Kirk House

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

At this assessment we did not assess all quality statements within this key question. We found people were not always treated with dignity and respect.

Systems were in place to promote independence and respond to individual needs, however it was unclear how they achieved good outcomes for people.

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.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

Relatives told us that staff knew their family members well. A relative told us, “Staff have a good understanding of [family member’s] gestures and facial expressions.” Despite these comments, care records viewed did not demonstrate that people were being treated as individuals and there was limited evidence to demonstrate how people were supported to make their own choices. How people spent their time was often segregated or limited to onsite activities and local walks; we did not see evidence that these options were aligned to people’s individual care needs. There was no evidence to show how people were encouraged to take positive risks or empowered to explore other opportunities that were unique to them.

Staff told us they understood people and knew their individual needs. Staff were able to tell us about people they supported, what made them happy and how they supported them to access the things they enjoyed. However, staff followed a culture which failed to value people and view them as equals, used derogatory language and failed to offer opportunities for people to grow and develop. Staff spoke of restrictive practices within the service in terms of physical and environmental restraint and control. Staff grouped people together who experienced restrictive environments and referred to them as ‘air lockers’ in conversation.

The language used in risk assessments and other care records about people was outdated and could be seen as derogatory. This showed people were not always treated equally and respected as adults. Statutory guidance such as the Right Care Right Support Right Culture policy reflect the power of language and the need to communicate with and about people as human beings.

The registered manager told us they completed an activity called ‘my say’ with people where they asked questions such as, how are they feeling, do they want to plan activities or have certain things on the menu. They explained that actions were then created from these meetings and allocated to staff to complete with people. We reviewed some people’s ‘my say’ documents. It was not clear from the documents how ‘my say’ provided individuals with a voice as questions were often too complicated. It was unclear how much people understood what they were being asked, which consequently made feedback unreliable.

Care plans included person-centred information regarding people’s personal needs and provided guidance to staff on how to support them. However, information could often focus on negatives and what people were unable to do instead of how staff could provide support and enable them. For example, in a person’s care plan it stated, “[Person] is not able to understand or to manage their own activities to achieve an ordinary and fulfilled life.”

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

Staff told us the provider had a dedicated wellbeing team to support staff with personal and work-related problems. They explained how the wellbeing team checked in on them to make sure they were ok.

However, we received a number of anonymous concerns from staff telling us they suffered work-related stress, and that staff morale was low. Additionally, staff told us they were moved around to work at other services and felt unable to speak up in case they lost their jobs.

The provider had a dedicated wellbeing team who worked with staff to discuss any personal or work-related issues. We were told how the wellbeing team provided staff with support when returning from long term sickness or making reasonable adjustments to enable staff to carry out their roles. We could see in debrief documents that staff wellbeing was a priority in the discussions following incidents. However, we received numerous concerns about how staff were being treated. Other records reviewed that gave staff a voice such as exit interviews and supervision notes showed staff had raised concerns about the workload and being moved between services amongst other concerns relating to their wellbeing. Exit interviews viewed as part of this inspection showed that some staff gave the way they were treated as reasons for leaving.