Home Instead North Norfolk

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (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 made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing, and communication needs with them.

People told us the service completed an exceptionally detailed and robust assessment on their needs, wishes, preferences, routines, and desired outcomes at the commencement of the service. They told us this also considered their family’s needs and routines and how best to deliver the service most effectively. One person who used the service said, “The manager carried out a very thorough care needs assessment, and how to fit it around my family’s and my own needs. It’s worked out well.” This thorough initial assessment allowed the provider to appropriately match staff to people based on their interests, personalities, and shared values. People also told us they were always introduced to new staff prior to any care visits which they appreciated; staff agreed this was the process. From the care records we viewed, we saw that exceptionally holistic and person-centred care plans were in place for people, developed with them and those important to them. Care plans detailed people’s life histories, goals, values, strengths, preferences, and personal routines helping to ensure staff consistently met people’s needs in all aspects of their life as required and as they chose. We saw that no detail was too small and helped to ensure a holistic and thorough approach. For example, for one person whose pet was extremely important to them, we saw included in the care plan detailed information for staff on how to support the person to care for their pet. The service had understood that the health of the person’s pet had a direct impact on the person’s wellbeing and was therefore exceptionally important. People’s needs were then reviewed on a regular basis, with them and others as appropriate including health professionals as required. These reviews happened more frequently after the commencement of the service to ensure the service was meeting people’s needs and to make any amendments as the service got to know people. People, staff, and partners told us the service was extremely proficient at adapting care to meet people’s changing needs. One person who used the service said, “My condition does vary and so do my needs, but the care team know me and understand the need for flexibility.” A partner agreed and told us, “The service is very flexible and responsive to people’s needs and goes the extra mile. For example, they do lengthy visits for people with complex needs which gives people the time they need.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People told us they received safe, effective care that was of consistently good quality that met their needs. We saw the provider thoroughly assessed people’s needs and focused on what was important to them in planning care delivery; the care plans we reviewed, and people’s feedback, demonstrated that. This included in relation to people’s nutritional and hydration needs and we saw many examples of where staff supported people to ensure good food and fluid intake. This demonstrated the service worked in line with legislation and within best practice guidance to deliver consistently high-quality care.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

We saw many examples of where the provider had worked proactively with other services and partners to support people and their relatives ensuring they received the best service possible. For example, when one person’s health declined, requiring them to move into permanent care, the staff member who supported them, and whom the person trusted, visited the person in their new care home to help settle and reassure them and ensure they received continuity of care. This worked exceptionally well to help reduce the person’s anxiety and supported their emotional wellbeing. It also had a positive impact on the person’s family who said of the staff member, “They have made such a difference to [family member’s] life and to mine. [Staff member’s] support has made all the difference and helped our little family get through it.”

Feedback from partners was consistently positive regarding how the provider worked with them for the benefit of the people who used the service. One partner explained how proactive the provider was in making referrals to support the health and wellbeing of people. They told us the provider never made assumptions about people’s needs and worked in an open and transparent way with them to meet people’s assessed needs. The partner told us how well the provider knew people’s needs meaning the care, support and treatment was holistic and exceptionally person-centred in meeting specific needs. Another partner said, “Home Instead North Norfolk are highly positive to work with… they stand out as they want to improve and go beyond standard expectations.”

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice, and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The ethos of the service was to provide care and support to allow people to remain in their own homes by encouraging and supporting independence, confidence, and liberation. It was clear from speaking with staff, that all worked to this ethos and understood the importance of it. One staff member explained how, with the skilled support, guidance, and encouragement of care staff, one person who used the service regained enough independence, confidence, and mobility to no longer require the service other than for companionship. This demonstrated that staff worked to the provider’s objective in delivering care that enabled and encouraged people to remain independent in their own homes for as long as possible. Another staff member said, “I feel it is very important for my client’s wellbeing to respect their dignity, encourage independence and support them in making choices, all of which make people feel useful, valued, respected, listened to, supported, and encouraged. By giving them choices in everyday life makes people feel in control, heard and empowered.” This was confirmed by people who used the service and their relatives. One relative said, “[Family member] has had a lot of health changes in the past year. The staff have picked up on this. They are vigilant and always report any concerns back to their manager… these are dealt with promptly.”

People’s care plans explained the support they needed to enable them to stay well and access any healthcare services as required. For people with diagnosed health conditions, we saw detailed care plans were in place providing staff with information on how to support that person to remain well including how the health condition impacted that person. A holistic approach was taken in supporting people as the provider understood how all aspects of a person’s life correlated and impacted upon each other. They understood that maintaining a person’s self-worth and sense of purpose increased the likelihood that the person would remain independent, healthy, and engaged. Staff had also received bespoke training for each person they supported which enabled them to better understand people’s health conditions and respond to any concerns or deterioration in health.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

The provider had robust systems in place that thoroughly and regularly monitored people’s care, expectations, and outcomes that had been effective in ensuring people consistently experienced exceptionally positive outcomes. People’s feedback, that of their relatives, and case studies demonstrated the positive impact the service had on people’s quality of life. One relative gave us examples of how they felt staff had provided ‘outstanding’ care, telling us how much they appreciated this and the positive impact it had on their family member. They attributed this to the way in which staff had built positive relationships with their family member.

In taking time to understand people’s motivation for requiring care and support, and what they hoped to achieve, the provider was able to quickly deliver the care people wanted and expected. This was strengthened by completing regular reviews with people, particularly at the start of the service, so changing needs could be captured and care delivery amended to meet those needs. One relative said, “We had a detailed discussion before coming to an agreement of what was possible.” Whilst a person who used the service told us, “The manager came to see me, and we discussed what would make my life easier.”

We saw many examples of where flexible, dedicated, and distinctive care and support had positively impacted on people’s lives and their wellbeing. For one person who was experiencing failing sight, we saw how the service adapted to the person’s changing needs, gradually amending how they delivered care to support the person’s autonomy, sense of self-worth, and confidence. We saw how the service sought advice and aids for the person to help them to remain independent and adapt methods of engagement given the person’s deteriorating eyesight.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People who provided us with feedback told us how consistently staff sought their consent when delivering care and support which they told us made them feel in control. Relatives agreed with one telling us, “Staff are kind and make an effort to engage [family member] in conversation while completing tasks. They ensure consent is obtained before carrying out care.” Through feedback from staff, we saw they understood the importance of gaining people’s consent before they provided care and support.

The provider had also sought formal consent for different aspects of the service from those legally entitled to make those decisions. People told us their planned care was discussed with them, and they received information to make informed decisions.