Ailwyn Hall

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 requires improvement. At this assessment the rating has changed to inadequate. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.

The service was in breach of legal regulation in relation to dignity and respect.

This service scored 35 (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 did not treat people with kindness, empathy and compassion and did not respect their privacy and dignity.

Although some individual staff treated people who used the service with empathy and kindness, we also observed instances where this was not the case. We noted significant periods of time during which staff, including agency staff, did not speak with or acknowledge the people they were caring for. We saw two staff taking the brakes off one person’s wheelchair and wheeling them backwards without speaking to them or telling them what was about to happen.

People were routinely referred to by their room number rather than their name which lacks dignity and adds confusion for people living with dementia. One person had their name clearly marked on the outside of their white trainers in black marker pen which did not maintain their dignity and risked treating them like a small child.

When we observed some people who used the service accessing other people’s rooms, staff told us this was routine behaviour for some and accepted the situation with little thought for people’s privacy and dignity.

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People were not valued as individuals. Care plans did not always outline people’s particular needs and preferences. Where care plans did do this staff, especially agency staff, were not always aware of the details. The senior management team were nearly all new to the service and they were unclear about people’s individual needs. One relative spoke to us about an incident where a senior member of staff had interacted, as they felt, in the incorrect manner with their family member. They said, ‘They just don’t know [them]’. We acknowledged this would improve over time, however it was a significant concern that many staff were not aware of some people’s needs and preferences.

We saw examples of where individualised care was not delivered. People were not referred to by their own name when being spoken about, activities were not tailored to people’s specific preferences or backgrounds and care was seen to be task focussed which did not always take into account people’s expressed preferences.

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

Our observations showed people had little meaningful choice or control over how they spent their time. People told us they were bored and frustrated with the lack of occupation and entertainment. One person said, ‘I am independent and bored as I don’t do much.’ On our fourth onsite visit we observed an activities co-ordinator working in an inclusive way with people making bird feeders, but they told us they were leaving the service and the provider told us they had interviewed and appointed a candidate, but they had not yet started their employment. Care staff did not have time to carry out this role.

We did not see evidence of people’s independence being promoted. There was little provision for people to follow their own interests. One relative of a person who was a long-term resident told us, ‘One thing – [they’ve] never been out - never gone anywhere. No walks out.’ A recently purchased minibus was shared with other services and had only been used once to take 3 people out during the 6-week onsite assessment process.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We observed staff acting to ease people’s distress and discomfort but some staff, including one-to-one agency staff, were new to the service and did not know people well or understand their needs fully. We observed people who were clearly distressed and upset being comforted and skilfully redirected to other activities. We also saw people being ignored as staff were unsure of what to do and other staff were not in the area and able to help. We noted occasions where senior staff intervened to support junior colleagues, but senior staff were unavailable at times due to other tasks they were required to undertake such as medicines administration.

People had pain medicines in place and a pain assessment in their care records. However, we noted one which had minimal details and would not provide guidance to staff in establishing if the person was experiencing pain. It did not refer to any additional information supplied by a relative and simply stated the person ‘has not expressed any pain since admission’. Other pain assessments were good and gave clear information.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

We received mixed feedback from staff and our observations were also mixed. Staff told us the commitment to their wellbeing had previously been very poor but, in response to a recent and serious safeguarding investigation at the service, the provider had been proactive in supporting staff’s wellbeing. One person said, ‘Before we were not listened to. They didn’t react. I can’t tell you how happy we are now.’ Many staff welcomed the new management team and felt they were supportive. However, structured support was not fully embedded for staff who may have been witnesses to abuse within the service. Staff were mostly concerned about the low numbers of staff at certain times and the ongoing lack of electronic devices to make timely notes in care records. They told us they had raised these issues multiple times, however they remained a concern.Although extra devices had been sourced, on our third visit we observed staff waiting for devices and sharing them which they told us they found stressful. This situation was much improved by the time of our fourth visit.