Home Instead Mid Cornwall

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

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 changed 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.

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.

The provider extended visits when extra care was needed if a person was feeling unwell. If a person had a fall and the family were unable to attend the service will arrange to be with the person until the ambulance attends.

Care plans were exceptionally individualised. The provider clearly demonstrated how they had worked closely with people and their relatives to ensure wishes and feelings were recorded. Care plans gave insight into the person beyond their needs to ensure they received a personalised service. For example, care plans described what colour bedding was to be used for each bedroom and assisting a person to appointments when needed, staff recorded what was discussed as a reminder for them to share with their family. Care staff told us, “A lot of it is being a listening ear and making sure the family member can do things, try not to take over but to assist, making sure everyone is involved, so as not making a family member husband/wife feel left out.” One person said, “I was very lucky, met [the owner] after breaking my hip and [Home Instead] were able to give me the time I needed.”

All care staff were able to access the care digitally via a secure app and staff told us, “The care plans were good, likes and dislikes, everything, drugs, family, what they need, what’s expected.” and “Small team and everyone knows what they are doing.”

The highly detailed and personalised care plan meant staff knew how to support people well.

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 small and consistent staff teams who knew them 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. One person told us, “There is consistency, which [my relative] needs even more now,” and “There are a small team of carers allocated to me, so it does change but I have never had a stranger walk into my house.” Care staff became well-acquainted with people and noticed even minor changes.

Professionals told us, “We will often use Home Instead for our more able patients for social outreach support alongside personal care needs and they have always worked to identify the right carer for the right person.”

The provider acted in a voluntary capacity for Parkinson’s UK having taken over the leadership of a local Parkinson’s café that provided support to people living with Parkinson’s Disease to support a local group in the community. The provider supported people using their service to attend.

The provider understood the importance of a multidisciplinary approach and worked closely with hospital discharge teams, social workers, district nurses, Rapid Response and Reablement teams to ensure smooth care transitions.

The provider was instrumental in guiding people and families to support services, as necessary.

A person had a live in carer, Home Instead continued alongside the live in carer as they did not drive, so that the person could continue to enjoy social outings.

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

We saw people’s care plans reflected any communication needs they had and gave clear details on how to support them effectively. The provider recognised that many of the people they supported often experienced hearing and sight loss, along with communication challenges due to dementia. To manage this, the provider conducted thorough assessments to identify needs, involving family members to overcome communication barriers. Care staff received training to support people with sensory and communication impairment, focusing on the ageing process and its effects. For example, eyeglasses to simulate, conditions like macular degeneration and cataracts were provided to staff so they would fully understand what it was like to live with these conditions. Care staff were observed by the manager in people’s homes to ensure they understood and met people’s needs effectively.

People, relatives and staff told us the provider kept them informed of any changes to their service or staff team, “The carers are very good at being on time, but if they do get held up, they [Home Instead] will let me know and I will tell [my relative] so they don’t worry.”

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 used an external organisation to carry out an anonymous survey, Pursuing Excellence by Advancing Quality (PEAQ), with people and care staff to develop the service and to improve practice. The survey results were shared with people and staff to continually enhance their services and practices. An internal survey for care staff to identify how improvements could be made was also carried out. This generated good ideas, for example, using team meetings more effectively.

The provider was in the process of making the office a more comfortable space for care staff by providing soft seating and pictures of staff pets adorned the walls.

Training ideas were explored and included possible workshops on how to continue to have stimulating conversations with people once the initial ’get to know each other’ stage had passed.

The provider listened to people about their needs, goals and aspirations and included them in choices on how they could be achieved. People were proactively involved in decisions about their care. People told us, “They are very good at generally keeping things smoothly running and tweak it regularly.”

People told us they knew how to make complaints, one person said, “No never complained, but if I had to, I know it would dealt with.” And another person said “[the staff] are here on time, no complaints about anything, never late and stay their full time.” 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.

People were able to make changes to and reschedule planned visits based on their needs and lifestyles. Where changes were made to staff visit schedules these changes were highlighted with staff to minimise the risk of visits being missed. A person with advancing dementia was able to stay at home with their dog when the provider was able to increase the visits to 3 a day at short notice. The service was able to provide emergency night care on 2 occasions to keep a person safe overnight when the hospital was at capacity. This supported people effectively to stay at home.

Care staff supported a person to relocate to a care home. The carer helped moved the person’s things to the care home and supported them to settle to into their new surroundings. This made the transition much smoother for the person and was reassured as they knew the carer so well. Staff and managers understood the value of this flexible approach in enabling people to live their own lives. A person asked the provider to help care for their relative whose sight was impaired to a level where they could not enjoy walks outside. Care staff were able to do this and continued to walk outside with them and their dog whilst their relative recovered from an operation.

People were supported to access health and social care services as required. Records showed people were routinely supported to book and attend appointments with GPs, audiologists, opticians, and dentists, to access more specialist services when required, staff told us, “Anything you come across the office sort out, like contacting a GP and the family.”

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.

Leaders undertook extremely detailed and person led needs assessments. These were used to create personalised care plans to meet people’s needs and ensure positive experiences. Staff knew people well and recognised that people wanted to continue to do things that mattered to them. For example, a person was always keen on the outdoors and care staff would take them out for coffee. On other days, the morning carer would help get a picnic ready with a thermos drink and the lunchtime carer would accompany the person to an area overlooking the river Fowey. Another person would be accompanied by a carer to walk their dog, and on a Sunday care workers would support the person to go to Church. Staff supported one person to visit local attractions where they would have a coffee, walk around and people watch.

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 systems for documenting and recording people’s preferences in relation to how support should be provided at the end of people’s lives. The provider had completed City and Guilds assured programs including dementia and end of life care training, which emphasized developing communication skills and understanding people’s behavioural expressions and unmet needs.

Care staff were observed by the manager in home settings to ensure they comprehended and supported people. Care staff told us, “End of life care plan is clear about their wishes,” DNACPR [Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders are completed and carers are informed. “Needs are very fluid when end of life, moving and handling care plan is updated and we are very keen on keeping the same care staff, small team, so everyone knows what they are to do.”