Better Care at Home East

The service was distinctive and innovative in how it trained and equipped its staff to take clinical observations and identify signs a person's health might be deteriorating. People and relatives spoke very positively about the care received, saying staff were watchful for any changes in their or their loved ones' health and contacted health professionals as needed. Because of this swift response, people were able to access healthcare without delay, avoiding the need for, or reducing the length of, hospital admissions.

The service worked closely with health and social care professionals, where necessary advocating for people to receive the treatment and equipment needed. This helped to ensure people had an improved quality of life, including being able to do things they cared about as they approached the end of their life.

People experienced an exceptionally responsive service that was tailored to their individual needs and wishes. People's needs were thoroughly assessed and formed the basis of highly personalised care plans. There had been some simple but innovative reasonable adjustments to promote people's independence and ensure their care needs were always met. Staff were attentive to people's preferences and suggested practical ideas to improve their quality of life.

There was a strong emphasis on good nutrition and hydration for health, with close attention to people's dietary needs and flexibility to accommodate people's needs and preferences around eating and drinking. Call timings were organised so there was enough time for people to have any support they needed with preparing and eating meals. The registered manager and staff were attentive to poor food intake, poor hydration and weight loss, and the importance of respecting people's preferences to address this.

People were supported to plan for and have a dignified, comfortable death in their own home, if that is what they wanted. End of life care planning took account of people's ability to understand and communicate

their wishes for the end of their life. Staff had the skills and empathy to understand and meet people's and families' needs at this time. Where necessary, the registered manager had provided a high level of practical assistance with arrangements after people died.

People and relatives had confidence in the ability of staff. Only staff of a suitable calibre were employed. However, there was one instance of reliance on an incorrect Disclosure and Barring Service (DBS) check. The registered manager addressed this immediately we drew it to their attention. We have made a recommendation about the service's DBS process.

People, relatives and staff praised the quality and leadership of the service. They felt the management team were friendly, readily available and supportive. The registered manager encouraged them to give feedback and suggestions, which were promptly acted upon. The registered manager and staff were clear about their responsibilities and the high standards expected of them. The registered manager had clear oversight of the quality of the service.

People and relatives said they felt safe with staff. Managers and staff understood their roles in recognising and responding to abuse. Risks were assessed and managed safely, in a way that was acceptable to people. Staff adhered to infection prevention and control procedures. People received medicines support from trained, competent staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.