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 a previous assessment we rated this key question Requires Improvement. At this assessment the rating has remained the same. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to people’s dignity and respect and good governance.

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.

Staff treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated families with kindness and respect.

People were positive about their relationship with the remaining staff group. They commented staff were “Kind and gentle” and described feeling safe with them. The staff group had a mix of skills. People had different relationships with different staff. Some people enjoyed a joke and engaging in general discussions with more vivacious staff members, while others visibly relaxed and appreciated the warmth and gentleness of other staff. A relative described their parent as “beaming” when they saw their favourite staff member.

Other relatives echoed the feedback from people. For example, “The staff are amazing, they’re there for family as well as the residents, they make you welcome… they go above and beyond” and, “They are always kind and caring, there’s been a turnover of staff recently, the previous staff were lovely…but even the new starters are always really friendly.”

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. However, staff 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.

The provider told us they had visited The Larches regularly. However, governance records did not show how they engaged with the people living at the home when they visited. A shower room was not clean and had not been set up to support a comfortable and pleasant bathing experience. This undermined people’s dignity. The delays in making the ground floor lift door safe did not demonstrate the provider had considered people’s individual experience and safety.

The staff group knew the people they supported well and what was important to them. Staff had taken time to listen to people’s personal histories and learn about their achievements and regrets. They used this information to spark a conversation or refer to an event in the news to draw out their opinion. We saw several people appreciated a programme featuring different types of dance and this was used as a general topic of discussion, with one person getting up to demonstrate their dance moves. Staff members showed a genuine fondness towards people in their care.

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

The service sought people’s consent in line with legislation and good practice. Records showed relatives were asked to provide copies of lasting power of attorney documents to ensure people’s legal rights were protected. However, due to a period without managerial support, staff lacked the support to understand how the lasting power of attorney worked in practice when it came to decision making. This meant a person’s replacement dentures had been delayed unnecessarily.

We reviewed the Service Improvement Plan (SIP) created to address concerns and areas for improvement following CQC inspections and feedback from the local authority Quality Assurance and Improvement Team. We saw the completion of specific care plans for people living with dementia had been added to the SIP in June 2025. This had not been completed with the completion date being changed and delayed.

The provider had not prioritised this work to be completed to help staff meet people’s individual needs. This was despite people living with dementia making up a high proportion of the home’s community. The provider had not recognised the significance of how dementia impacted individual lives and those sharing a communal space with them.

The provider did not always listen to and understand people’s needs, views and wishes. However, staff did respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. Staff responded to people’s requests for help, such as using calls bells quickly.

We saw staff encouraging people to improve their mobility regularly walking with one person to increase their confidence as part of their care plan goals. One particular staff member was gentle and encouraging in their approach which we saw helped people to relax and follow guidance more easily.

Some people became more restless at certain times of the day and more vulnerable to falling; staff did not restrict their movement but quickly brought them their walking aids which they had forgotten and walked with them. One staff member said some staff needed reminding to allow people to walk rather than encouraging them just to sit down. The narrowness of the corridors downstairs could mean there was congestion when people were up and walking about which staff addressed calmly to prevent tempers fraying as people had to wait for each other to make space.

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.

Staff told us the provider was not transparent about plans for the home and their futures. Staff said this worried them and impacted on their sense of security. For example, 1 staff member said, “with all the recent changes it has been scary as you don’t know what is going to happen and you ask yourself is my job safe.”

Staff said other staff had left the home because of the pressure and demands of the provider, which was confirmed by whistle-blowing concerns received by the CQC about how the provider ran the service and interacted with managers and senior staff.

Working conditions for staff in the main office were unpleasant due to the heat. We recorded a temperature of 29 degrees on the first day of our visit. There was no natural light or air as the room was windowless. Despite cooling equipment, the room remained uncomfortably hot and airless. The type of lighting also potentially added to the temperature. Having experienced time in the office with staff, we were concerned about the well-being of staff who used this space. Staff said the heat was unpleasant to work in, making it hard to concentrate due to their uncomfortable working conditions.