Respectful Care

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question as good. At this assessment the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 96 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider ensured a thorough initial assessment was carried out for each person prior to support commencing. Management told us, “I do initial assessments where I will support the client and family to do a care plan tailored to their needs. I will review this regularly and change when needed.” This assessment detailed all the person’s needs, their interests and preferences. This meant staff had all the information required to provide effective care and treatment.

Staff fed back to us how they proactively took part in a continuous assessment of people’s needs at each call to ensure needs continued to be met. Staff said, “I believe I assess every time I go to a call, because being mindful is part of the job and I am trained to be conscientious,” and “As we attend clients on regular intervals [we] can assess if any change in needs or support and escalate to the relevant senior or manager,” And “I feel everyone is involved in the ongoing assessments of need in a way because any changes are always reported to the office and therefore things can be looked at and adapted as needed to meet the needs of individuals.”

We reviewed 10 care plans and we saw evidence that care plans were comprehensive and person-centred, outlined personal preferences, health conditions, tailored support plans, risk assessments, mobility requirements, and communication needs. Staff told us “These detailed plans enable us to provide high-quality, individualised care that meets each person’s assessed needs.”

People who were non-verbal had a personalised communication passport guiding staff on how to communicate with them and how to recognise their different emotions, or if they were in pain. A family member told us, “The carers have learnt to recognise [person’s] signs, a blink or smile and the “conversation” begins; it is lovely.” Another said, “Carers sit opposite [person] so that he can identify the carer by body language.”

A professional fed back to us that, “the pre-assessment process was thorough and well-organised. The worker was knowledgeable in their field and implemented a positive risk assessment for the person, this stood out as we often see risk adversity. They were able to meet flexibly at a time convenient for myself and the person with support needs, without any delay.”

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The provider utilised the PAL Instrument (Pool Activity Level) assessment, which is a tool used to assess cognitive and functional abilities of people living with dementia. For example, this was used to guide staff on how to best communicate with people whilst supporting them. This meant staff knew exactly what care to provide to allow people to have meaningful and enriching lives.

People’s care plans provided staff with information on how to maintain good levels of hydration and nutrition, indicating what to prepare for them in a way that would make them most likely eat and drink. For example, “I would like staff to prepare my meals, however I may need more encouragement or be prepared a smaller plate of food, so I don’t feel overwhelmed with a full plate.” Where someone was on a modified diet due to swallowing difficulties clear guidance was documented in the care plans in line with best practice guidelines.

Staff knew the importance of ensuring care was delivered in line with good practice. Staff told us, “We follow good standards with lots of training.” A professional told us, “They demonstrate good practice and a sound working knowledge of moving and handling and the equipment needed to support someone safely.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

A professional told us, “The communication from Respectful Care has been clear and consistent, both by telephone and email. They respond promptly to information requests and keep us informed about any changes or updates, which is greatly appreciated and helps maintain positive professional relationships.” Another said, “Excellent communication both through email and telephone contact. If I have asked to speak to a particular member of staff and they are not available a message is left, and I am contacted within an acceptable timescale.”

The provider had developed and embedded documentation to assist in an emergency. This detailed all the vital information including people’s medicines, specific needs and whether they had any advance decisions, such as whether they were for resuscitation or not, in place. Where people were at risk of going missing the provider ensured they had the Herbert Protocol (a form designed to gather information about individuals with dementia to help police locate them quickly if they go missing) in place to help liaise with the police.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. The provider had developed their own guides to support staff to understand best practice guidance, such as blood pressure monitoring in different aged people. They also launched a vital signs initiative and had a ‘Vital Signs Champion’, who was available to monitor both staff and people’s blood pressure and heart rates. This helped identify any potential health concerns to reduce the risk of increased support needs.

Where people lived with specific medical conditions such as diabetes, staff were provided with information on these in the person’s care plan to enable them to deliver appropriate care and to identify the need for any referrals. A professional told us: “Their referrals are timely and accurate to the person’s current needs.” People spoke positively about staff knowledge of health needs, for example a person told us, “The carers know about the SALT (Speech and Language Therapy) review and are very, very careful with his food.”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

People’s outcomes were discussed at initial assessment and then were regularly reviewed to ensure they received the care and treatment in a way that was best for them. Staff took it upon themselves to monitor people’s outcomes and achievements to see where they could help support them. A professional told us, “They ensure that care needs are followed as discussed, while maintaining flexibility to achieve positive outcomes. For example, in a tricky case where the individual and family were non-engaging and regularly cancelling support, the carers' positive attitude and ability to gain trust and build positive relationships which eventually led the family to accept the necessary support to keep them safe.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff considered The Mental Capacity Act (MCA) routinely at initial assessment; if an MCA assessment was not required, the person was asked to complete consent forms to ensure they understood and consented to support. Staff had a very good understanding of the importance of obtaining people’s consent before delivering care. Staff told us, “Always assume capacity unless assessed otherwise. We encourage clients to make their own decisions wherever possible. We involve family members, advocates, and professionals if a client lacks capacity. We follow the least restrictive option when supporting clients,” and “You always gain permission before any activities are carried out.”