Archived: Sovereign House

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 Inadequate. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.

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 and registered manager did not always treat people with kindness and compassion, or respect their privacy and dignity.

Staff had not been provided with information about people’s preferences, wishes, personal histories, backgrounds and potential. However, staff knew people well and we observed they treated people with kindness and compassion.

Staff knew how to communicate with people appropriately despite not being given information about people’s communication needs and preferences. However, people had to rely on information being given to them by staff as information, such as how to raise concerns, was not available to them in other formats.

People were given privacy, however they were not always treated with dignity. For example, people did not always have their own toiletries and these were shared between a number of people. One person’s bed did not have a sheet on and we observed they had been lying on a slide sheet which did not cover the entire mattress.

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

Care had not been planned with people, and those who knew them well, to meet their individual needs and preferences. Time had not been taken to understand people’s personal, cultural, social and religious needs and action had not been taken to ensure these were met. For example, several people had mental health needs such as anxiety or depression. Care had not been planned to identify any changes in their mental health and support them to remain well.

People did not have access to a range of activities and were not supported to be part of the local community to promote and support their independence and wellbeing. We observed people were not supported to take part in pastimes they enjoyed during our visit and staff confirmed they did not have the time to spend with people. One person told us they enjoyed reading but were unable to use their electronic reader as staff had not supported them to download books onto it. People were not supported to be part of their community, including going out or inviting community groups to visit people at the service.

The provider had not considered equality when planning people’s care and people had not been asked about their individual needs and any protected equality characteristics, such as race or sexual orientation. People’s age or any disabilities had not been considered and any potential barriers to care and treatment had not been identified. There was a risk people would be discriminated against and this would go unchallenged.

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

People were not always supported to understand their rights because the provider had not ensured a variety of communication tools were used to support people to understand and communicate their needs. People’s capacity and understanding had not been kept under review to identify any changes in their needs and ensure these were always met.

Care was based around a routine established by the registered manager without people’s consultation or involvement. The routine concentrated on tasks and not what people wanted to do and when. For example, there was a ‘bath book’ in place and people confirmed they were offered a bath once a week on the same day, they were not offered the opportunity to bath when they wanted.

People and their relatives told us they were able to maintain relationships. Relatives told us there were no restrictions on visiting and they could visit their loved ones when they wished.

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

People’s needs, views, wishes and comfort were not a priority and staff had not been supported to quickly anticipate these to avoid any preventable discomfort, concern or distress. For example, relatives told us staff had provided care with the intention to maintain a person’s comfort in bed. However, no guidance was in place for them to follow and staff had not used recognised techniques to do this and ensure maximum comfort.

Staff were not always alert to people’s needs and did not have the capacity to take time to observe, communicate and engage people in discussions about their immediate needs. Staff took planned breaks together, away from people, meaning there were no staff available to quickly respond to people. The registered manager had not taken time to find out how to respond in the most appropriate way to people’s needs whilst respect their wishes and no guidance had been provided to staff.

Appropriate tools and technology were not in place to support staff to quickly recognise when people needed urgent help or support. The call bell system in place did not facilitate the use of equipment such as remote call bells or sensors to alert staff that people needed support in all areas of the service.

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.

The provider had not considered the wellbeing needs of staff, including the necessary resources and facilities for safe working, such as rest areas. The staff room was used for the storage of medicines and other stock. It was not used by staff during their breaks and we observed staff taking their breaks in the dining room where there was a risk their break would be interrupted by people, relatives or visiting health care professionals.

Staff had not had opportunities to provide feedback, raise concerns or suggest ways to improve the service. They were not supported to take part in regular supervision meetings to discuss their practice or any concerns they had. Action had not been taken to understand staff’s experience of working at the service, such as surveys or questionnaires. Staff told us they did not feel it was effective for them to complete the cleaning and cooking as well as providing care during the same shift. They felt these roles should have been separated to ensure they always had the time, skills and experience to complete the tasks.

The provider and registered manager had not taken time to understand the equality and diversity needs of their staff. No information had been obtained about protected characteristics and action had not been taken to offer any personalised support staff needed. No action had been taken to support effective communication within the team or check that the culture was open and free from any bullying or harassment.