Broadoak Grange

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.

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, compassion and respect, promoting their privacy and dignity in day-to-day interactions.

People and their relatives spoke positively about the care provided. One person told us, “The staff are fantastic, out of this world.” A relative said, “[Staff] treat [person] with respect, dignity and kindness. I have never seen anything of concern. [Person’s] face lights up when particular staff are around.”

Throughout the inspection, we observed warm, caring and respectful interactions between staff and people.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People were not always supported in a way that recognised and responded to their individual preferences, interests and what was important to them. During the inspection, we observed limited meaningful activities for people living at the service. People and relatives told us there was a lack of opportunities for engagement. One person said, “They used to have an activity coordinator, but they don’t do very much now.” A relative told us, “The only thing is, [person] doesn’t do anything, [person] likes bingo and a bit of a dance and they don’t do anything. I haven’t seen anything being done.”

Staff spoke positively about supporting people but told us they were often required to focus on completing tasks and did not have sufficient time to spend meaningful one-to-one time with people due to staffing pressures. Concerns regarding the lack of activities had also been raised in resident and staff meetings, demonstrating the provider had not taken effective action to address the issue.

People's diverse needs and preferences were not always fully considered within care planning. For example, 1 person's Christian faith was recorded; however, there was no guidance for staff on how to support them to practise their religion or use faith-based support to promote their wellbeing when distressed, such as access to worship, readings or religious music. This meant staff did not always have the information required to provide truly person-centred care that reflected people's individual needs, preferences and beliefs.

The provider did not always ensure that people knew their rights and had choice and control over their own care, treatment and wellbeing.

People were not always fully in control of their lives. There was no evidence to show how people led on their care and how they were involved, with reviews and goal setting. People we spoke with were not aware of their care plans. When speaking with one relative about care planning, they told us, “It was taken out of our hands.” Care records did not demonstrate that people, or their relatives and legal representatives where appropriate, had reviewed, agreed to, or signed their care plans, meaning the provider could not be assured care reflected people's wishes, preferences and informed involvement in care planning.

However, staff told us they supported people to make individual choices when they were at the home, including choosing what they would like to eat and where they would like to spend their time. Our observations supported this.

The provider did not always ensure people’s immediate needs were responded to consistently and in a person-centred way. While staff knew people well and demonstrated a caring approach, systems and guidance were not always sufficient to support staff to respond effectively when people experienced anxiety, distress or required reassurance.

Feedback from people and relatives indicated staff had a good understanding of people’s individual needs. One relative told us, “[Staff] would do anything for anyone, but there could be more staff, they get pushed too much.”

However, we found insufficient guidance was available to support staff to respond consistently and effectively when people became anxious or distressed. For example, 1 person’s Positive Behaviour Support plan did not provide clear guidance for staff on how to recognise early signs of distress or the action they should take to de-escalate situations. This meant staff may not have had the information required to provide safe, person-centred support during periods of distress.

During our inspection, we observed call bells were answered promptly. However, the provider lacked effective oversight of response times across the service. Although call bell audits were undertaken, these only checked whether call bell systems were operational and did not monitor how long people waited for assistance. As a result, the provider could not be assured that people consistently received timely support when requesting help or that delays in responding to people’s immediate needs would be identified and addressed.

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.

Feedback regarding the provider's approach to staff wellbeing was mixed. While some staff spoke positively about the support available from some managers, others described examples where they felt the provider and management had shown insufficient consideration for their personal wellbeing and individual circumstances. Staff confirmed they received supervision; however, several told us these sessions did not provide meaningful support or opportunities to discuss concerns. One staff member said, “We have supervision, but what is the point if they don’t listen to what we say.”

This feedback was consistent with wider concerns about the provider’s culture, where staff did not always feel listened to, valued or empowered to influence change. As a result, the provider could not demonstrate they had embedded an effective approach to supporting workforce wellbeing or creating a culture where staff felt supported, respected and able to raise concerns openly.