Archived: Lancashire Domiciliary Care Service

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 remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 75 (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 treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff respected people’s privacy, and we observed positive interactions, with staff using people’s preferred communication styles and therapeutic touch for reassurance.

Staff spoke with kindness, compassion and were dedicated to their role and the people they supported. One told us, “I love my job. I get a lot of enjoyment out of working with people.” Another added, “I love the relationships I build with people, every day is different.” However, some verbal and written terminology needed improving to ensure it was respectful and in line with expected standards.

Following feedback, the registered manager took action to reinforce appropriate terminology with managers and staff.”

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The provider’s self advocacy group developed a booklet for staff during their induction, emphasising the importance of getting to know people, respecting their individuality, helping skills development and respecting people’s homes.

Care plans included people’s personal histories, routines, likes and dislikes to help staff understand their individual needs and preferences. Staff demonstrated a good understanding of people and their idiosyncrasies. A housing partner said, “I have always found staff to know and understand [people’s] personal situation.” A healthcare partner added, “(Prior to our visits) staff have set up music for [people] to ensure their preferences are met, and ensured timings of sessions align with people’s needs and schedules.”

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Care plans promoted choice and control, and we saw evidence people were involved in day to day decision making. A staff member explained how they always took the lead from people saying, “It’s not about us, it’s about [person].”

Staff supported people to access to a wide range of on site and community-based activities. One person told us they enjoyed going to the gym and spoke about upcoming holidays. On site activities included sensory rooms, arts and crafts sessions, animal care and horticulture groups.

The provider had 2 cafes in the local community, with a 3rd due to open at Lisieux Hall, giving people opportunities to volunteer, learn skills and meet new people. Paid opportunities were also made available at the service; a person had recently been employed as an advocacy assistant.

However, not everyone received the same level of support to access meaningful activities. One person with autism had no pictorial timetable, despite care plans highlighting the importance of routine and visual cues to promote engagement. There was limited evidence of regular activities in their care records.

Following feedback, the registered manager reviewed the person’s timetable and assured us they would increase activity levels and improve recording systems.

The provider 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.

Staff knew people well and could recognise when they were experiencing discomfort, pain or distress, including through non verbal cues. A relative told us, “[Person] never admits to feeling unwell, but staff know them well enough to contact us if they feel [person] requires a doctor.” One person communicated using different gestures. Information in their care plan clearly explained what each meant and the required distraction techniques.

Staff responded promptly when people showed signs of distress. We observed a person becoming anxious about an upcoming activity; staff reassured them, successfully deescalating the situation. A relative also shared, “Recently I saw [person] was upset. [Staff] just got up and started dancing slowly with them around the lounge and they calmed right down. It was lovely to see.”

The provider cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff felt well supported when struggling at work. A staff member told us, “I get a lot of support. If I’ve got issues it gets dealt with straight away. [Managers] will do anything to support your welfare.” Some managers were trained in mental health first aid, and permanent staff could access healthcare and counselling services.

A recent change to the way staff were paid had been introduced in response to staff feedback. This had helped improved morale.

The provider had initiatives to recognise and reward staff, including referral reward schemes, an awards evening for teams and individuals, and newsletter acknowledgements for qualifications or long service.