or health conditions. For example, the provider sourced and delivered specialist training specific to people's individual medical conditions. This helped ensure the staff team supporting the person had a detailed understanding of their condition, the challenges they may face, and the adjustments required to meet their needs effectively. This approach enabled staff to provide personalised support that promoted equality, inclusion and positive outcomes, while reducing the risk of people experiencing barriers to receiving appropriate care and support.

The provider demonstrated a commitment to promoting greater understanding of dementia within both the workforce and the wider community. They had sponsored a dementia bus, an immersive training experience designed to help people better understand what it may be like to live with dementia and the challenges people can face in their daily lives. The provider arranged for the dementia bus to visit the local community and invited staff, people using the service, members of the public and other health and social care professionals to participate in the training. People who visited the dementia bus participated in a group de brief after, which allowed them time to discuss the experience. This helped attendees gain a greater understanding of the barriers, inequalities and experiences people living with dementia may encounter, promoting more compassionate and informed approaches to care and support. Thenominated individual told us, "It's the only thing that can put you in someone's shoes." Relatives who attended the dementia bus training provided positive feedback about their experiences. Feedback included comments such as it was an “amazing and insightful experience” and the training helped them gain a greater understanding of what it can be like to live with dementia.

This demonstrated the provider's commitment to increasing awareness, improving understanding and fostering a more inclusive community for people living with dementia.

The provider had policies, training and systems in place to encourage people and care staff to speak up about equality and diversity. There was a whistleblowing policy in place encouraging people and staff to speak up.

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.

Care plans clearly recorded Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions, helping to ensure people’s immediate clinical wishes were understood and respected. However, care records generally lacked detailed information about people’s wider end of life wishes, preferences and values.

The provider had an in-house trainer who had undertaken additional specialist qualifications to enhance their knowledge and expertise in end-of-life care. This enabled them to deliver a higher standard of end of life care training to staff, helping to ensure staff had the skills, knowledge and confidence to support people receiving support at the end of their life.

While the service responded well when people were nearing the end of their lives, this approach was more reactive than proactive. There was an opportunity for improvement in supporting people to have earlier conversations about their future care and end of life preferences, while they were still able to fully participate in these discussions. This would help to ensure care is consistently aligned with people’s wishes and provide greater reassurance for both people and their families.