Agnes Court - Care Home with Nursing 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

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 person centred care.

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.

The provider treated people with kindness, empathy and compassion and respected and staff treated colleagues from other organisations with kindness and respect.

People and their relatives described staff as caring and friendly and we observed positive interactions during the assessment. A person said, “I can’t fault them (staff).” A relative told us, “The carers are really kind and they know [person] very well.” However, people’s privacy and dignity was not always respected. Although the registered manager was aware that a person preferred to keep their curtains open, they had not considered or implemented additional measures to protect the person's privacy and dignity. For example, no privacy film or other environmental adaptations had been used to reduce visibility into the room from outside. This meant the provider and registered manager had not fully considered how to respect the person's preference with the need to maintain their privacy and dignity.

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.

Some people and relatives told us opportunities to pursue hobbies, interests and community activities had reduced due to staffing pressures. Relatives reported fewer outings and limited support to access activities that were important to people. Inspectors observed that, outside of organised sessions led by the activities coordinator, people often spent prolonged periods with limited meaningful engagement. A person told us, “When [activities staff] is not here, you can tell the difference.” The registered manager acknowledged they have had difficulties finding staff who are able to drive the minibus to accommodate more community outings. A relative said, “One thing that would be beneficial to [person] is more availability of the van.” Another relative said, “They (people) don’t go to town or trips like they used to.” And “[Person] loves going to the disco, but they (staff) don’t take (them)”. This meant people were not always supported to lead full and meaningful lives in line with their preferences, interests and aspirations.

People spoke positively about the activities coordinator and the variety of activities available within the home. During our visit, we observed people enjoying the activities on offer in the activities room. A relative said, “They (staff) know how much [person] loves music and play the songs [person] likes specially for (them) and have arranged for (them) to go to a couple of concerts this summer.”

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.

People were not consistently supported to maintain or develop their independence, limiting their choice and control over everyday aspects of their lives. Staff told inspectors that tasks people were able to undertake themselves, such as shaving, were sometimes completed by staff because it was quicker. Environmental barriers also reduced independence, including a lack of adaptations that would enable people to independently access outdoor spaces, resulting in increased reliance on staff support. One person told inspectors, “I just want some independence,” after being unable to access condiments without assistance. Opportunities to promote independence in everyday activities, such as making drinks, managing money, and accessing the community, had not been fully explored or embedded in care planning. People with a learning disability or autism were not always supported in line with the principles of Right Care, Right Support, Right Culture, and opportunities to maximise independence and choice were missed. Care records did not consistently demonstrate how people would be supported to achieve goals relating to independence, money management, volunteering, personal safety, or community participation. This meant people were at risk of becoming unnecessarily dependent on staff and were not consistently supported to exercise choice and control or achieve outcomes that were important to them.

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

Some people and relatives described delays in receiving support. For example, people and relatives told us there were occasions when call bells were answered but people were told staff would return later, resulting in discomfort and prolonged waits for assistance. A person told us, “Some of them (staff) come in just to turn it (call bell) off so it doesn’t go to emergency mode.” Relatives also reported concerns about staffing availability during evenings and weekends affecting people’s experiences. This meant people did not always receive timely support when they needed it. People generally told us they felt safe and staff responded when support was required, and we observed staff attending to people’s immediate care needs throughout the assessment.

The provider cared about and promoted the wellbeing of their staff. Staff spoke positively about working at the service and described leaders as approachable and supportive. A staff member said, “I feel well supported by both my colleagues and managers and am confident that I can raise any concerns or ask for guidance whenever needed.” Another staff member said, “I always feel extremely supported within Agnes Court and find that I am always encouraged and praised.”