The Larches - Tiverton

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 changed to Requires Improvement.

Requires improvement: This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 55 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We observed staff treating people with dignity and respect. Interactions were kind and people seemed happy with the care provided. People told us the staff were caring. A person commented, “The staff are very humane, they treat me like a person. I was at a previous home, down the road from here, but I didn't like it. The food was appalling, the staff attitude was appalling, and then I came here and it's much better here.” With a family member telling us, “Staff have been brilliant, nothing has been too much trouble. They've been so nice.” Staff worked well together, which was reflected by the calm atmosphere in the service. Staff told us they always treated people with kindness. A staff member said, “It's like a little family, but we have a lot of people who have high needs, and we don’t always have the staff we need to safely support people.”

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff and managers spent time to get to know people and to understand their individual preferences. Their knowledge of people was reflected in how they spoke about people, giving details of people’s likes and dislikes and how they met their individual needs. Regular meetings with people living at the service and relatives were in place and people felt their concerns were listened to.

Opportunities had been given for people to try new things and staff encouraged people to do this. The Activities staff for the service were passionate about ensuring people had control of their lives and worked hard to resource more ways people could be independent and reach their goals. Although there were opportunities for people to go on outings and external entertainers were regularly booked, staff told us they felt the reduction of their hours contributed to people not having access to 1:1 support or additional opportunities for engagement. The service employed 2 staff to manage the activities, but recently their hours had been reduced. One of the activities staff members told us, “We only do activities on a 1:1 basis due to staffing. I will go to the library and get all the things for reminiscing and the ladies all like to have their nails done but my hours have all been cut now and so have the activities; I was doing 13 hours a week and now they cut my hours down to 8 hours. My [colleague] does a senior role and does activities but when we organise parties and trips and group activities, we do this from home. I am working 4 hours today and tomorrow and by the time lunch is done there is not much time left for activities, and I have spent time with only one person today. This means there are a lot of people I have not been able to spend time with. People are not getting stimulated at all here and when we are not here nothing is done.” Activities were not always able to be tailored to each person’s interests, and although there were 2 dedicated staff members working in the Activities team, they were not able to fully explore people’s goals and aspirations due to lack of time and resources.

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.

Staff knew people well and observed for any signs of pain and discomfort. Care plans had been developed which explained how people expressed if they were in pain or distress so staff could respond quickly. However, due to low staffing levels, especially in the afternoon, staff were not able to quickly respond to people’s call bells. One staff member told us, “It can be quite busy and there are times when we can’t attend the bell within 5 minutes, and we can’t just leave people, and you don’t want to rush people. It can be stressful with our walkie talkies and staff will say go and please attend the bell, but if you are in the middle of personal care you can’t just leave someone, so it would be good to have more staff to answer bells and sometimes we do have to ask people ‘do you mind if we leave you’ and it makes me quite sad that we have to do that.” Another staff member told us, “It's very difficult. We've got one person who uses a sensor mat, and is a high falls risk, they have fallen and broken their hip a few months ago, and they are mobile, but there's not enough staff, especially in the evening to attend to the call bell when they alert the sensor mat. They’ve had a recent fall 1-2 weeks ago. I think we could support people to be safer if we had more staff.” The provider had also recently implemented a change to handovers, now only requiring medicine staff to attend daily handovers. This meant information was not received by staff in a timely manner and put people at increased risk. Staff told us they felt this system was dangerous and they did not always have time to read the handover book or the electronic app when they first came on shift as call bells were going off and they prioritised answering these. This was discussed with the provider, and we were told this process would be reviewed. At the time of the inspection, no changes to this system had been implemented.

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

Although managers were onsite daily and staff felt they were well supported by their managers, staff told us they had very serious concerns with how the service was run and how the provider communicated with staff. Staff told us they had concerns about the financial viability of the service and felt completely unsupported by the provider, often describing their actions and decisions as ‘detrimental’, ‘dangerous’ and ‘uncaring’. Staff told us the provider would not attend staff meetings and relay decisions through the manager. Staff told us when the provider would communicate with them, the communication was rude and done through electronic messaging, which staff felt was unprofessional. We spoke to several staff who told us their decision to leave the service was due in whole to the actions and communication of the provider. The service did not have any staff incentive programs or initiatives to show staff were valued.