TogetherCare

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 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 79 (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.

People with highly complex needs received exceptionally personalised care from staff and leaders with bespoke training tailored to individual care needs. This included areas such as percutaneous endoscopic gastrostomy (PEG) nutrition, spinal cord injury care, and associated bowel management. The provider worked closely with individuals, their relatives, and a wide range of health professionals to ensure treatment decisions were shaped entirely around each person’s wishes. They also advocated strongly on people’s behalf whenever this was needed. This proactive, person‑led approach meant people avoided unnecessary health crises, experienced greater stability, and were able to live with dignity, comfort and control despite the complexity of their conditions.

People told us that staff worked closely with them to meet their care needs and support them to meet goals and aspirations which were important to them. One person told us, “I am very happy with my carers, and I am looking forward to going out with them and being supported to do more in the community. I have improved so much under [their] care that I want to now go back out in the community”.

Professionals told us the care provided was person centred, one professional said, “Their [provider] commitment to providing person-centred care is evident, and they remain a valued partner in ensuring the timely and effective provision of care services”. Another professional discussed how the care staff had supported a person to make significant improvements, they said, “In the case of a complex care package there has been significant improvement in the [young person's] quality of life and he has developed trusting relationships with his care team”.

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

People’s individual communication needs were assessed and recorded in their care plans as a guide for staff to refer to when needed. The provider gave people information in a range of different formats or languages if required.

Managers and staff were aware of their role and responsibilities to meet people’s communication needs and make information accessible. We saw that the provider adhered to the Accessible Information Standard. Since 2016 all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard. (AIS) The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication.

Managers and staff followed guidance in care plans to make sure they communicated with people in a person-centred way to enhance their understanding.

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

People’s individual communication needs were assessed and recorded in their care plans as a guide for staff to refer to when needed. The provider gave people information in a range of different formats or languages if required.

Managers and staff were aware of their role and responsibilities to meet people’s communication needs and make information accessible. We saw that the provider adhered to the Accessible Information Standard. Since 2016 all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard. (AIS) The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication.

Managers and staff followed guidance in care plans to make sure they communicated with people in a person-centred way to enhance their understanding.

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.

Policies and procedures were in place to manage and respond to complaints. The registered manager and management team carried out reflective practice following any complaints or concerns to identify learning which was then shared with the staff teams. Audits were in place to analyse trends or themes. We did find not all concerns received directly to managers in the office were recorded in the complaints log. This was due to an acceptable resolution being agreed during the call. This meant data was missing when analysing themes and trends. We fed this back during our inspection.

Professionals were positive about the way the provider responded to concerns, one professional said, “I have found all the staff very efficient, helpful and caring. If I have any issues that have been raised by service users, I have always been able to contact Together Care and they have resolved the issues or put plans in place to ensure that the problem is eradicated”.

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

People received care and support, which was accessible and considered their individual needs. People were positive about their support and were supported to access community services, medical appointments and hobbies.

Call times were managed and monitored in line with local contractual requirements. Where people preferred alternative call times, the management team discussed this during reviews and adjusted arrangements when capacity allowed.

Staff also had appropriate access to support in an emergency, including out of hours guidance.

People experienced positive outcomes because support was tailored to their individual needs and circumstances. The provider gathered feedback from relatives and professionals to understand the impact of care.

Feedback reviewed during the assessment highlighted positive outcomes for people, including improvements in health, wellbeing, confidence and quality of life. People reached out via the registered manager to give feedback about their progress and what the support provided had meant to them.

Staff received training in equality and diversity, they told us they supported people to keep well, happy and achieve their goals. Policies and procedures underpinned all safe working practices, and this was supported by training and ongoing competency monitoring.

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.

Where people wished, their preferences were discussed sensitively and clearly recorded in care plans, including decisions such as Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), and end-of-life or funeral wishes.

Staff demonstrated a good understanding of end-of-life care and the importance of maintaining people’s comfort, dignity and emotional well-being. We saw cards received from relatives expressing a genuine gratitude for the way their loved one was supported at the end of their life, including comments such as, ‘We would like to express our sincere and heartfelt thanks to all of the carers who looked after [relative] in her final weeks – whose kindness, compassion and dedication meant so much to [relative] and to our family at such a difficult time’, and ‘Your team did amazing and we will be forever grateful’.

The provider was committed to helping people receive end of life care in their own home when this was their choice. Professionals told us, and records showed, the provider often responded to urgent referrals for new people outside normal office hours. This helped people remain safely at home with their families during the final stages of their life.

The registered manager was considering ‘end of life’ accreditation for the service, showing how they embedded the importance of ensuring the right support is in place.