What life is like for people using this service:

• People using this service still benefitted from an outstanding caring and well led service. People consistently told us how they were treated with exceptional kindness, compassion and respect. We received overwhelmingly positive feedback on how staff were supportive and went the extra mile to get care just right for people. One person told us, “I am very lucky to be here and feel loved and cared for.” Another person told us that they had exacting details of how they liked their night time care, but this was provided just how they liked it and was written down so they did not have to repeat themselves. One person told us, “If you have to go somewhere then here is the perfect place.”

• People were truly placed at the centre of the service and were consulted on every level. Respect for privacy and dignity was at the heart of the service’s culture and values. It is embedded in everything that the service and its staff do. People and staff feel respected, listened to, and influential. One member of staff explained that their role was to give people who lived there a ‘purpose to their lives’. They told us, “I have the best job and it is a privilege.”

• People received exceptionally personalised care and support specific to their needs and preferences. People decided who provided their care and support, and when. Each person was respected as an individual, with their own social and cultural diversity, values and beliefs. People had their human rights upheld. One person whose first language was not English had their care plan written in two languages to make it accessible to them.

• The whole service continued to have a good track record. The service remained at the heart of the local community with strong community links with a whole host of different community groups regularly visiting and people accessing their community.

• Staff were motivated by and proud of the service. One staff member said, “This place is so friendly and supportive. The staff go above and beyond. The culture is positive from the top to the bottom.” There were high levels of satisfaction across all staff. There was a particularly strong emphasis on continuous improvement with staff gaining additional qualifications and how the service delivery could develop and improve for people who lived in the sheltered accommodation and flats.

• more information in Detailed Findings below

Rating at last inspection:

OUTSTANDING (The date last report published was 23 June 2016)

About the service:

Seckford AlmsHouses is registered as a domiciliary care agency providing the regulated activity 'personal care' to the people who live in the Seckford Almshouses in Woodbridge. The service provides very sheltered accommodation and support to people who live in their own flats within the building.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remains Outstanding.

Follow up:

Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Outstanding.

This inspection took place on 30 March 2016, and was announced.

Seckford Almshouses is registered as a domiciliary care agency providing the regulated activity ‘personal care’ to the people who live in Seckford Almshouses in Woodbridge. The service provides very sheltered accommodation and support to people who live in their own flats within the building.

On the day of our inspection there were 27 people using the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service provided outstanding care and support to people which was very responsive their needs, wishes and preferences. People were enabled to lead meaningful and fulfilled lives with the confidence that any changing needs would be met. Our observations showed extremely compassionate carers who consistently demonstrated empathy, understanding and warmth in their interactions with people. Staff had an enhanced knowledge of the people they cared for. Feedback from people and their relatives was extremely positive and throughout the inspection we saw how the senior management encouraged and embedded best practice. This approach meant staff were highly motivated and committed to providing an exceptional standard of care.

Staff were driven to continue their learning, and were trained in areas relevant to the people they were caring for. As a result they were skilled and competent to meet people’s diverse needs. Staff roles included ‘champions’ who had increased knowledge in areas such as dignity in care and dementia. Skills learnt were promptly cascaded to others in the team on a regular basis, sharing learning and understanding to ensure people received the best care possible.

The service actively promoted a positive, inclusive and open culture. Management were visible, led by example and embodied the highest standards of care and support for people and staff. There was a clear vision and set of values which they worked towards, and which was embedded throughout the staff team. Staff referred to the ‘seckford standards’ of involvement, compassion, dignity and respect, and were proud to work in the service. The management team had established links to community organisations, and used these networks to enhance people’s experiences and quality of life.

People were protected from risk of abuse and staff were trained to identify potential signs. Staff and management were knowledgeable in safeguarding people at risk of harm, and were confident to speak up if they had concerns. Follow up contact was promptly made to other professionals to prevent delays, which demonstrated effective oversight of potential or actual risks.

Risk to people was identified promptly and effective plans were put in place to minimise these risks, involving relevant people, such as relatives and other professionals. Where risks were more complex, comprehensive guidance was in place to guide staff, including the most effective approaches to use, or particular communication methods suited to the individual.

Safe recruitment procedures were in place to ensure the suitability of new staff coming to work in the service. Interview methods were used which assessed candidate’s own values in providing care which was dignified and respectful, and in line with the ‘seckford standards’. Expectations of staff were clear and transparent from the outset.

People's achievements were recognised and celebrated. As a result staff understood more about people’s past and the culture was one which placed importance on valuing people’s life experience.

Staff understood the importance of gaining people’s consent to the care they were providing to enable people to be cared for

We talked with eight people who used the service to gain their views and experiences. They told us their needs were met and staff treated them well. One person told us, “It took me over a year to settle in and to adjust to a new setting but they (staff) have been excellent. Not only do they (staff) help you, they give you a quality of life with all the activities they provide. There is always something going on to keep you active and busy. There is great variety and choice and it provides company, stopping you becoming lonely and isolated.” Another person said, “No organisation is perfect but this one comes close. I think this is one of the best. There is no ill treatment by staff, we are all looked after really well, listened to and totally respected.”

All eight people told us that they were satisfied with the service provided. One person said, “I have no complaints. I have never made a complaint and nothing here is troubling me. There is no need to complain. There is always someone to speak to if you need to and the staff are pretty good at helping you sort things out.” Another person said, “Overall the standard of care here is very good and I have no issues.”

People confirmed they were consulted about the care and support that they were provided with and understood the care and treatment choices available to them. One person told us, “They (staff) know how I like things done. I like things done a certain way and they understand that.” Another person said, “I have the greatest admiration and respect for the young people who come here and dive into the deep end and get involved in caring for us. They draw on the experience of the existing staff who are excellent and well trained. All the staff here learn quickly how to do things and to check with you that’s what you want and how you want things done. That’s really important.”

We looked at four people’s care records which provided information for staff on how to meet individual’s health and care needs. We saw that people’s choices and preferences were reflected in the care records and written in a way that promoted independence.

The care records showed that people's needs were assessed and care and treatment was planned in line with their individual care plan. We saw evidence in the care records that people received safe and coordinated care, treatment and support where more than one provider was involved.

We saw that the service provided enough qualified, skilled and experienced staff to meet people’s needs. We looked at staff records and spoke with three members of staff who told us they were being appropriately supervised and supported. Staff we spoke with were knowledgeable about the people they supported and on how to meet their needs.

We saw that the provider had systems and procedures in place to regularly monitor and assess the quality of the service provided.

During our inspection we observed that the interaction between staff and people who used the service was friendly, respectful and professional.

We had the opportunity to talk with four of the people who use the service. All of the people we spoke with were happy with the care they received. They told us that they were supported in the way they wanted to be and were able to make their own minds up about the decisions they took regarding their care. They were complimentary about the people who supported them.

One person who we asked what they thought of the quality of care said, “They (the staff) offer a jolly good service.” Another person told us that, “The staff are always helpful, I couldn’t fault them.”