One Step South Domiciliary Care 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 remained “Good”. This meant people’s needs were met through good organisation and delivery.

This service scored 82 (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 and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. People were in control of their own care and treatment with regular opportunities to discuss their care with their staff team, to ensure their current needs and wishes were understood and responded to. Regular opportunities were sought and taken to ensure people had opportunities to drive and inform their own care, to ensure it reflected how they wanted to live life on a daily basis. When we visited people in their own homes we saw they were engaged in a variety of tasks that were meaningful for them, including preparing to go out Christmas shopping with staff, engaged in creative activities such as painting, exploring their passions such as music and even taking part in a first gate. Staff knew each person as an individual, and people’s care documentation reflected them as individuals including what they wanted from their own care and how staff should support them in achieving their goals. One relative told us, “Staff know my relative really well and always fight her case. Currently they have a wheelchair, but staff are advocating for them to have an adapted car which will allow them to engage in the community more often- which is really important to (person name)”.

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. There was a consistent staff team who knew people as individuals with their own strengths, abilities and goals. One person we spoke to had experienced trauma relating from a distressing incident at another health and care setting, and required a consistent team who could reassure them who were specifically recruited to be able to meet their communication needs. One of the staff who worked with this person told us “It’s important to communicate clearly every step that is happening so they know what is happening and to reassure them that they are safe”. This approach had reduced incidences of distress completely, and the team had been working with them to focus on therapeutic ways to manage their emotions such as creative activities. We saw they had created pictures of all their staff members which were displayed in pride of place in their flat, and they talked with pride about creating these and the importance of their staff team to them.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual need. Staff worked creatively to ensure people were communicated with in a way that was accessible, and empowered them to be engaged in their own care and treatment as equal partners. For example, the provider had supported people with easy read information and videos to understand the importance of cancer screening, and provided guidance on how to be aware of their own bodies and check for lumps. As a result of this work several people had recently attended cancer screening appointments with the support of staff.

There was clear guidance on how staff should communicate with people to enable them to make decisions and be in control of their day to day life. This included using tools such as pictures, sign language or how to interpret verbal cues or gestures to ensure people’s voice was heard and used to drive their own care. One relative told us “Most of the staff working with my relative have a background in sign language. (Person name) has a reasonably good vocabulary of signs, staff can pick up what he’s saying. Staff have proactively asked for further training from the provider and they have been supportive of this.”.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. There were frequent opportunities for people to share feedback about their own care or that of a relative. Each person had a designated key worker who would meet with them at least monthly to talk to them about their care, giving people an opportunity to talk about what was working well and any changes they wanted to make. This also allowed people to discuss what they wanted to achieve from their care, and how staff would help them work towards their goals. There were also regular surveys for people and their families, and where any concerns were raised there was clear actions taken to address them. One person told us, “Staff know me well and I feel listened to. If I want anything I can always ask, and I have a weekly meeting with my key worker which is really good.” People and relatives felt comfortable that their voice would be heard and if they wished to make a complaint then this would be responded to appropriately. A relative explained “The manager is very responsive. They listen to our suggestions.”

The provider was exceptional at ensuring people could access the care, support and treatment they needed when they needed it. There was strong understanding of the inequalities faced by the people they supported, and a commitment to working together to ensure people received the care and treatment they needed to live life to the highest quality possible. The service had created equality and human rights profiles” which set out inequalities in society faced by the people they supported, and set out commitments of how they would together to ensure people would be advocated for and supported on a day-to-day basis.

One person had moved to the service having previously been in hospital for a lengthy period of time where their health had significantly deteriorated, staff had worked closely with them alongside wider professionals to ensure they received the support and treatment to regain independence and control over their own life. This person had previously been unable to leave bed and needed full support with managing their personal care and diet. However, they were now able to mobilise with a wheelchair and have greater control over their personal care, with staff now working with an occupational therapist to assist them to start to walk independently. They had previously been anxious about leaving the building but now were able to regularly engage in their local community, including attending nightclub events which had significant meaning to them as they had a passion for music. Staff had worked tirelessly to ensure they had accessed the support and care they needed to engage in their wider community once more, and feel safe and supported in doing so.

Another person was being supported to attend hydrotherapy and music therapy sessions, which had a significant positive emotional benefit in managing their mental wellbeing. Staff had learned from this person that being out in the evening caused them greater anxiety and distress, so they were working collaboratively with partner organisations to explore looking for services closer to where they lived to ensure they could still receive the psychological benefits this care and treatment brought them.

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 worked creatively to break down barriers for people in having the quality of life and outcomes that others in society may take for granted. This included supporting people in building friendships and relationships, developing life skills and interests that empowered people to build their self-belief, and engaging in wider society on their own terms as equals. One person was currently in the process of transitioning, which staff had worked closely alongside them with respect to provide gender affirming care which promoted their choice and self-identity. On our inspection, this person was having a first date in their own flat which was being supported by staff who had also been assisting them to explore online dating to enable them to maintain and grow safe and affirming relationships.

Another person we spoke to was also being supported to build relationships and friendships which they spoke of with pride saying, “Staff here are really good. They have supported me to see my girlfriend who is helping me learn life skills. I’m now able to maintain and develop my own friends, and go out into community which I have never had a chance to do before”.

At one of the services we visited, people had asked if they could hold a Pride event to show their support to one person living at the service. This had been supported by staff and now grown into a yearly event to promote a commitment to equality and inclusivity, and the freedom of people with a learning disability or autistic people to express their own self and gender identity and sexuality with openness and pride.

People were supported to pursue and develop new interests which brought them meaning and joy. One person we spoke to shared they had recently joined several local singing and dancing clubs, including taking part in competitions which had increased their self-belief and confidence. A relative told us “They take (person name) out quite a bit, they take him shopping every week, to the cinema, he was going to a nightclub, they have taken him to London, he is going out more than me!”

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. Staff worked closely alongside people to provide them with the information and confidence they needed to make important decisions about the future. If people felt comfortable in doing so, they were supported with sensitivity in making plans for how they wished to be cared for at the end of life. There was an open and positive culture of reflecting upon death and bereavement. One person we spoke to had recently lost a close member of their family, and staff had worked with them closely to give them time and safe to process their loss and to reflect on their own wishes for the future. They had empowered this person to use the memory of their loved one to inspire them to raise money for a cancer charity. The person told us with pride how they had raised £300 last year and had already raised £150 this year, which they explained helped them keep their loved one’s memory going and use their loss to make a positive difference to others.