Catherine Tam Agency

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

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 96 (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 and support were delivered in a way which people valued. It respected their individual characters, needs and preferences.

People and relatives told us staff involved them in decisions from the start of the service and throughout care delivery. People made day‑to‑day choices about how their care was provided. Daily routines were entirely shaped by people’s choices. For those who did not like a structured routine, activities were not planned in advance. Instead, people chose what they wanted to do each day. However, it was acknowledged for some people that routine was important. Where this was the case, staff knew what people liked to do and when. Strong care teams were in place who knew people well and respected this.

The service supported people to live empowered, inclusive and fulfilling lives. The provider’s values were clearly embedded in practice, and leadership fostered a compassionate culture, focused on achieving outstanding outcomes for people. For example, visiting different countries people had expressed to visit, or worked on plans for people to develop their independence further.

Staff were passionate about providing meaningful, high‑quality support. People were encouraged to work alongside staff to build skills in cooking and housekeeping. One person told us they had been supported to carry out building work, such as putting up internal stud walls, with the supervision and support of staff and ensuring health and safety was met, as they wanted to change the layout of their home.

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.

People were supported to access health and social care professionals when needed. Any advice or guidance was recorded in people’s care plans and was understood and followed by staff.

People and relatives told us staff consistency knew people well and understood their individual preferences, routines and behaviours. Relatives described how this continuity contributed to improved health outcomes, including reduced reliance on medication, improvements in behaviour and emotional wellbeing, and increased confidence and independence.

The provider worked flexibly with people and families to ensure care was adapted to changing needs and choices. People told us staff fitted support around what they wanted to do and were led by their preferences.

The provider strived to ensure that everyone had excellent continuity of care, and that all necessary appointments went smoothly to ensure people had the best possible outcomes. For example, the provider met weekly with one person relatives, and their advocate to ensure that care was planned, there was consistency, clear communication and any concerns could be addressed. This approached ensured the best possible outcomes.

Professionals gave positive feedback on the way the service worked in partnership with them.

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

A wide range of accessible materials were consistently available, enabling people to understand their care, treatment and support in ways that made sense to them. The service celebrated individuality and supported people to express themselves. Religious festivals and special days were marked within the service, with people actively involved in planning events. Staff communicated using each person’s preferred methods and adapted their approach where needed.

People told us they felt fully informed and involved in their care. They were made aware of changes within the service and consulted with. One person told us they were spoken to like a friend, not like someone who needed care. They felt this broke down barriers and opened up communication.

A relative also told is, “They always tell me what’s going on. For example, if [person] hurts [themself] or has a healthcare appointment. I go with them to some appointments. I can speak openly with carers saying what I would like for [person].”

The provider was commitment to ensuring every person could understand and participate in their care. This personalised approach to communication supported and empowered people, promoted independence and created an environment where everyone felt informed, included and valued.

The provider was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff always involved people in decisions about their care and told them what had changed as a result.

People had different communication styles. The provider had devised feedback forms in several communications styles, including written, verbal, pictorial and Makaton. This meant that whatever someone's communication style was, they were able to provide feedback on the care and support they received, which help shaped the future of the service.

There were robust complaints policy and procedures in place. People who used the service told us they felt able to raise any concerns with the manager or staff and felt assured they would be dealt with. Although the people we spoke to told us they had not had cause to raise any concerns, they felt able, should the need arise. They had trust that this would be dealt with promptly and appropriately.

Relatives told us staff actively listened to them and clearly valued their knowledge of their loved ones. Staff worked in partnership with families to develop detailed guidance and consistently followed this in practice. Families told us staff respected their views and would always make time to speak to them. They felt communication was open. One relative told us how they find it hard to trust people and found the transition of their loved one needing external support difficult due to their cultural traditions. However, the relative told us due to the openness, honesty and willingness to listen and learn about their cultural traditions, they felt listened to. The relative told us they would not trust anyone else to care for their loved one.

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

People were supported to access healthcare when needed, and families were informed and involved when appropriate. The service actively identifying and removed barriers that might prevent people from receiving care, support, or wider opportunities to ensure reasonable adjustments were made where needed. Leaders and staff ensured services were accessible and flexible, enabling people to access support in their own homes and through community‑based support.

The service widened access through volunteering opportunities. This ensured people from different backgrounds, including those with complex needs or limited prior engagement, could access support in ways that suited their circumstances, in a way that supported their independence and future goals. Staff worked hard to mitigate any barriers and supported people to ensure they were not discriminated against due to their disabilities.

People had been supported to attend routine medical appointments. Records showed people had access to services such as opticians and dentists, with visits being recorded regularly and any areas of concern or adjustments needed, shared promptly. Any observations of change in healthcare needs were discussed with the person and relevant healthcare provider. External stakeholders provided glowing feedback about the care provided and found the staff team communicated well with them and responded to any information requests promptly.

Staff and leaders were innovative in how they listened to information about people who were 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.

Having completed robust assessments and engaged with appropriate professionals, leaders arranged for tailored training to be delivered to staff to ensure people did not experience disadvantage or prejudice. This training was refreshed when new staff started, or if it was felt people would benefit from doing the training again.

Outcomes for people using the service truly reflected the principles and values of 'Right support, right care, right culture', promoting choice, independence, control, and inclusion. People were recognised as the experts in their own lives. There was an emphasis on what people could achieve first, followed by any support they required.

Staff consistently championed people’s rights and upheld equality and diversity with respect. The service supported people to live as independent as possible and had supported many people from residential care into a supported living environment.

The whole staff team showed an in-depth practical knowledge in meeting the needs of people using the service. They continued to look for and achieve further improvements in their knowledge and skill sets. The registered manager's expected standards were exceptionally high, and staff were committed in achieving these.

Throughout the service we saw evidence of the wide range of activities that people had participated in. The provider supported people to grow and develop their skills, interests and hobbies. One person using the service told us they had found the support for independence ‘freeing’. They found encouragement from staff promising for a more independent future and were supported in an appropriate manner to prepare them for further independence.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

Some people had told the provider that they did not wish to discuss this in detail. Where this was the case, it was clearly documented in care plans. These were reviewed regularly. People were not asked to make decisions before they felt prepared. Where people had expressed clear directives on how they would like their funeral care to be, staff had ensured that this was clearly recorded.

The provider was mindful that this could be a difficult subject for people to talk about. They offered discussion in a less formal setting. The provider told us they had recently discussed this subject at a recent management meeting. They told us, “It's something we've said to revisit every six months, in whatever way feels appropriate at that time with whoever is the most appropriate person, because that's the other thing as well. Sometimes it's a better discussion with a member of staff that's got a really close relationship rather than [the manager] going to talk to everyone about it. It's who is the most appropriate at the time on a six-month basis or more frequent if needed.”

When supporting a person at the end of their life, staff spoke of different cultural norms and how these can differ. The management then pursued this topic for discussion and link in with a local university regarding research into the subject on end-of-life care. Staff were provided with training which had positive outcomes and detailed understanding on what care should be provided when people are at the end stages of their life.