Home Instead – Eastbourne and Hailsham

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 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 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 made sure people were at the centre of their care and treatment choices andthey decided, in partnership with people, how to respond to any relevant changes in people’sneeds.

Care plans were exceptionally individualised. The provider clearly demonstrated how they had worked closely with people and their relatives to ensure their wishes and feelings were recorded. Care plans gave insight into the person beyond their needs to ensure they received a personalised service. For instance, care plans described what to sing with a person during a specific routine to reduce their anxiety, or which side to dress a person first and the reason. Staff told us care plans were extremely detailed and invaluable, and felt they knew a person just by reading it. For example, for one person it was vital they had support delivered in a specific way to get them ready for their workday. Their care plan detailed the person’s routine from how to wake them in the morning, what to say at certain stages, and why the person took a break at a specific point during their routine. The highly detailed and personalised care plan meant staff knew how to support the person exceptionally well. This resulted in the person experiencing less frequent moments of distress and empowered them to start their workday the right way.

Feedback from people, relatives and professionals confirmed care was extremely person-centred and described how the service was exceptional in the way they tailored and adapted people’s support. For example, one person told us about their health condition which fluctuated. They told us how staff knew them exceptionally well and recognised when they had relapses and required extra support. They said, “On one occasion, my [condition] got worse. Staff recognised straight away I needed extra support, and the manager came out to update my plan. I really appreciate how attentive staff are to any changes in my condition. They always involve me in decisions about my care.” The provider was exceptionally proactive in involving people and relatives in reviews of care. Outside of formal reviews, leaders regularly checked in with people and relatives to ensure there were no changes to their needs.

Staff fully embraced the excellent person-centred culture of the organisation and put people at the heart of the service. They were reliable, consistent and truly dedicated to caring for people. Some staff told us, “We always give the person an opportunity to talk with us regardless of tasks. For our clients, their wellbeing and needs come first. When they are being listened to, their health is better. It's an opportunity for them to tell you their troubles; to make them feel better” and “We don't have this kind of service in my home country. Here, it is all about the person, we treat them with respect and dignity. It has inspired me because we treat them as if they are our own family.” People consistently praised staff in delivering a unique and flexible service which met all their needs and exceeded the expectations of their relatives and other professionals.

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 had consistent staff teams who knew and supported them exceptionally well. Relatives told us this had been vital for people living with dementia to have a consistent staff team which reduced their anxiety and distress. The provider had good links with community health and social care services. This enabled discussions and decisions with professionals to ensure care and support was joined up to consistently provide better outcomes for people.

The provider continually looked for ways to reduce social isolation for people, and to support re-integration into the wider community. For example, the provider recognised people had become socially isolated following the Covid-19 pandemic. They created a ‘Community services and wellbeing guide’ which detailed a variety of events and groups people of various ages and capabilities could attend and participate in. This guide was shared with people using the service and their families. They told us this information was extremely useful to plan trips and activities they wanted to attend. This guide was also shared with local services and charities who reported they were extremely popular and requested more from the provider. The service continues to provide this guide as it has worked exceptionally well. The provider also worked with local services to setup a community café which was a free, dementia friendly service, for anyone to attend where they could develop friendships and participate in activities. The provider supported people using their service to attend. It had a positive impact and enabled people to regain their confidence and independence in the community. A professional said, “The staff are great with everyone and always make sure people are comfortable and safe with a drink and a piece of cake! All staff are extremely kind and welcoming, hence why there is such a great return of the community to their cafes.”

The provider had an exceptional understanding of the local community. They actively contributed to safe, effective practice and research to develop their knowledge about the different elements associated with care, ageing and dementia. They took part in numerous community and charity pilots for older people living with dementia to share learning and experiences. This work included supporting a peer-to-peer support group to contribute to a local authority's dementia strategy to ensure peoples voices were heard. They were able to signpost people to other services if they were unable to deliver a service themselves. This enabled them to offer people a holistic service that was seamless and ensured continuity of care. The provider joined up with other local services and charities to share learning and experiences. For example, the provider created a strong link with a charity that supports people in the community living with visual impairments. The charity had concerns that many of their members had memory issues which their staff were not always confident to support with. The provider invited them to attend their ‘Virtual Dementia Bus’ training, which they found significantly beneficial. Equally, when the provider sought additional training for their staff on the impact on people living with visual impairments, they worked with the charity and used their aides which mimicked different visual problems. Staff found this training extremely beneficial to support people using the service. The provider continually demonstrated their passion and commitment to ensure everyone had excellent continuity of care with good outcomes.

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

People’s care plans reflected any communication needs they had and gave clear details of how to support them effectively. People and relatives told us the provider had great communication processes. They were kept informed of any changes to their service or dedicated staff team. The registered manager was aware of accessible information standards (AIS). AIS provides the legal framework to support people with their communication needs.

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 actively sought opportunities for co-production. They encouraged people and relatives to participate in events and processes to share feedback and ideas. This included attending the providers community dementia café or sharing experiences and learning through the newsletter. The provider had regular meetings, surveys and discussions with people and relatives about the services performance and development. For example, people and relatives told staff their ID cards were difficult to read as the print was very small. This had a negative impact on people with sight impairments and memory loss as they could not easily see what the staff member’s name was. Leaders and staff discussed the feedback to identify a solution. The provider produced new ID badges where the reverse side had staffs’ first name in very large print. This solution had worked well for people. The provider demonstrated people had meaningful involvement and influence in service improvement.

The provider listened to people about their needs, goals and aspirations and included them in choices on how it could be achieved. They were extremely proactive in involving people in decisions about their care. All people and relatives told us they had regular ‘check-ins’ with leaders where they could share ideas or raise concerns. This process had worked exceptionally well as the service had no formal complaints at the time of this assessment.

The service had a culture of open and honest discussions, and any issues were dealt with immediately. Concerns were seen as learning opportunities and the provider reflected on how the service could improve. People and relatives told us they felt confident to speak up and felt listened to. Comments included, “I cannot find fault with them, they are perfect. No complaints at all”, “I always know they will call me if there are any problems with [person] which means I can get on with my day-to-day life.” We saw evidence that low-level concerns were taken seriously and investigated. Resolutions were shared with people and leaders followed up to measure the impact of the changes made. This ensured people received consistent, personalised high-quality care.

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

The provider was innovative in seeking ways to identify potential discrimination and inequalities that could disadvantage diverse groups of people in accessing services in the wider community. They actively worked with local groups and charities to understand the people they supported who faced similar challenges. Learning was shared across the staff team to ensure effective personalised support was in place. We viewed evidence on how this holistic approach worked exceptionally well in reducing barriers for people accessing health care services.

Staff excelled in identifying when people needed additional support from other agencies and supported them to access these without delay. For example, one person had communication difficulties and previously had a medical condition that if left untreated, could be fatal. Staff monitored the person closely and recognised signs that the condition may have returned. They sought support from a clinical team who were initially dismissive of the concern. Staff advocated on the person’s behalf to ensure they did not face any barriers to their care. Staffs’ quick actions meant the person received a speedy diagnosis and treatment was started immediately. This resulted in the person making a full recovery. Feedback from professionals was consistently high about the provider recognising people’s changing needs and proactively seeking support.

The provider was consistently flexible with their service delivery to meet people’s needs. They not only valued people using their service, but their individual support networks too. For example, a person told us how staff supported both their and their spouse’s health and wellbeing. The person was reliant on their spouse to provide care outside of the providers care visits. They told us how staff knew their spouse well enough to recognise when their physical health had deteriorated and required hospitalisation. They said, “The carers are brilliant. They saw [spouse] was unwell, contacted the ambulance straight away and they were taken into hospital. [Leaders] straight away put extra visits in place for me so I could stay at home. Their communication and coordination with [health professionals] was great. I felt supported and safe.” The person also told us that staff included their loved one in their outings and the positive impact it had for them both. This demonstrated the providers positive and inclusive culture of loved ones involved in providing care to people using their service. The provider had an out of hours protocol for people and relatives to contact them if they needed help outside of their care calls. This had worked exceptionally well and had a positive impact on people.

People and relatives told us their calls were on time. Staff recognised when their own care delivery could be delayed and proactively rectified this. The provider had robust monitoring procedures for timekeeping. Records demonstrated this had worked really well as punctuality was exceptional.

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.

The provider always supported people with their individual preferences and actively found ways to go above and beyond to ensure they had equity in experience. Leaders undertook extremely detailed and person-centred needs assessments. These were used to create personalised care plans to meet people’s needs and ensure positive experiences.Staff were ambitious and resourceful; they described how they supported people when they recognised that a person may want to achieve something. This included returning into the community or volunteering to attend appointments with them that they were anxious about. People were supported to celebrate cultural events which were meaningful to them. Some people were supported to access their place of worship after many years of not being able to. This had a significantly positive impact on their well-being and had broken down the barrier preventing them to feel able to achieve this. For example, a person had not attended a religious event in many years because they had no family to support them. Staff enabled the person to attend the event to celebrate a personal memorial anniversary and join in community Christmas festivities. This had an immensely positive impact on the person’s wellbeing to celebrate a significant date in a meaningful way.

The provider demonstrated exceptional values of putting people first, advocating on their behalf to ensure they did not experience any barriers to care. This included working with a variety of healthcare professionals across various care settings to ensure equal opportunities for everyone to get the care and treatment they needed. The provider also supported unpaid carers with any training needs and guidance to allow them to safely care for their loved ones when staff were not there. For example, moving and handling for specific equipment in their homes.

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 service was not supporting anyone at the end of their lives at the time of assessment. However, details around people’s wishes and decisions were recorded in their care plans.The registered manager said, “We have discussions with people and relatives about their plans and wishes. For us, the care does not end when people pass away. We want to be there to support their family members too.”