Dimensions Lincolnshire Domiciliary Care Office

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People told us staff treated them with kindness and were happy with their care. People’s diverse interests and beliefs were taken into account when providing care to ensure these were respected. While overall, observation of practice and people’s feedback was positive, some practice in terms of language used did not always uphold people’s dignity and privacy, this was addressed immediately for review and further development by senior managers. People’s choices were respected and their right’s promoted. The registered managers had led some very specific and complex pieces of work in order to respond to people’s changing needs which had led to positive outcomes and improved quality of life. The provider was pro-active in considering staff well-being and supporting staff during personal difficulties by implementing flexible working practices and reasonable adjustments.

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.

People were happy with the care and the staff team supporting them. When asked their views about the staff, one person told us, ”The house is good and I like the staff.” Another person said, “They are nice, they are interesting.” Another person told us what they would do if they were unhappy. They said, “I would talk to the staff, they make me happy.” Relatives echoed this view and told us they trusted the staff team. A relative wrote, “Thank you so much for all you do for my beloved [family member]. Coming yesterday set my heart at rest. They are so happy. Thank you is just not enough.” One relative told us, “The people looking after them are very kind and they look after them really well”. Another relative said, “I see how [staff] treat my [family member] with respect. [Staff] are very good.”

Staff showed a great understanding of and compassion for the people they supported. They were passionate about ensuring a good quality of life for people and ensuring people were respected. A staff member told us, “ I think the best bit (about working here), is how much [staff] care about the people we support, the caring side of things, they genuinely care.” Another staff member told us, “I spend time with people and build relationships as in they know they can talk to you.” Leaders responded quickly to change records when we identified some language that was used that was not in line with the provider ethos and did not promote people’s dignity and privacy. This was changed following a review, during the assessment process and lessons learnt shared with other leaders.

Professionals who worked with the staff team spoke about their views on how caring the staff and provider were. One professional wrote feedback explaining how nice and homely they found a person’s home, how happy the person appeared to be with the staff support and how smartly they were dressed. Another provider told us, “There is a high level of respect, compassion, empowering and maintaining dignity for the people they support. I would trust them with a member of my family, which unfortunately I cannot always say with other providers.”

People were treated as individuals and encouraged to follow their own personal interests and ambitions such as learning to cook, going on holiday, playing musical instruments or gaining employment. One person told us, “I’m happy here. There is plenty of room, I can go for a walk. The staff are nice, they look after me very good. I have a laugh and a joke with them.” A relative said, “It’s the best place my [family member] could ever be at. [Staff] do a lot with them. They attend a day centre and stay for tea. They love the dance class.” Other relatives told us, “[Staff] are diligent in the way they give the care. They are very compassionate, they understand that my [family member might not be feeling well. They all have a laugh and a joke with them. They involve them.”

Staff told us how they ensured people were treated as individuals and with respect. A staff member told us, “You talk to people and get to know the person and find out their likes and dislikes, if something is coming up and talk them through it, give them reassurance, also like when you go to the GP, they will talk to you but remind them to talk directly to the person and like anybody else. It is how you would want to be treated and going back to what do you want today.”

People's care plans showed that people were supported in ways that supported their personal preferences, needs and choices. People's cultural and social needs were also taken into account. Guidance for staff about how to meet people's needs and how they chose to spend to their time in line with their preferences were very detailed and tailored to each person. This ensured a consistent approach which minimised events that might cause people distress.

People told us they can make their own decisions and change their mind about things they like to do or eat etc. People had choices over how they lived their lives, relationships, who they lived with and which staff supported them. People and relatives told us about ways staff had supported them to be more independent. For example, learning to cook and clean, getting a job, learning how to be safe in pubs in order to meet up with friends and have safe relationships. One relative told us, “[Staff] look after my family member] really well. Trying to help them walk again with the use of a walking frame. Encouraging them to do things.”

Staff told us how they encourage people to learn new skills and take responsibility for themselves and their home. One staff member said, “[Person] has their jobs they like to do, like hoovering the communal areas and at night empty the bins and do the recycling.” Another staff member said, “We makes sure we check all water temps and food and fridge freezer etc and room changes, some people can now do it in part or fully independently to put their new sheets etc on. They all know how to use the washing machines and one person will unload it even though they do not yet know how to put it on.”

People were supported to build the right care package and living environment to meet their individual needs. The providers policies promoted people's right to choose and learn and develop their skills and decision making. Outcomes for people were reviewed regularly by staff and leaders to identify patterns and trends and look at how they could do further promote people’s independence.

People told us staff meet their needs. People had ‘hospital passports’ to be used in emergencies so that health professionals understood their history, conditions and what was important for them to enable equal access to treatment. Relatives also felt people were care for well and they were kept informed, where appropriate, of any emergencies. One relative told us, “Going back a couple of years ago my [family member] broke her arm. {Staff] let me know straight away. It was a pure accident. They took my [family member] to the hospital. They do whatever is required to be done.”

Staff had a really good insight into the needs of the people they supported. They listened to people’s verbal and non-verbal language, were aware of slow and fast triggers for events which might cause distress and acted quickly to minimise this. The understood how best to communicate with people and anticipated people's needs and likely reactions. Staff understood when to call for emergency medical support in the event of an accident or ill health. They told us how they would always stay with people in hospital to help offer reassurance and ensure they were safe.

Staff felt very supported by both the registered managers and the provider. Staff shared accounts where managers and the staff team have supported their well-being during difficult times and made reasonable adjustments where needed. Staff felt they had access to various tools for support and could approach anyone, including senior managers for advice and support if struggling. Staff told us this helped to be able to continue to perform well in their roles. One staff member said, “The [registered] manager is very supportive, and the deputy. They are both really approachable they get back to you straight away. I am happy to raise any concerns.”

The provider had processes in place to monitor staff well-being and contingency plans for any changes. They had tools in place staff could access to support their mental and physical health and look at what staff needed from them. The provider took a flexible approach to staff support based on individual need.