Northumberland Mid & North Domiciliary Care Agency

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 outstanding. At this assessment the rating has remained outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.
 

This service scored 95 (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 treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.
People experienced exceptionally kind, caring and respectful support from staff who knew them extremely well and were committed to understanding what mattered most to them. Staff had developed meaningful and trusting relationships with people over many years, enabling them to provide highly personalised support that reflected individual preferences, promoted independence and enhanced wellbeing. We observed staff interacting with people in a warm, discreet and sensitive manner, consistently protecting people's privacy and dignity while encouraging them to make choices and retain control over their daily lives.
There was a strong culture of respect throughout the service. Staff consistently demonstrated an understanding that they were supporting people within their own home environment, rather than expecting people to fit around the routines of the service. Visitors, relatives and professionals were welcomed warmly and included in the person's wider circle of support, helping to create an inclusive and family-centred atmosphere.
Feedback about the caring approach of staff was overwhelmingly positive. A visiting professional said, "Staff appear to know [person] very well and have developed strong working relationships with him over many years. They consistently present in a manner that meets his needs and promotes his wellbeing. From my observations, [person's] privacy and dignity are respected at all times." This reflected what we observed during our visit.
Staff spoke passionately about delivering person-centred care and demonstrated a genuine commitment to ensuring people lived happy and fulfilling lives. One staff member said, "I would find it impossible to do this work if the people I support weren't being cared for in a person-centred way, and their happiness and contentment wasn't obvious." Their comments reflected the values and culture we found across the service.
People were equally positive about the impact staff had on their lives. One person said, "[Staff] are good people, I like them." Another said, "[Staff member] is a great fit, we have a great atmosphere and they make my life." Every person and relative we spoke with praised the kindness, patience and respect shown by staff. Their consistent feedback, alongside our observations, demonstrated a service where people were treated with exceptional compassion, dignity and respect, and where caring relationships were at the heart of the support provided.
 

The provider treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The provider took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.
Staff demonstrated an excellent understanding of each person’s preferences, presentation, and communication styles. This insight enabled them to provide meaningful activities or consider wishes and ambitions which contributed significantly to people’s happiness.
One person had a quiet personality and preferred their own company most of the time. They were an accomplished musician and loved the opportunity to perform for people. Staff supported him to make his own record and to perform on stage at the Sage, a large local performance venue.
Staff worked to support people’s individual needs with other organisations. A healthcare professional said, “One notable strength of the service is its consistent and proactive advocacy for [person]. Staff have demonstrated a commitment to safeguarding his wellbeing and ensuring his needs are met. For example, [the service manager] took prompt action in reporting concerns regarding [the property provider] when she believed [person’s] property was not being maintained to a safe standard. The team's proactive approach helps ensure [person] remains safe and well supported.”
 

The provider was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.
People were consistently empowered to have maximum choice and control over their lives, and staff were highly skilled in supporting people to make decisions in ways that reflected their individual communication needs, preferences and abilities. There was a strong culture of promoting independence, where people's rights, aspirations and autonomy were placed at the centre of care and support.
Care planning and risk management processes were designed to promote choice and independence rather than restrict them. Staff demonstrated an exceptional understanding of how to balance safety with people's rights to take positive risks and live fulfilling lives. Risk assessments clearly evidenced the use of least restrictive practices and focused on enabling people to achieve outcomes that were important to them. This included supporting people to use kitchen facilities independently, supporting one person to safely access a woodworking workshop and use a range of tools to create artwork, and enabling another person with known risks relating to sexualised behaviour to safely access their community and maintain meaningful relationships while protecting the wellbeing of themselves and others.
Staff were particularly knowledgeable about supporting people to make informed decisions, and consistently applied the principles of the Mental Capacity Act (MCA). Their understanding extended beyond compliance and focused on enabling people to retain control over their lives wherever possible. One staff member explained, "Once you have established capacity via care plans and risk assessments, you should help them as much as possible, allowing them to make mistakes while ensuring their best interests are always maintained." Another member of staff told us, "I make sure by following the principles regarding the people we support are assumed to have capacity and are allowed to make their own decisions, respecting people's right to make their own choices even when they don't seem like the safest choices to me." These comments reflected what we saw in practice.
Staff demonstrated creativity and determination when supporting people to maintain choice in situations where risks or changing needs could otherwise limit opportunities. For example, one person had recently been advised by healthcare professionals to follow a modified texture diet to reduce the risk of choking. Staff recognised negative the impact this had on the person's food intake and worked collaboratively with healthcare professionals, and those who knew the person well, to identify safe alternatives that maintained both the person's wellbeing and their ability to exercise choice over what they ate. This person-centred approach ensured safety measures did not unnecessarily diminish the person's quality of life.
People were supported to maintain and develop their independence in all aspects of daily living. This included making decisions about how they spent their time, maintaining relationships, expressing their sexuality safely and appropriately, participating in their communities, developing practical life skills and deciding how they wished to receive care and support. Throughout our inspection we observed staff routinely offering choices, encouraging people to complete tasks independently where possible and respecting decisions people made about their day-to-day lives.
People spoke positively about the control they had over their lives. One person told us, "I choose how I spend

The provider was exceptional in how they 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.
People received exceptionally responsive support from staff who knew them extremely well and recognised changes in their wellbeing quickly. Staff worked in small, consistent teams, enabling them to understand people's individual needs, preferences and communication styles. There was a strong person-centred culture across the service, where people felt comfortable seeking support and could be confident staff would respond promptly and compassionately.
Throughout the inspection, we observed staff responding sensitively to people's immediate needs. When one person became distressed by the presence of an unfamiliar visitor, staff quickly recognised this and provided calm reassurance, ensuring the person's wellbeing remained the priority without making them feel they had disrupted the inspection. Staff also acted promptly when people experienced changes in their health. One person told us, "About a month ago I felt nauseous and dizzy, staff called an ambulance and I was taken to hospital."
Relatives consistently praised the responsive and caring approach of staff. One relative said, "My niece is rather anxious... the care is exceptional." Another told us, "She is well looked after by staff who are very caring."
The provider shared examples of staff going above and beyond to meet people's needs in times of crisis. Following one person's cardiac arrest, staff performed CPR until emergency services arrived, helping to save the person's life. Staff remained closely involved throughout the person's 10-week hospital stay and worked tirelessly to support their successful return home. This demonstrated a service where people's needs always came first and where staff were committed to providing support when it mattered most.
One person could become anxious when accessing the community but enjoyed participating in activities outside their home. Staff developed a personalised approach which ensured the person could quickly return to their home whenever they wanted to. By placing the person in control and responding to their individual needs, staff increased their confidence to access the community and participate in activities that were important to them, without anxiety becoming a barrier to their independence.
 

The provider cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.
Staff were very proud to work for the service. There was a low staff turnover and a supportive environment for all staff, no matter where they worked in the service. Staff felt able to raise things with the management team who always made time to listen to them in the moment. The registered manager described a recent push to support staff mental health around both work and home life.
Staff comments included, “Our manager is always on hand to support us with changes and challenges,” and, “I have an amazing manager, who presents as an incredible role model, has the patience of a saint, has a wealth of information at her disposal.”