Brockenhurst

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. 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 supporting dignity and respect.

This service scored 50 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

People’s right to privacy was not well respected. We observed people going in and out of other people’s rooms on multiple occasions. Staff did not always notice and react when this happened. We observed how one person was accompanied back to their room after lunch and found another person in their bed. The staff member had to ask them to leave. We observed a male person going into the bedroom of a female person who was a person of faith. Their bedroom was set back from the main corridor and staff did not notice this was happening. One person was talking with us when another person came into their room uninvited and sat on their bed. The person said, “It’s always happening.” On the first floor there were no staff around and a person was seen going into another person’s room which made them distressed and anxious. They said, “I just have to shout for help when this happens.”

Some people were sharing their room with another person. There was only a curtain between the beds which did not support people to have privacy in their rooms. We noted people, or those who had the legal authority to agree to shared rooms, had signed an agreement however there was no indication of whether this agreement was regularly reviewed to check if this remained the most appropriate arrangement for people. One person told us they would prefer to have a room of their own, but they did not know if this was possible.

Staff were observed to be kind in their interactions with people but the language they used did not always support people’s dignity. For example, a staff member spoke about staff collecting “the feeds” from the kitchen, they were referring to people’s lunchtime meals. Another member of staff was observed supporting people in the dining room, they were heard telling a person to “Eat properly.” Some staff were discreet and asked people quietly about their personal care needs, others were not discreet and spoke loudly about a person’s care needs in front of other people.

People and their relatives spoke highly of staff and described them as kind, one person said, “The staff are caring.” We observed staff seemed to know people well and people appeared comfortable with them. One person told us, “The staff seem to know what I want.” A relative said, “The staff are lovely, top notch.”

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

Care was not always person centred and sometimes failed to take account of people’s individual needs or preferences. One person told us staff had removed their beard because it was in poor condition. They said, “I miss having a beard,” and their relative said, “He always had a beard, but I think they removed it because it was matted.” We noted the person remained clean shaven and there was no reference to them having a beard within their care plan.

Some care plans lacked detail and did not always provide guidance for staff in how to meet individual needs and preferences. For example, a person was observed at meal time, they appeared to have few or no teeth making it difficult to chew the meat they were eating. A staff member supporting them did not know if the person should be wearing dentures or not. The person’s care plan did not identify if they had dentures. All the care plans we sampled had minimal detail regarding people’s oral health care needs. We observed some people’s toothbrushes were in poor condition and needed cleaning.

People’s choices and preferences were not always clearly noted including their interests or hobbies. For example, a care plan identified a person enjoyed participating in activities but does not identify what activities. Another person was identified as liking music but no reference to what kind of music they preferred. This did not support a personalised service.

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.

Some people needed support with eating. We observed how a member of staff was supporting people with verbal prompts and encouragement. However, two people were not eating their food. A staff member did not sit down next to the people and speak to them, but filled a spoon with food, lent over and put the spoon into their mouth without checking with them first. One person said, “I don’t like it,” the member of staff did not respond or offer any alternative. This did not support people to have choice and control.

People were encouraged to walk around to retain their independence, however risks of falls were not well managed, and staff did not always provide support to people who needed it. We noted some people were walking independently, including accessing other people’s rooms. Staff were not always available or did not always notice and redirect people, this meant people’s privacy was not being protected.

Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We observed people did not always have a call bell near them or were not able to use a call bell to alert staff if they needed help. One person who was in bed on the upper floor was heard calling out for help. We noted there was a call bell near the bed, but it was not within the person’s reach. They told us they did not like to press the bell because staff told them off. They said a staff member had told them, “The red button is just for emergencies, don’t keep ringing it.” This person needed support with a hoist and sling to move from their bed. There were no staff on the upper floor when they were calling out. They said they called for help because they needed to use the toilet, but they had been told to, “Go in the pad.” This did not support the person’s dignity.

We observed how a person with dementia was calling out and showing signs of being distressed. A staff member came to support them but there were no staff available to support the other people in the room who had become upset by the noise. One person said, “I don’t like the noise,” another said, “I’m a bit frightened, is everything all right?” A member of the inspection team offered reassurance and then went to find a staff member.

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.

Staff had not all received the training and support they needed. Only one staff member had completed training in Dementia. Systems for assessing risks and developing care plans were not robust and this did not always provide staff with the information they needed to deliver person-centred care. One staff member told us the care plans were not regularly updated, and records were not well maintained. They explained how this meant they were not always aware of changes. They explained, “We have to rely on each other for updates.”

Staff told us they were happy working at Brockenhurst and described a consistent staff team. One staff member said, “Many staff have worked here for years.” One staff member said they felt well supported in their role, they told us, “Matron supports me, I go to her, she makes decisions.”