King Street - Care Home Physical Disabilities

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

This means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last inspection we rated this key question good. At this inspection the rating has changed to inadequate. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.

The service was in breach of legal regulation in relation to dignity and respect

This service scored 35 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not treat colleagues from other organisations with kindness and respect.

Where interactions were observed, staff treated people with kindness and compassion. However, ineffective staff deployment meant people were often left without meaningful engagement or emotional support for extended periods. This was particularly concerning for individuals at risk of experiencing poorer outcomes, who may have required more consistent and personalised attention. One person who required staff to anticipate their needs had fallen asleep in their wheelchair at the table in the dining room for over two hours without intervention. Another person was placed in their wheelchair in a communal dining room. They communicated through an electronic communication system and had requested to move from their wheelchair. The person had still not had their request responded to later in the day when inspectors observed the dining area.

During our observation, we noted that staff did not demonstrate consistent respect for people’s dignity. We saw staff not mobilising a person correctly, resulting in them being left suspended in a hoist for a period of time. This caused unnecessary discomfort and compromised the persons dignity.

These gaps in care significantly compromised people’s dignity and emotional wellbeing. The provider failed to ensure caring practices were consistent, inclusive, and aligned with the principles of Right Support, Right Care, Right Culture.

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 had protected characteristics recorded in their care records, and staff demonstrated a good understanding of individuals’ preferences and personal histories. However, this knowledge was not consistently used to tailor care and support. Opportunities to promote choice and independence were limited, and people were not always supported to pursue their individual interests or aspirations. This meant that care delivery did not always reflect a truly person-centred approach.

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

There was limited evidence that people’s individual aspirations and preferences were actively supported. Staffing constraints and poor deployment meant people were often grouped together for activities, rather than being offered personalised options. People and relatives told us there were barriers to going out and achieving the things they enjoyed due to a lack of available staff and drivers, which restricted their opportunities and negatively impacted their overall experience of care. One person told us, “The weekends are boring. We don’t go out very often as they are struggling for drivers, so we don’t get to do what we want to or choose to. The holidays here are too expensive because I have to pay the carer to come with me.” The approach to care did not fully recognise people as individuals with their own identities and aspirations. This falls short of the expectations set out in Right Care, Right Support, Right Culture.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

During the inspection, we observed people waiting for extended periods following their request for support, and call bells sounding frequently throughout the day. In one instance, a person’s call bell was not responded to for over 20 minutes.

People confirmed they raised this as a concern within resident’s meetings. One person told us, “I want to help to make the home like it used to be. I waited 30 minutes to have help to go to the toilet and 30 minutes for dinner.” Staffing constraints meant individuals were left in communal areas without engagement or supervision. Staff told us, and records confirmed, that during busy periods they struggled to respond effectively to people’s requests for help. People who required support during episodes of distress were sometimes left isolated until staff became available, increasing the risk of emotional and physical harm.

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.

A lack of consistent leadership, effective communication, and emotional support left staff feeling uncertain and undervalued. Several staff members reported experiencing fatigue and burnout, which impacted their ability to deliver compassionate care. Comments included, “The staff mix is ok. Although more staff are leaving, who are good workers, meaning we have more agency staff. They don’t know what they are doing, which means the permanent staff have to do twice as much work. It’s not sustainable and is exhausting” and “Staff want to do the best they can, but there is so much uncertainty now. There have been several changes in management and we are unsure of what is expected of us.”

Additionally, recent changes in management and leadership created further instability, leaving staff unclear about expectations and unsupported in their roles. This contributed to low morale and reduced the capacity of the team to respond effectively to people’s needs.