1st Homecare Solutions Limited

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 100 (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. People and relatives told us that the support they received was vital to them and their families. One person told us, “We work together with the carers. They treat me with dignity and respect, and I couldn’t imagine being without 1st Homecare. I am like an extension to their team, 1 family.” A relative told us, “I thought my [family member] would have to go into care. It’s because of the support we get from 1st Homecare that [family member] is able to stay at home. Their support and kindness has been vital to us.”

We saw numerous examples of where staff went over and above their roles. For example, 1 person who needed 2 staff for all their personal care needs had a very early hospital appointment at 6:00am. They were very anxious about being ready on time to attend their appointment. Two staff volunteered to provide a care call at 05.15 on the morning of their appointment to ensure they had support with their personal care, were comfortable and had breakfast before they went for their appointment. This reduced their anxiety and staff repeated this again for a follow up appointment.

A staff recognised how 1 person was passionate about trucks and organised, in their own time, for them to go to a truck procession locally which they really enjoyed. The staff member, with the person’s permission, sent some photos to their relative who lived abroad. The relative expressed their appreciation and thanks that their family member was being cared for in a kind and thoughtful way.

Staff cared for people in a way that exceeded expectations. For example, staff supported 1 person to overcome their anxieties about leaving their home. They were matched with a staff member who had also experienced the same anxieties and understood how the person felt. This made them feel more comfortable about going out and lessened their anxieties. The person and staff member had built up a very positive relationship resulting in reduced anxiety when going out and both looked forward to their visits.

There were some people using the service who had no local family to visit them on Christmas day. For those without close family the deputy manager made up Christmas dinner plates for people that included Christmas pudding and a Christmas cracker. They delivered these to people without family to ensure they felt included and remembered at Christmas.

We also saw how staff had been a vital part of helping 1 person to become empowered to make their wishes known and improve their quality of life. The person was unable to communicate using words, and it was apparent that relatives were talking for them. Staff suggested using a white board so the person could make their wishes and preferences known to staff. This involved staff asking relevant questions regarding their care provision and the person would reply to them by writing on the white board. This ensured staff were able to tailor the care plan in line with the persons wishes and empowered the person to participate and make their own decisions. In addition, the person’s confidence grew, and they were able to access the family app to communicate with staff and make their views and wishes known.

Staff were highly motivated and demonstrated real empathy and compassionate understanding for people. For example, 1 person had a birthday, but family were unable to visit which made the person low in mood. A staff member bought them a bunch of flowers and a small cake and sang Happy Birthday to the person whilst attending their care visit. This cheered the person up and they said they were ‘very touched’.

One person’s family asked if their family member could be supported to attend a relatives wedding who would otherwise be unable to attend due to their personal care needs. A staff member who knew the person well volunteered and spent the day and evening with the person as a guest at the wedding. This meant the person was able to maintain important family links and attend a special family occasion.

Health and social care professionals consistently praised the staff and the management for the care people received. One told us, “I have found the staff to be very considerate and kind as well as very knowledgeable.”

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. One relative told us, “The carers are absolutely wonderful and treat [family member] like family. My [family member] does have some mental health needs and can on occasions become very distressed. The carers know just exactly what to do to calm and ease [family member’s] distress.” Another person commented, “Last week we went to the garden centre and my word it makes the world of a difference to have these carers to go out with, very friendly and caring.”

Staff recognised that using technology was vital for some people to maintain contact with family and friends but that it was often difficult to use and understand. One staff member was very good at using modern technology and was happy to support people using the service if they needed support with a new phone or laptop etc. This enabled people to understand and manage communication with families who may live abroad or couldn’t visit regularly via, video calls calls or texts and messages.

For example, the staff member accompanied 1 person to the mobile phone shop to support them to buy and then set up a new phone. The person had been anxious that they would be sold a phone they could not use effectively and being escorted by someone who understood the technology made them feel more comfortable and less anxious.

The same staff member also supported another person (in their home) who had bought a new phone and tablet. The staff member helped them set up the devices up so that they were able to do online grocery shopping and face time their family which was very important to them. This enabled the person to maintain close family connections which in turn made them feel less anxious.

All staff regardless of their role demonstrated an excellent understanding of people’s cultural, social and religious needs and how to meet these in individual ways. For example, staff supported a person living with dementia to attend their place of worship and parish lunches as their faith was very important to them.

Staff went the extra mile to ensure people were involved in their care. For example, staff worked with 1 person who was unable to communicate using words to investigate different ways of communicating. Eventually the person, with staff support, came up with a “type to speech” app on the person’s mobile device. This allowed the person to type what they wanted to say to staff, and the device would translate the typed message into speech. This enabled the person to have greater say and control over their care and how it was provided.

Staff felt it was very important to support people to continue with their interests and hobbies. For example, 1 person enjoyed searching through charity shops looking for board games and staff supported them to do this this. The staff would then spend time playing the board games with them. This provided a great deal of pleasure to the person and prevented them from becoming socially isolated.

There was a strong organisational commitment and effective action to ensure there was equality and inclusion for everybody. For example, there were preferred pronouns within people’s files. People's care was planned with them, and they were fully involved in developing their care and support plans which ensured they were always treated as individuals. Topics of interests were a big part of the initial assessment an-assessment process. Staff took great interest in people and worked in partnership with them and their families to develop life stories that included detailed information. For example, memories about their childhood, family life, occupations, hobbies and interests. Staff commented that having such information helped to strike up meaningful conversations and was used to develop a person-centred plan of care.

Information was sought about people’s preferred routines and the ways in which their care would fit into their lives rather than their lives having to change because they now required care and support. This meant people’s care was delivered in a holistic and person-centred way. The care plans clearly recognised people as unique individuals and recognised their diverse strengths and needs.
 

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 well-being. A relative told us, “A relative told us, “The carers are very good at getting [family member] to do the things they are able to do. They are always encouraging [family member] to do as much as they can.” Another relative commented, “[Family member] has managed to re-gain skills they lost after being in hospital for a long time. This is especially true about their mobility. Staff always support [family member] to walk with them.”

One of 1st Homecare’s objectives, was ‘To assist clients to maintain their independence and quality of life in their own home.” Staff echoed this sentiment in feedback. One staff member said, “I support people’s independence by involving them in their care by letting them make choices and treating them with respect.” Another member of staff commented, “I support clients to maintain their independence by most importantly listening to their choices. Supporting and encouraging their opinions and wants as well as always asking and never assuming.”

We saw that 1 person had been supported to set up a new phone and tablet. This allowed them to do online grocery shopping and face time their family which was very important to them. This enabled the person to maintain their independence with grocery shopping rather than rely on someone else to do their shopping for them.

We saw numerous examples where people had been supported to maintain or increase their independence. For example, after a long stay in hospital 1 person was finding mobility difficult and painful. Staff ensured necessary equipment was put in place in the person’s home and advised the person that the local authority may be able to support with adaptations to the house such as changing the bathroom and staff supported the person to do this until it was agreed and completed. This meant the person was then able to complete most of their personal care independently. The deputy manager commented, “We see this client as a whole person striving to remain in their own home and have sourced and continue to source ways of allowing this client to remain and keep their independence.”

Staff always empowered people to realise their potential and ensured they were fully involved in their care provision. For example, 1 person developed early onset dementia and found their dementia diagnosis really upsetting as they kept forgetting the order for completing tasks. A guide was developed with step-by-step plans of when the person liked to shower, how they liked to put on their makeup, how they liked to dress and which jewellery they liked to wear. Staff only supported the person when they forgot a step or looked confused about what they needed to do next. This enabled the person to remain living alone in their own home.

Staff had an exceptional understanding of protecting and respecting people's human rights ensuring they were able to make decisions about their care, treatment, and well-being. One staff member told us how it was important to involve people in their care and support, including all the small choices that ensured people had control and choice. They said, “I always give people a choice. I would never do anything they didn’t want me to.”

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. A relative told us, “When [family member] had a fall, the carers acted quickly to call an ambulance. Another time [family member] was unwell and the carers were quick to contact the GP and arrange a visit. Their quick action prevented [family member] from having to go into hospital.”

Staff responded to people’s immediate needs quickly and sensitively. For example, on 1 occasion a staff member supporting a person with a debilitating, ongoing and persistent health condition found the person was very distressed. The person explained they had tried to contact their GP but had not been successful. To ensure the person received the health support they needed swiftly the staff member went to the surgery and arranged for a GP to make a home visit to the person. This relieved the person’s anxiety and distress and also ensured they received the health support they needed.

Staff went over and above their roles to ensure people’s immediate needs were identified and addressed. We were informed about an occasion when there was a heavy snow fall in the area. A double up team (2 staff) were able to make it to the affected people who needed 2 staff for their personal care needs. The 2 staff were informed that other staff members had not been able to make it to complete single handed calls, so the double up team completed the single calls as well. They also delivered bread and milk to those unable to leave their homes due to the weather. This meant that because staff had responded to people immediate needs, they were able to provide the care people needed and also ensure they had essential supplies.

One person using the service had a health condition which meant there were often impromptu GP visits. Staff were able to accommodate their calls to be able to fit in with the GP visits. This meant the person didn’t miss their essential calls from the GP and ensured their health needs were met.

Staff supporting 1 person living with dementia noticed they were becoming withdrawn. Staff approached the persons family to put companionship/social calls in place. This was agreed and staff commenced taking the person out to local garden centres for coffee and cake and out shopping. Staff swift actions in recognising changes to the persons behaviour had made a big difference to the persons overall well-being and confidence. The provider informed us, “We feel it is really important to have continuity for our clients when the carers are visiting, this does help the carers to identify anything abnormal or sudden changes in the clients demeanor so they can act immediately to get them to medical attention they require.”

Staff were aware that if anyone had a fall their course of action was to call 999. Staff always stayed with people until their next of kin arrived. If there was no one available, care visits would be rearranged so the staff member could stay with the person, ensuring they remained safe until the paramedics arrived. Staff were well trained and were provided with specialised training to support people safely and in line with their preferences. The registered manager informed us that as part of the induction training and refresher training, staff covered areas to support them in an emergency. For example, staff completed training in basic life and first aid support, diabetes, falls prevention and the safe administration of medicines. This meant that staff were well trained and fully prepared to recognise when people needed urgent help or support.

The provider always cared about and promoted the well-being of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care. Without exception, staff gave us very positive feedback about how well they were supported in their job roles. One staff member told us, “It has been a pleasure to work for 1st Homecare for the past 3 years, and I am proud to be a part of a wonderful team. The company puts care at the heart of everything, not just for the clients but for the staff as well. I’m proud to be part of this team and wouldn’t hesitate to recommend it.”

The registered manager and provider understood how important staff well-being was and how this directly impacted the support people received. They focused on having regular discussions both formally and informally with staff to make sure they had the right support to be the best they could in their job roles. They put measures in place to support staff in the best way possible. For example, if staff struggled with mental health well-being they were supported by the management team with coping strategies. We saw an example of how a staff member had been well supported when they suffered extreme anxiety. Senior staff encouraged the staff member to call the office when feeling anxious and they were on hand to help calm the staff member using breathing exercises and talking slowly to them. The senior staff also provided the staff member with telephone numbers for several charities as well as talking therapies and they supported the staff member to make a GP appointment. In addition, work hours were changed and there were regular welfare checks from the senior management team. The support the staff member received resulted in their improved mental health and they requested to go back onto the more complex care calls.

Two staff had a traumatic experience involving the death of a person using the service. Both the staff members were asked to visit the office, and all their care calls were taken off them. The management team sat and chatted to them, ensured they were both calm and supported them to make a GP appointment. The staff members were given the contact details for bereavement and carers charities.

A culture of developing staff to reach their potential had been established. Staff felt invested in, given the opportunities for self-development available to them. New staff were required to complete a comprehensive induction and did not work alone until assessed as competent in practice.

The provider was committed to continually motivating the staff team and recognising their commitment to their role. For example, staff special occasions and achievements were recognised and celebrated. These included a birthday bonus, staff going on maternity leave were presented with a luxury baby hamper and at Christmas a luxury Christmas hamper was given to each member of staff. The provider organised an ’Our Values’ award monthly. This was judged by the providers values which were compassion, respect and dignity, openness and honesty, collaborative working, commitment to quality of care and caring with a smile.

The provider had an anonymous employee survey twice yearly where staff could make suggestions for improvement. The deputy manager informed us, “We heavily encourage a non-judge-mental open-door policy for carers to make suggestions, complaints or if they have any concerns. We have staff meetings whereby we encourage carers raise any concerns anonymously.” There was a buddy system where an ‘intake team’ shadowed and supported new staff. In addition, new staff shadowed experienced carers until they are confident and competent to go out into the community independently.

Staff working at 1st Homecare Solutions consisted of a variety of ages and cultures. Staff who practised different faiths were supported during religious holidays, for example, a change in shift patterns and adequate breaks. The provider offered a discount incentive which could be accessed online.