Home Instead North Norfolk

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.

This is the first assessment for this service. This key question has been rated 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 93 (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.

People consistently received outstanding personalised care and the systems and processes the provider had in place ensured this. Due to the robust and highly individual approach to understanding what people wanted to achieve from the service, the provider was able to identify and match staff to their interests, values, beliefs, and personalities. This had forged positive, supportive, trusting, and caring relationships that placed people at the heart of the service. One relative said, “Staff have all been really caring, compassionate, and respectfully listening well to what [family member] wants at any given time. [Family member] is able to go out regularly so has a better quality of life.”

Through feedback and discussion, staff demonstrated a commitment to ensuring people received a highly individualised service and evidenced they understood how to achieve this through building respectful, reliable, and compassionate relationships. Staff told us the provider gave them all the tools they needed to deliver this and that they were always encouraged to work in such a way. One staff member summed this approach up and the impact it had. They said, “The service stands out because it focuses on relationship-led care and longer visits, which allows staff to build genuine relationships with clients rather than feeling rushed. The longer visits mean staff have the time to get to know the people they support, understand their preferences, routines, and personalities, and provide care in a more personalised way. This approach helps build trust and consistency, which is especially important for older people or those living with dementia as they benefit form seeing familiar faces and having time to feel comfortable with the person supporting them. It also allows staff to provide care that goes beyond basic tasks. Overall, this relationship-led approach helps create a more holistic and person-centred service where clients feel valued and supported, and staff can deliver care in a compassionate and meaningful way rather than simply completing tasks.”

The provider understood the importance and impact of scheduling care calls to meet people’s needs and had systems in place to consistently support this. People were supported by small teams of staff, including where people received live-in care to ensure continuity of personalised care; people appreciated this. One relative told us, “The staff who support [family member] are excellent. They are skilled and knowledgeable, and all know [family member’s] needs well and are very kind, caring, compassionate, and respectful. [Family member] sees the same members of staff. This continuity is invaluable, for both [family member], the staff, and myself.”

People, and their family as appropriate, were involved in the regular reviews of their care plan and relatives had access to this, as well as the daily notes staff made, via an app (an app, short for ‘application’, is a software programme designed to be used on smartphones, tablets, or computers). Relatives told us they appreciated this, provided them with reassurance, and showed their family members were receiving safe, effective, and compassionate care that met needs. One relative said, “Each visit is recorded on the app with details of the tasks completed, which allows me to monitor care remotely and keep updated. The service meets [family member’s] needs. Our priority is they remain safe, receives medication correctly and has meals prepared, and we can see from the visit records that these needs are being met.”

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.

We saw many examples of where the service had facilitated people to access and engage with their local community and, given the rural area the provider delivered care in, this was an exceptional achievement. Many people told us that due to the service they received, they were now able to access community events and facilities where they had previously been unable to do so which had reduced isolation and loneliness. For one person, the service had supported them to reengage with their faith meaning they were once again attending church and associated events. This had enhanced the person’s happiness, reduced anxiety, and provided a sense of purpose and belonging. Their relative told us, “The service definitely meets [family member’s] needs. I would have no hesitation in recommending the service. Every staff member has been really lovely.”

To ensure they understood the community the people they supported lived in, the provider was prominent in its locality. Its office was accessible with parking nearby and occupied a significant location on the high street of a local town. Furthermore, they attended local events to advertise their services and raise awareness of challenges faced by older people and worked with local charities and professionals to understand the needs of the people they supported. The provider also sponsored a Dementia Bus that provided training to people, allowing them to experience what living with dementia might be like by letting them enter the world of that person. The provider used this to raise local awareness of dementia and what it was like living with the condition.

The provider had built mutually respectful relationships with other professionals and partners with the aim to ensure people continued to receive exceptional care. They also used these relationships to signpost people to other services if they felt this would be beneficial or if they were unable to provide it themselves. All the partners who provided us with feedback spoke extremely highly of the service and the impact it had on the quality of people’s lives. One partner said, “There is a clear aspiration to be the best in class when it comes to the quality of care provided. I have also observed a strong level of commitment among staff, with individuals often going above and beyond to ensure the people they support receive the care they need.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs had been assessed, and the care plans gave staff detailed information on the level of support people needed enabling staff to provide person-centred care. People had also been provided with information on the service so they could make informed decisions. One relative said, “The commencement of the service was a very positive experience. Two members of the managerial team visited [family member] and I in [family member’s] home. We were able to have an open and honest discussion as to the type of care we were looking for. We did not feel under pressure to make a decision and did not have to wait long before the service started.” People received rotas so they knew which staff member was supporting them and when and this was provided in people’s preferred formats. Information was available in other formats such as Braille and large print, and we saw examples of where the service had adapted the care they provided to meet people’s communication needs as these changed. The evidence showed the provider was meeting the Accessible Information Standard which states providers must assess and record people’s communication needs and provide information in accessible formats.

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.

The provider, and staff, were passionate about continually improving the service and had many systems in place that allowed people to provide feedback and suggestions. They actively encouraged this and used all feedback as a mechanism to drive improvement and make the care delivery better. This included very regular reviews with people, and surveys amongst other formal and informal processes. We saw many examples where the service had liaised with people, and their family, to seek feedback in order to continue to develop and enhance the care and support they provided. For example, for one person who used the service, how staff maintained their home environment as part of the care package was especially important to them. The service therefore met with the person so they could explain exactly how they wanted each room of their house cleaned and maintained including what products to use where. As a result, and in consultation with the person, the service drew up a detailed cleaning list for each room to enable staff to meet the person’s needs recognising how important this aspect of the service was to them. The provider also had a complaints policy in place but had received none. This was because of the proactive and highly responsive approach they took to delivering the service. They ensured people, and their families, as well as staff felt comfortable in speaking up due to the exceptionally supportive, open, and welcoming culture the provider had established. This meant any issues were quickly identified and rectified preventing concerns and/or complaints. People, and their relatives, confirmed they had not needed to raise any concerns but told us they would be comfortable in doing so should they need to in the knowledge they would be meaningfully listened to, and their concerns actioned. One relative said, “We enjoy a good relationship with the management. If there are ever any issues, they get sorted.” Staff agreed the provider’s focus was on ensuring people were happy with the care they received and that they were always trying to make improvements by carefully listening to people. One staff member said, “Clients are listened to and get regular meetings to give feedback about their care. I think Home Instead North Norfolk is innovative and always striving to improve things and the care we deliver. I love working for them. I feel very supported and listened to.”

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

Staff were available whenever people needed assistance including in emergencies, such as overnight, when an on-call system was in place. People praised how responsive and communicative the service was and told us they could always speak promptly with a staff member when they needed to. One person who used the service said, “The office staff are always accessible” whilst a relative told us, “There is excellent communication between the service and myself. I am able to access the carer’s notes, and the office staff are quick to respond if I need to contact them.”

Staff commended the responsiveness of the management and office team when they raised queries or concerns over people’s care or changing needs. One staff member gave us an example of when they had to use the on-call system with a concern. They said, “Whenever I have called to speak to someone in the office if they aren’t available, I will always get a call back every time. When I had to speak to on call about a concern, they discussed this with the family and sorted this out promptly.” Another staff member told us, “The team never hesitate to jump into action if there is a sudden discharge from hospital, a sudden change in someone’s condition with the team going out and providing training and support for new conditions or equipment, reviewing and assessing people post hospital admission or if there is a change to the living situation.” We saw many examples of where the service had worked promptly and flexibly to ensure people received the safe, compassionate, and skilled care they needed at the time they needed it, even if this was outside of normal working hours. The provider’s priority was ensuring people were safe and not distressed, including ensuring the health and welfare of their staff when emergencies arose.

People told us, and the records confirmed, staff arrived at the time agreed and stayed for the allotted time; the data confirmed the punctuality of the service was exceptional. We saw that the provider promptly added extra visits to people as required or requested and to support people with changing needs or declining health to maintain their wellbeing and promote their health. As staff knew the people they supported exceptionally well, they excelled in identifying when people needed additional support including from other health and/or social care professionals. This meant people received the dedicated and personalised care they needed exceptionally promptly. The partners who provided us with feedback, confirmed this. One partner said, “Home Instead North Norfolk are very good at knowing their client’s needs and proactive in sending referrals as well as asking questions. They never assume people’s needs.”

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. People received exceptional individualised care meaning people’s experiences were consistently positive including those most likely to experience inequality. The provider strongly advocated on behalf of the people they supported, and we saw examples of this. Staff also delivered care that went above and beyond to ensure people’s outcomes were consistently positive, adapting care as needed to meet people’s needs. Staff also received bespoke training on the needs of each person they supported meaning their knowledge, skills, and competencies had been honed to further assist in meeting people’s individual needs. We saw staff had supported people with health conditions that are more likely to impact older people, such as visual and cognitive impairments, in a way that supported their autonomy and independence. For example, staff supported people to engage in their local community, attending events, visitor attractions, and any cultural events that were important to them. This had a significantly positive impact on people’s happiness, wellbeing, and general health. For people with visual impairments, staff supported them to better engage with the world around them giving them the confidence to do so.

People were at the heart of the service and the provider, and their staff, had an exceptional knowledge of the people they supported and the barriers they faced. They worked in a person-centred and imaginative way to break done those barriers by working with professionals and other partners to ensure equal opportunities for everyone who used the service. They also understood the impact of caring responsibilities on family members and had provided support, training, advice, and signposting to help them in their roles. One relative told us about the positive impact the service had had on their family member telling us, “Staff have taken that (emotional) burden away from me. I feel confident and reassured because the carers are competent and responsible.”

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. The provider had sought people’s wishes, values and preferences making it easier for them to assist people with future decisions as required; people’s relatives and significant others had been included as appropriate. Staff had received training in end-of-life care and we saw, for one person who was entering the later stages of their life, the service had assessed their needs in a fully holistic manner taking into account their wishes and preferences.