Complete Care and Enablement Services

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 changed to good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 80 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We observed numerous positive interactions between people and staff. In one of the services visited, people sat close to staff and were tactile towards them. It was obvious that good, trusted relationships were established. One person told us a member of staff was like a “new mum” for them. Staff allowed people the time to speak openly and used humour appropriately within conversations.

Staff took part in games people liked to play. We observed a staff member playing a game on an electronic tablet with a person. The staff member and person were seen to be laughing and having fun in each other’s company. Staff understood the need for people to have their dignity maintained, and we observed staff providing appropriate physical contact with people when requested, such as hugs and stroking people’s hands for reassurance.

Following the death of a close relative, staff had showed great care and compassion towards a person, providing both emotional and physical support. They had been supported to create a memorial in the garden so when their bedroom curtains were open, they could see it. The memorial garden was extremely important to the person, and they were proud to show it to us during our visit to their home.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. These were detailed in care planning and clearly met through an ongoing collaborative approach to care.

We spoke with 1 person at length, who told us they used to be anxious. They were very complimentary of the support they received from staff who knew them well. They told us, “They [staff] know me better than I know myself. They know when something is wrong.” They went on to explain about their individual needs and said, “I have a food aversion; I don’t like my food touching each other. They [staff] know this and serve my food in separate bowls.”

Care plans were person-centred. Staff had a sound knowledge of the things that made people unique and were meaningful to them. Bathing and showers were more than personal care for one person as water play served as a primary sensory activity. The person could choose to access a new wet room, a spa or an inflatable pool. Support plans reminded staff to offer all forms of water play.

Communication plans for people were clear. Staff demonstrated a good understanding of what people needed through verbal and non-verbal cues. People were able to thrive and make their needs known because staff understood them well and had clear guidance. Staff advocated well when needed for people with external partners and professionals.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. Staff supported people to achieve as much independence as possible, considering their health and social care needs.

A person with complex health conditions was supported by staff to attend swimming lessons; this ensured an expressed wish was met and the person enjoyed telling us about achieving their goal.Staff encouraged people to support themselves as much as they could in looking after their homes. A person who used specialist equipment to mobilise helped to maintain a clean and tidy apartment by washing pots and dusting.

We saw a good person-centred approach in relation to off-site activities where possible, but on occasions these were hampered due to a lack of drivers on shift or lack of access to personal monies. We raised some concerns regarding 1 person’s limited finances to fund activities and outings; the provider could evidence the steps taken to resolve this with the social worker and financial appointee.

Staff supported people to maintain close relationships with their loved ones. One person was supported in speaking with an elderly relative via the telephone. Staff ensured people who had capacity were allowed to make decisions for themselves. This included people having access to alcohol. Not everyone wanted to do activities and staff respected people’s choices. One person we spoke with said, “I don’t want to do them; they [staff] still ask me, even though they know the answer.” Whilst not everyone’s activity planners were fully updated, we did see evidence that activities were taking place. One person made cookies at home, attended the cinema, went shopping and made healthy meals, including chicken stir fry. Manager’s we spoke with took appropriate steps to ensure people’s current interests and preferences were fully reflected in planned activities so that opportunities for meaningful engagement were maximised.

The provider 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.

Staff had developed communication profiles for when people were unwell. For one person, it had been identified that their mood fluctuated significantly and when low their engagement with activities, including communicating with staff, lessened significantly. To help address this, documentation provided staff with guidance, including a description of the change in communication and suggestions of how they should be supported, which included “give me time to think”, “only ask simple questions” and “use short simple sentences.”

A professional from the local authority told us a person in receipt of support had been admitted to hospital for a lengthy stay. The staff team had continued to support the individual in hospital, making sure they felt confident in a strange setting, where hospital staff were not familiar with them and their communication style. Staff were able to work in collaboration with hospital staff to ensure the person’s health and care needs were met

Staff were trained in Positive Behaviour Support (PBS). On one visit we attended, we observed staff responding appropriately to a person who was presenting with heightened emotions. Staff acted calmly and prioritised the safety of all involved. They followed the appropriate actions as indicated in the person’s support plan.

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.

Staff were recognised for their hard work. We received unanimous feedback from staff about feeling supported by the management team. One member of staff told us, “Managers come back and tell us how well we are doing.” Staff appreciated the positive feedback and morale remained high. Staff we spoke with felt listened to at a local level; there was good morale within teams. We also saw evidence of staff covering services within local areas where this was required.

The provider held a national awards ceremony annually; this service had been successful in winning numerous awards, including manager of the year, newcomer of the year, team of the year, team leader of the year and outstanding achievement of the year. There were also external care awards for which individual staff and teams received nominations. We saw 1 member of staff had been nominated in all of the 7 categories of the Cristal Care Awards 2024, including celebrating personalisation in care, recognising quality improvement and leading the way. Where staff and teams had been successful, awards were on display in the respective homes of the people they supported, and the achievements of staff were acknowledged and celebrated by all.

The provider ensured there were mechanisms in place to monitor, support and promote staff well-being. Staff felt they were extremely well supported by leaders and managers. A staff member said, “They support you when you are not well. When I returned back to work after an absence, I did not feel up to completing medication as I did not want to make mistakes, and they made sure other staff did that until I felt confident again.” The providers commitment to supporting and developing staff was reflected in their high retention rate. Staff felt valued and important; their welfare mattered to managers.

We saw evidence of forums being held for overseas workers, to keep them informed and included. ‘Feeling safe to speak up’ forums were attended by 48 members of staff in total, all of whom found the session helpful or very helpful. Staff told us they were encouraged to speak up about any issues and were confident the manager would be supportive. One staff member said, “We are very much encouraged to speak freely; [manager] is very open and transparent. I have no issues in raising any concerns I might have.”

Staff had access to an employee assistance program and could seek information and advice in connection with a range of issues, including domestic abuse, stress and anxiety, finances, childcare and bereavement. This was a free service and available to staff 24 hours a day. The provider had negotiated an employee discount scheme; valid at a range of street shops and some online services. Staff told us this was extremely helpful to them. Staff also had access to the ‘Wisdom’ app if this was their choice; this app aimed to track staff wellness, improve mental health and promote resilience.

There was obvious commitment from the provider in working together with staff to check on their welfare, share best practice and promote positive outcomes, both for the staff and the people they supported.