Keys Hill Park

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 service 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 changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 60 (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 always ensure people were treated with kindness, empathy and compassion. Staff mostly respected people’s privacy and dignity.

People and their relatives told us not all staff treated them with kindness and respect. For example, one person described how some staff ignored them, spent time on their phone and did not respond when they spoke to them. However, some people described how regular staff did know them well and they felt able to talk to them easily and ask for support when they needed to.

We identified some robust practices from regular staff who over time had built up supportive and caring relationships with people and knew them well. They supported people to maintain contact with families and peer groups and access activities of their choice. Nonetheless, we had mixed feedback from relatives. Whilst some comments were positive about the staff and management, and said they were kind and caring, others described poor practice. Comments we received included a relative who said: “They [staff] listen to me. I am happy with the service and so are they [relative]. They have a key worker.” Another relative said, “It’s the running of the place I am not happy with and especially when I can't fight for my relative.”

During the 4 days of our visits to the service we observed staff showing kindness and compassion to people. However, we also observed agency staff who did not understand people’s needs well and this impacted on their ability to effectively communicate with them and treat them with dignity and respect. For example, one person was upset that their support was being provided by agency they did not want to work with. Another person told us of plans they had but were anxious that there might not be the regular staff available to facilitate this.

One relative told us, “It's the regular staff who understand their [people’s] needs but there is no continuity. It does worry us when we go that we don't know the staff.”

The service treated people as individuals but did not always ensure people’s care, support and treatment met their needs and preferences. The service considered people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics when providing a service.

Whilst there were strong connections between regular staff and people using the service we found fragmentation of service delivery. People using the service reported ‘key staff’ were not always available to support them and staff allocated to them did not always fully understand their needs. Whilst care plans were detailed permanent staff raised concerns about agency staff not always having temporary access to these electronic records.

People were supported to have their say and staff recognised people’s strengths and aspirations. Goals were evidenced through their care plans and good news stories showed how people had achieved an agreed goal.

People’s individuality and protected characteristics were documented as part of their assessment. Staff who knew people well had a good understanding of their needs and the impact their disability might have on them and the type of support they might require. However, some people told us they did not always understand staff due to language barriers. In addition, they described staff using ‘banter’ [teasing remarks.], which were not always considerate of people’s needs and understanding. We discussed this with the provider, who told us they would review.

The service promoted people’s independence, meaning people knew their rights and had choice and control over their own care, treatment and well-being.

Most of the evidence we gathered was positive and we observed people going about their daily routines and being promoted with their independence. For example, we observed people being supported by staff, to cook, clean, plan their menus and they had separate areas of the kitchen to store their food. People told us about the life skills they had acquired and the support that enabled them to access leisure opportunities. Some people attended clubs and early evening activities.

The provider kept records showing how they celebrated people’s successes and achievements based on their wishes and looked at ways to positively reduce risks for people. Within these stories they gave examples of steps taken to help people achieve what they wanted to achieve.

However, people and staff told us activities were based on the availability of staff which sometimes diminished people’s choices and autonomy. It also meant people did not always receive their ‘preferred staff’ who they considered more able to respond immediately to their needs and wishes

Whilst staff promoted independence for some people well, this was not always consistent. Some people’s wishes were worked towards and successes celebrated. However, for other people inconsistent staff support when they did not have the right skills and knowledge, impacted their independence, choice and control? – if changes made review score and opening statement.

The provider did not consistently 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.

Although meetings and one to one conversation helped people express themselves, people’s needs were not always known to staff, to enable them to respond appropriately. For example, staff did not always recognise and respond appropriately to people’s distress or changing health needs as described in the safe section of this report. Although staff would try to help people quickly when they needed urgent help, they did not always have the necessary tools or equipment available.

Continuity of support was important to ensure people’s needs were met in a timely way and people’s relatives remained confident in the service being provided. During our assessment some people and their families raised concerns about a lack of consistency in meeting people’s needs and ensuring both planned and spontaneous activities took place. In addition, people using the service and their relatives raised concerns about their experiences and support from staff. For example, concerns were expressed about people’s autonomy and safety particularly in accessing the community with the support necessary to keep them safe. We shared this with the provider to ensure concerns could be properly recorded and escalated to show how people’s feedback was being addressed.

However, the provider had recently carried out a survey where a number of people using the service had complained about irregular staff. We were assured that the provider was taking action to address this.

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

Staff told us they did not always feel supported, and this impacted on the culture and how people, received care and support from staff. Whilst we were provided with evidence of staff support, training, supervision and appraisal, staff spoken with, expressed their frustrations about their workload and the perceived lack of support at senior management and provider level.

Staff described the continued high numbers of staffing vacancies, high use of agency staff and significant increase in the number of hours required to support people, had increased their workloads and placed unreasonable demands on them. Staff described ‘burn out’ and their concerns about speaking out. Several staff referred to experiences of racism from people who used the service and this was addressed by the provider immediately upon our feedback. We fed this back to the provider to respond to and consider how they would ensure inclusivity for everybody within the service.

People’s relatives, whilst praising individual members of staff, felt stability and continuity of staff was the biggest challenge which impacted on the communication and experiences of people living there.