Elmside

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

with compassion, kindness, dignity and respect.

At the last inspection we rated this key question as good. At this inspection this key question has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 65 (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 wanted to ensure people were treated with kindness, empathy and compassion and respected their privacy and dignity. However, some staff were not consistently adhering to the providers, or the manager’s, expectations.

People and relatives gave mixed views about staff approach. A person said, “Staff are nice they are just busy.” Another person said, “Staff are nice, but busy so all feels a bit rushed.” A relative whose family member had recently passed away said, “The staff were caring.” Another relative said, “Support from staff has been excellent.”

Staff were kind and friendly when interacting with people. We observed most staff to be attentive in most instances and appeared to have good relationships with people. We saw doors were closed during care and support. A staff member told us, “Whilst assisting with personal care I make sure curtains and bedroom doors are closed to allow privacy.”

However, some people told us they felt staff did not want to assist them and support was given reluctantly and in a rush. We asked staff members to assist a person who was calling for support and who had told us they were in pain and felt ignored. While it was our understanding this person frequently asked for support, there was a risk that opportunities for not only emotional reassurance, but physical support, would be missed as staff could be dismissive of their need for support as this was noted as normal for them to call out.

On Cedar unit staff supported people living with dementia. Some staff took time to really engage with people. For example, a staff member was sitting with a person who wanted to stay in bed, going through a magazine talking about their favourite beach, even though it was busy as it was lunchtime. However, some staff needed further supervision and training to ensure they were engaging with people appropriately and did not miss opportunities for positive engagement. For example, when a person was waiting for some equipment change, a staff member was waiting with them. However, they did not communicate with the person, instead they stood waiting and checking their handset. A staff member told us, “Apart from a couple of staff, I find that the staff approach is positive. The friendliness and kindness of the staff shines through to me every day. We have some challenging residents who will complain constantly about lack of care and attention even if they have just been changed, repositioned or attended an activity which they’ve really enjoyed. That can make the job difficult, but the staff have excellent patience!”

Also on Cedar unit, the toilets were dementia friendly. The toilet door was yellow with clear signage to help people find their way to the toilet independently. However, the toilet next to communal area was locked. We noted one was being repaired however the other was used by staff and locked when they came out. We asked staff about this, and they told us it was to stop people using it alone and ‘making a puddle’. We asked the senior on duty and the registered manager if this was standard practice and done to reduce falls risk. They advised the toilets should be unlocked. We discussed this was impacting on people’s dignity and independence. The registered manager added this to their action plan and workshops for staff.

There were management walk rounds and checks in place to help monitor that people were supported with dignity and kindness. The registered manager told us they were aware of some issues and had been completing more supervision and workshops to improve staff approach. They told us they were disappointed that we had observed this practice and people had the need to share less positive feedback but would take further steps to address the concerns. We were assured by the registered manager’s, and wider management teams, response and plans in place that these points would be taken seriously.

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.

People and their relatives told us they felt they were treated as an individual, in most cases. A relative said, “The staff and support are the reason we wanted [person] to stay here.”

Staff were able to tell us about people’s individual needs and preferences. We noted a staff member changed a glass to one more suitable for the person prior to them sitting to the table.

Staff were seen, and heard, offering support as people needed.

Care plans were detailed and gave information about people’s needs, preferences and lifestyles. These were updated with changes and reflected people’s involvement.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People and relatives were positive about how they were supported in relation to independence and choice. People said they could choose how to spend their day, what to eat, when to get up and go to bed for example. However, some people told us while staff knew their preferred times, they didn’t always adhere to this as they were busy.

Staff felt people were supported to maintain independence choice and control. They also felt there were sufficient opportunities to promote their wellbeing.

We observed people being asked if they were ready for care or support, where they wanted to sit and if they wanted to join in with activities. Most people in the main part of the home were able to tell staff what they wanted. On Cedar unit, people needed more support to make choices.

The provider 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. However work was ongoing to ensure all staff understood the importance of applying this consistently.

People said their needs were not always met promptly. A person said, “I waited [number] minutes last night after pressing my bell.” Another person said, “They know I need the toilet at this time, it may seem a short time for them but not for me.”

Relatives were positive about staff approach and how attentive they were to meet people’s needs.

The management team had systems in place to assist them have oversight of all care provided to help ensure each person received the care they needed when they needed it. The management team carried out checks to ensure people’s needs were met appropriately. These checks had identified any shortfalls in relation to some aspects of care delivery and approach and there were plans in place to address these issues. There were daily meetings and toolbox talks about people’s experiences.

We saw staff responding to people when it was needed in most instances.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Most staff said they felt very supported by the management team. A staff member said did say they felt they were not always listened to. We discussed this with the management team and the fact that some information held in relation to action taken is privileged and cannot be shared with the wider staff team.

There were human resources (HR) forums held in the home to offer support to staff as they had had management changes. These forums generated action plans that the regional manager had oversight of to help ensure staff were supported and heard.

Staff received regular supervision and training. Further training and support were ongoing to help drive the improvement the management team expected.