Essex Care Consortium - Marks Tey

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 good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Managers and staff treated people with kindness, empathy and compassion and respected their privacy and dignity. Managers and staff treated colleagues from other organisations with kindness and respect. People and their relatives were consistently positive about the caring attitude of staff. Relatives told us the staff team knew their family members well and they were kind. Comments included, “Staff treat (Person) with respect and dignity and try to make them happy,” and “When my (Person) was in hospital the staff came every day to sit with them in shifts to make sure that they were not alone.” Another relative commented, “I would give them 10 out of 10 for my (Person’s) care.”

We observed staff were kind and compassionate in their delivery of care. Care did not appear task focussed and was centred around people’s individual needs. Staff demonstrated they knew people well and understood their communication needs. We observed staff asking permission before entering people’s rooms which showed us their privacy was respected. Care plans showed that gender related care preferences had been discussed with people and minutes from meetings showed these preferences had been reinforced to ensure people’s dignity was upheld.

Managers and staff had a good rapport with people and responded to them respectfully with warmth, kindness and compassion. The atmosphere within the service was welcoming, warm and relaxed. People were seen moving around the service freely and comfortably and approaching staff for support when they needed it. We saw positive interactions between staff and the people they supported and between the people living at the service. External professionals told us that they were treated with respect when working with the service. One professional said, “We are treated with kindness and respect from staff and leaders. I believe we have a very proactive working relationship to meet the needs of the residents”.

People’s individual needs and preferences were understood and reflected in their care, treatment and support plans. These considered people’s strengths, abilities, aspirations, culture, unique backgrounds and protected characteristics, including their religious beliefs and sexual orientation. One member of staff told us, “I am aware of people’s individuality. We have people who like to wear women’s clothing, this is known historically by staff, but we respect their privacy.” People were encouraged to keep and develop their independence and were supported to realise their ambitions. The registered manager told us, “(Person) had expressed their wish to move county. Their funding authority had been contacted and had been in touch to start the process.” Care plans included information about people’s goals for the future. This information helped staff support people to achieve their aspirations and learn new skills. One care plan showed a person had expressed an interest in trying new activities including horse riding and attending social evenings to meet new people. Staff had arranged these activities; however, staff had reported the person had not enjoyed the activity, but it had been noted the activities should be considered again if the person expressed further interest. Another person had been supported to rebuild a relationship with a family member and had started to visit them independently.

Care delivered was personalised and tailored to people’s individual needs. Staff showed understanding in how to effectively communicate, interact, engage with or support people living at the service in a meaningful way. Communication passports and 1-page profiles were used to capture key information about people in one place so that staff and external professionals could access information about how to support people quickly and easily. We observed staff communicating with people in ways they understood. For example, where a person was nonverbal, we saw simple signs being used and staff could explain what this meant for that person. A member of staff told us, “We use various Makaton signs and speech when communicating with (Person) and use social stories to help them understand any changes to their normal routines.”

Managers and staff promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. People were supported to maintain and develop relationships with those close to them, including social networks in the community to promote and support their independence and wellbeing. A relative told us, “(Person) can use their iPad to facetime us every day. They will call in the morning, afternoon and again in the evening when they want to”. Staff told us people were supported to meet with their family and friends regularly. Comments included, “Visitors can come anytime; they are here all the time. Recently I contacted (Person’s) family as their birthday was coming up. I invited their family member to come for (Person’s) birthday, and we took photos of them together. (Person) was happy,” and “(Person) has a friend, an ex-member of staff who used to be their keyworker many years ago. They still visit (Person) regularly and takes them out.”

Care plans included people’s life histories, helping staff understand their backgrounds and tailor support. Plans and risk assessments reflected people’s’ routines, interests, preferences and relationships, and included personal statements showing people had an active role in planning their care. Relatives told us staff promoted people’s right to choose. One relative told us. “My (Person) was supported to make choices about a week’s holiday, long weekend breaks, shopping and attend colleges courses of choice.” A staff member told us, “We support people to make decisions, even if these are unwise decisions, which may impact on their safety. For example, “[Person] wanted to go out on their bike to the supermarket on a busy road. As they had capacity to make that decision, they went, however I made sure they had their safety hat, lights on their bike, and made a note of the clothes they were wearing. I did regular checks in their room until I knew they were back safely.” We received positive feedback from external professionals about how the service promoted people’s independence. One professional said, “I feel management and staff advocate well for people. They are aware of the risk that too much care and support can be restrictive practice”.

People enjoyed a range of activities, and some were supported by staff to go on holidays. Both bungalows had been decorated for the Christmas period and people displayed pride in showing us the decorations they had put up. A staff member told us, “We try to support people to be independent, we support not do for. People go to day care where they can get involved in projects, gardening, feeding chickens, they have an allotment as well which enables them to build skills.”

Managers and staff listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. Records showed a person had become anxious at night, hit their head and had a cut to the top of their head. Staff had taken appropriate action calling 111 and were advised to take them to accident and emergency where they had their head stitched and a CT scan. The registered manager told us they had seen a decline in (Person’s) mobility; and falls were becoming more regular. As a result, they had increased staffing at night from 1 to 2 in each bungalow to ensure more staff were available to support people through the night and prevent further falls.

Managers and staff were alert to people’s needs and were quick to recognise and respond when people were starting to show signs of anxiety and took time to see, communicate and engage with them to discuss their immediate needs to try to alleviate their distress. Staff told us they had received challenging behaviour training, which had equipped them with the skills to know how to support people when they were experiencing difficulties managing their emotions and anxieties.

The provider did not consistently support or enable staff to deliver person-centred care. Although staff meetings, supervisions and appraisals occurred and included positive and constructive feedback, several agreed actions were not followed up, particularly training requests in end of life care, mental health and catheter care. Actions from staff meetings were not logged centrally with clear outcomes of how or when these had or were to be addressed. Supervision, and appraisals for the registered manager needed to improve as they had not had access to ongoing support and development opportunities from the provider.

Staff told us that they felt supported at work and that the workload was manageable. One staff member told us, “Tasks are organised well, and I can complete my duties safely. If the work ever becomes busy, the team supports each other, and the manager helps to make sure no one is overwhelmed. Overall, I feel comfortable with the workload”. However, where staff were struggling at work, whilst the registered manager had shown compassion, there was no formal competency-based process to support staff that were not performing as expected. The registered manager told us the company human resources team were in the process of implementing a policy and procedure for managing performance.

Recruitment records included health questionnaires which ensured any reasonable adjustments could be assessed and implemented for employees. The nominated individual told us they were in negotiations with an insurance company to provide private healthcare and well-being services to staff to support their wellbeing and mental health where needed. They advised the service also had designated mental health counsellors and a mental health first aider staff could access if they needed to.