Active Homecare

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

People were treated with great kindness, empathy and compassion. Staff treated people as individuals and made sure their care and support fully met their needs in line with their preferences. People’s independence was always encouraged and promoted ensuring they had choice and control over their care and support. Staff knew people very well and took time to observe, communicate and engage people in discussions about their immediate care needs. The support and well-being of staff was promoted to enable them to always deliver exceptional person-centred care.

This service scored 100 (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. People and relatives told us that the support they received was vital to them and their families. One person told us, “It’s because of the support I get from my carers that means I can stay living in my home. I am so grateful for them being there for me.” Another said, “We struck lucky the day we found this company. The carers go over and above for us all the time.” A relative commented, “Having the carers gives me peace of mind. [Family member] is getting the best care and is in safe hands. If I have any worries about [family member] the carers help me. They have improved my life, and I can’t imagine not having them around.”

We saw numerous examples of where staff went over and above their roles. For example, staff took people out for their birthdays in their own time. One person had mentioned to staff that they had never tried a [name of fast-food outlet] meal but had seen it advertised on TV. The staff member brought them a meal from the [fast-food outlet] on their next call. We were told the person became quite partial to this and had a meal from there regularly. Staff supported 1 person to take their pet to the vets when they became ill and when the person eventually had to seek further support in a residential setting the staff member took the pet to visit them. They also sent regular pictures of the pet to the person and the family which brought them comfort and reduced anxiety.

We also saw another example where the staff member had been a vital part of helping [person] to maintain their quality of life and dignity. One person had a debilitating condition and when Active Care first took over their care package it was apparent the person was very socially isolated. They did not like to leave their house which caused them to be anxious and they suffered with very low mood. Over time staff built up a good rapport with the person and started to come up with ideas of things they enjoyed. Staff supported them to go swimming weekly which had improved their mobility. Staff made the person an ‘Active Homecare Star Swimmer Award’ certificate and gave this to the person which increased their confidence and self-esteem. This also resulted in more activities such as going out for lunch once a week, joining a lunch club and taking short holidays. This had a very positive impact on the persons confidence, mood and self-worth.

Staff cared for people in a way that exceeded expectations. One person was a big football fan. They were feeling low in mood and had lost confidence in going out of the house. To raise their mood a staff member contacted one of the persons favourite football players who provided a personalised video for the person. The person was really pleased with their personalised message and their family were very grateful to the staff. It lifted the persons spirits and mood.

We saw other examples of where staff members had gone over and above their role. For example, 1 person’s mobility had reduced, and they no longer felt confident to leave their home. It had been an important part of the person’s life to regularly visit the barber. Staff did offer to take them to the local barbers; however, they didn’t feel comfortable doing this anymore. So, 1 of the staff members that supported the person contacted a local barber they knew and arranged for them to visit every few weeks when the staff member was present. The client really looks forward to this and boosted their moral.

Staff were highly motivated and demonstrated real empathy and compassionate understanding for people. For example, staff felt it was really important to celebrate people’s birthdays and people always received a card from the staff team on their birthday and tried to make big birthdays special for people. One person had a milestone birthday so 2 staff members took them to a local country estate for afternoon tea and champagne in their own time. The rest of the staff team completed a video for the person to watch on their birthday. This made the person feel very special and the family expressed their gratitude by making a cake for the staff team to share.

Health and social care professionals consistently praised the staff and the management for the care people received. One told us, “Active care has always shown to be a caring team take time to talk to the patient and family and work out the best possible package that works for the patient.”

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. Staff knew people extremely well and understood their diverse needs and individual wishes.For example, 1 person who had a degenerative condition did not believe in prescribed medication but did believe in a more holistic approach, mainly based around their diet. The management and staff team worked with the person to gain a good understanding of their dietary needs working with them on suitable recipes ensuring all food was cooked fresh for them. Staff put together a cookbook of all the recipes the person enjoyed and that met their dietary requirements. This meant the person received the care and support they wanted.

One person using the service had a debilitating condition and suffered with a lot of anxiety. It was decided they should have only 2 regular staff members to support them, to reduce their anxiety levels. Staff supported the person to set goals to improve their confidence. They set themselves a goal to lose weight and eat healthier. Staff supported them to join a gym, and 1 staff member always went to the gym with the person, taking part in exercises as this stopped the person feeling embarrassed. The other staff member supported the person to do some healthy batch cooking. This consistency had been important for the person to engage with staff and had resulted in the person gaining confidence and improving their self-esteem.

All staff regardless of their role demonstrated an excellent understanding of people’s cultural, social and religious needs and how to meet these in individual ways. For example, 1 person’s family member was in hospital which meant they were not able to attend their church group on their own. A staff member volunteered to take the person to their group that ensured they were able to continue to practice their chosen faith and meet with others from their faith group. Staff supported another person with specific spiritual needs to meditate by helping them to complete certain rituals that were important to their meditation practice.

Staff felt it was very important to support people to continue with their interests and hobbies. For example, 1 person with a degenerative condition had difficulties communicating verbally and lacked confidence to go out socially. Staff supported the person to join some local clubs where a staff member would go with them, this included a local arts and crafts club which the person used to enjoy. Staff also planned days out with the person, for example they took them to a zoo because they loved animals. This had reduced the persons social isolation and increased their confidence when out.

People's care was planned with them, and they were fully involved in developing their care and support plans which ensured they were always treated as individuals. Topics of interests were a big part of the initial assessment and re-assessment process. Staff took great interest in people and worked in partnership with them and their families to develop life stories that included detailed information. For example, memories about their childhood, family life, occupations, hobbies and interests. Staff commented that having such information helped to strike up meaningful conversations and was used to develop a person-centred plan of care. Information was also sought about people’s preferred routines and the ways in which their care would fit into their lives rather than their lives having to change because they now required care and support. This meant people’s care was delivered in a holistic and person-centred way. The care plans clearly recognised people as unique individuals and recognised their diverse strengths and needs.

 

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and well-being. One person told us, “My carers always get me to do the things I’m capable of doing myself. They are always encouraging me.” A relative commented, “[Family member] has re-gained skills they lost after being in hospital. The staff have been exceptional at getting [family member] to be able to stay at home instead of having to go into care.”

People's support and aspirations were planned proactively and in partnership with them and their families. For example, 1 staff member was a big football fan and they really wanted to visit their team’s new stadium, however they did not feel confident enough to go without staff. One staff member who supported the person had planned to contact the stadium to find out about disabled access and how the visit could be managed. The staff member had already asked the managers that once the trip had been organised 2 staff members were made available to support them. We were informed that when the staff member told the person the trip was achievable, they were, “Over the moon.”

Staff encouraged people’s independence by fostering social engagement opportunities and by creating a supportive approach that promoted independence. For example, 1 person who was still mobile but unable to walk far enough to their stair lift was left feeling they had no choice but to go into a care facility. However, the staff worked proactively and adapted their living room so that everything was available to them without having to go upstairs. This ensured the person was still able to stay in their own home and maintain a degree of independence. Their relative told us, “This has made a big difference and [family member] has less falls now. It gives me peace of mind as well and [family member] has gained some independence back.”

Staff always empowered people to realise their potential and ensured they were fully involved in their care provision. For example, 1 person suffered from short term memory loss and struggled to communicate verbally. To support them to remain independent staff put a chart together with daily reminders of what they needed to do such as feed their pet, have a wash, brush teeth and make breakfast. The person used this as a tick chart and found it very useful. In addition, the same staff attended the care calls to ensure a consistent approach.

Staff had an exceptional understanding of protecting and respecting people's human rights ensuring they were able to make decisions about their care, treatment, and wellbeing. One staff member told us how it was important to involve people in their care and support, including all the small choices that ensured people had control and choice. They said, “I always check and get consent from clients before I do anything. I involve them in their care and always ask them what food they want, what they want to wear. It’s about always giving people a choice. The little things matter, such as what perfume people want to wear, whether they want to wear make-up, and we always give them that choice.”

Care plans reflected an enabling approach. They clearly described people's dependency levels and explained what people were able to do, or wished to do, for themselves, as well as detailing the tasks people needed staff to support them with. Care plans also described people’s communication needs and information was provided to people in formats they could understand. Staff met with people, their relatives and other external professionals to discuss their support and any changes required, and these were reviewed regularly and updated when a person’s care requirements changed. People were supported to ensure their voice was heard using independent advocates if that was required. An advocate is an independent person who can provide a voice to people who otherwise may find it difficult to speak up. The service could provide people with information about advocacy services if they needed it.

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. A relative told us, “When [family member] had a fall, they contacted me straight away. They arranged for paramedics to come and following the fall we had a meeting to put changes in place to try and reduce [family members] falls. It has worked well.”

People and relatives found staff responded to people’s immediate needs quickly and sensitively. For example, 1 person had been discharged from hospital with a specific piece of equipment in situ. A carer noticed that the piece of equipment was not working, and the person appeared confused. They were able to take the persons temperature, which was raised, and they rang 999 straight away. The provider swapped the staff members shifts so they could stay with the person until the paramedics arrived. The staff member was able to provide the paramedics a full hand over including all current medication and past medical history and gave them the hospital passport to take with them. This swift action prevented further complications arising such as sepsis.

A staff member who visited a person on a regular basis noticed that on some occasions their behaviour seemed different, showing signs of confusion which wasn’t their normal behaviour. The carer noted that the person had a wound and was concerned there were signs of infection. They rang the persons GP where it was confirmed the persons wound was infected. Again, this swift action prevented further complications and meant they did not have to be admitted to hospital.

The provider informed us, “We feel it is really important to have continuity for our clients when the carers are visiting this does help the carers to identify anything abnormal or sudden changes in the clients so they can act immediately to get them the medical attention they require.”

Staff were aware that if anyone had a fall their course of action was to call 999. Staff always stayed with people until their next of kin arrives. If there was no one available, care visits would be rearranged so the staff member could stay with the person, ensuring they remained safe until the paramedics arrived.

Staff were well trained and were provided with specialised training to support people safely and in line with their preferences. The registered manager informed us that as part of the induction training and refresher training, staff covered areas to support them in an emergency. For example, staff completed training in basic life and first aid support, catheter and stoma care, diabetes, falls prevention and the safe administration of medicines. This meant that staff were well trained and fully prepared to recognise when people needed urgent help or support.

The provider always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care. Without exception, staff gave us very positive feedback about how well they were supported in their job roles. One staff member told us, “We are a lucky staff team. We have the best managers who really look after us. They care about our well-being and will always go above what they need to do to help us. If we have personal problems, they go all out to help us.” Another member of staff commented, “This is the best company I have ever worked for. The managers and the staff team are the best. The support is fantastic, and I feel valued and listened to.”

The registered manager and provider understood how important staff well-being was and how this directly impacted the support people received. They focused on having regular discussions both formally and informally with staff to make sure they had the right support to be the best they could in their job roles. They put measures in place to support staff in the best way possible. For example, if staff struggled with mental health well-being they were supported by the management team with coping strategies. This could include a change of hours, regular meetings to talk about how they were coping, and staff were offered the providers mental health helpline which offered sessions of cognitive behaviour therapy. This was completely confidential, and the staff could arrange this for themselves if they preferred.

A culture of developing staff to reach their potential had been established. Staff felt invested in, given the opportunities for self-development available to them. New staff were required to complete a comprehensive induction and did not work alone until assessed as competent in practice. Staff told us there was an excellent buddy system that ensured new staff had full support from a consistent and experienced member of staff. The provider’s training was completed by an in-house trainer and the registered manager. Having the training in-house allowed the management team to support staff further and deliver the training in a way that suited them.

The provider was committed to continually motivating the staff team and recognising their commitment to their role. For example, staff special occasions and achievements were recognised and celebrated. Throughout the year the provider organised different events for the staff whether this was an afternoon tea out as a team or a picnic on the lawn at the office. Every year the provider always organised something for staff at Christmas that had included meals/ lunches out and the previous year the registered manager and care manager cooked a homemade Christmas dinner for the whole team and set the office up for a Christmas party. Staff feedback was that this was very much appreciated and was a lovely way to end the year.

There was a suggestion box where staff could submit suggestions and ideas that could be discussed in team meetings and had implemented suggestions made by staff. The provider listened to staff feedback regarding what training they would like to complete and if they felt there was a need for further training in certain areas. The provider regularly arranged for specialist teams to come in and visit we would provide cakes and lunch for the team. These included specialist training in relation to pressure ulcer prevention and dementia care. Other organisations visited the service’s such as the blind veteran’s charity team which helped with equipment for the blind, the continence nurse to support with incontinence, stoma care and catheter care. Staff told us they found these sessions really helpful.

Staff working at Active Homecare consisted of a variety of ages and cultures and the provider was supportive of everyone in the staff team. The provider had a menopause policy, and people who practised different faiths were supported during religious holidays, for example, a change in shift patterns and adequate breaks. The provider offered a discount card to all staff for which the provider paid their yearly subscription. This offered discount codes for staff off of certain shops and restaurants making staff feel valued.