Milford Del Support 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 – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has improved to 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.

There was a genuine person-centred culture, where staff worked with people and their families to truly understand how to support them. People were at the centre of everything staff did to ensure their needs, wishes and goals were understood and they were supported to live fulfilled lives. The provider ensured the service was exceeding the standards in “Right support, right care, right culture” guidance.

The service developed a multi-disciplinary team (MDT). Members of the MDT included a speech and language therapist, occupational therapist, specialist nurse, psychologist, psychiatrist and a counsellor. The provider paid for the service of the MDT.

The MDT regularly assessed people and held meetings with them, their families and their core staff team. This resulted in people receiving timely, person-centred support. We saw people were experiencing improved quality of life as their mental wellbeing had improved. . A professional told us, “The service’s MDT is phenomenal, people have almost instant access to clinical assessments and treatments, they would otherwise have to wait over 18 months to receive or sometimes would never have been available to them. The MDT is reassuring and reflective, where everyone can share ideas.” A person told us, “The MDT has been brilliant, I have always been included, I have been properly diagnosed and have a better understanding of my condition.” A relative told us, “The MDT monthly meeting has been exceptionally good for [person’s] health and wellbeing. Having all the right people in place means we can make dynamic decisions and get input from everyone to make sure we are heading in the best direction. [Person’s] best interests are front and centre in every meeting. I have been consulted on every decision and event, but this is the first time I have ever felt the results coming from the meetings - that normally I would be feeling alone and arguing the case for - are unfolding naturally, sometimes without even needing me involved. Because everyone is seeing what I am seeing before I even say anything. The feeling is of everyone being on the same page.”.

People were actively encouraged to achieve their goals and live their life beyond the service. We saw many examples where people’s independence and quality of life had greatly improved. For example, when a person did not feel safe or confident to go out alone, staff worked with them to use assistive technology to gradually reduce the staff support needed, until the person was happy going out all day on their own. The person was also being supported to plan a holiday. Staff told us, “[Person] has come such a long way, you can see how much their self-confidence has grown.” The person told us, “I feel safe when it comes to times that I struggle as there is always a plan in place as to what to do, this has meant I can go out on my own, I am so happy”.

We received a large amount of positive feedback about how the service ensured people received person-centred care. For example, “My staff are very friendly and approachable. I feel like my care is very person centred, and I have never felt unsafe.” “My staff provide attentive care and are adaptive, my advanced conditions are discussed and dealt with professionally and in a person centred way.” A professional told us, “Milford Del is an outstanding care company that consistently places the needs and well-being of their clients [people] at the heart of everything they do. Their team is incredibly responsive, compassionate, and dedicated to providing high-quality, person-centred support. They go above and beyond to ensure clients[people] feel valued, safe, and well cared for. Milford Del sets a high standard in the care sector and is a truly supportive and reliable organisation.”.

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

People had a core staff team to help provide them with continuity of care and developing trusting relationships. This helped to reduce anxiety, and people could do things they wanted to do without restriction. A family member told us, “the core team have been fantastic, they really understand [person’s] needs, [person] is engaging more, doing activities and household chores, they are even enjoying cooking”.

People were actively involved in staff recruitment and choosing members of their core team. This meant people were supported by staff who had the correct experience, knowledge, skills and training to support them effectively. A person told us “Interviewing and choosing my core staff has made a massive difference to my life, I fully trust the staff I have chosen, they have helped me go out independently, something I never thought was possible.”

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was available in different formats, depending on individual needs. We saw people accessing their care plans electronically using a ‘read aloud’ mode, some were in ‘easy read’ and others contained signs and symbols. This enabled people to be actively involved in communication and decision making. A person told us “This service has been transformed and is like a totally different place. Communication is so much better, and I am able to control how I am supported that has made a world of difference to my quality of life”.

Staff communicated effectively with people through difficult transitions. For example, staff researched the characters and learnt the language used in a person’s favourite computer game and used this to help them understand a transition plan. This meant the person was able to understand each stage of the transition, develop their own support plans and achieve their goals. A professional told us, “The team were phenomenal, we only had 12 days… the way they effectively communicated and engaged with [person] had a huge impact on the successful outcome, furthermore staff have enabled [person] to go out for the day, this is the first time [person] has done this in 12 years.”

The provider enabled 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 service involved people in aspects of their care, support and their lives. People were encouraged to attend a monthly meeting to share ideas and make improvements to the service. Feedback from people about the meetings included, “I've been in need of care support for 25 years this September and have never had the opportunity to share, which in my opinion is a much needed place to discuss any worries, stresses or put across any ideas, positive or negative and know you'll be listened to. I feel that it's a much needed lifeline and think that other care support agencies would do well to take on board this amazing idea and follow by example”, and “I like [name of the meeting] and being involved in decision making to be heard not ignored and included is all we ask”.

People were supported to complete audits, which were used to develop action plans and improve the service. People worked with the provider to agree what the focus of the audit would be and were given training to support identifying any concerns or good practice. This meant people had a clear understanding and were empowered to raise concerns where needed.

The provider had a complaints policy and procedure, which was displayed in an easy read and picture format. There was also an app people could use to provide feedback on their care. A family member said, "When there have been things that have gone wrong or things that I haven't been happy with, the registered manager and her team are always keen to help and solve any issues as quickly as possible." Complaints received by the service were investigated and appropriate actions were taken when required.

Where people wanted staff to fully understand their diagnosis and how this affected them, staff worked with the person to develop bespoke training for their staff. People told us “My team now understands how to support me and how my mental health affects me, rather than just having general information that isn’t always true for me”.

Advocates who worked with people told us, “The service goes above and beyond to ensure peoples voices are heard, even if the person is not able to communicate verbally, they intuitively know when people are dissatisfied, and look how issues can be quickly resolved”.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

When the provider moved as their office wasn’t accessible to some people, they made sure the new office was fully accessible. This meant people could use the office for social gatherings, meetings, training and employment.

The service was able to recruit people using the service to work in the office, where this had previously not been possible. Bespoke support was provided to people all the way through the recruitment process, reasonable adjustments were made to enable people to fully participate in the recruitment process. Once people had begun working in the office, they were fully supported with their training and induction, a number of people gained part time paid employment and are thriving in the workplace. A person told us “ I have a real paid job and I feel normal, it’s amazing”.

The provider worked with the MDT to research medical advances that could benefit individuals. This information was shared with the person and their families. This meant people had access to life changing treatment as soon as it became available to them.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People’s desired outcomes were documented, and staff supported them to achieve their goals. Some people were supported with step by step guidelines to help them complete activities and increase their independence.

We saw evidence of how the service worked to ensure that the delivery of care promoted equality and removed barriers. For example, people wanted staff to fully understand their diagnosis and how this affected them and so they worked with staff to develop training which went beyond general information and was person centred.

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.

At the time of the inspection, no one using the service was receiving end of life care, but some people had life limiting conditions. The registered manager worked closely with the local hospice, healthcare professionals and family members to help ensure people's needs could be met and they would receive appropriate support at the end of their lives.