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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

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question inadequate. 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 providing safe care and treatment and the governance of the service.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Although we witnessed positive interactions during our site visit. We observed an incident whereby staff were not communicating well with a person who was distressed and one staff member walked away with their fingers in their ears. We did however witness other staff members treat people with kindness and patience.

Staff told us, “Residents (people who used the service) here are well looked after, I think they enjoy being here.”

People and relatives described staff as pleasant and felt people were looked after well. One person said, “They (staff) look after me and when they have time they come and talk to me.”

The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. Most interactions between staff and people were positive. However, we did see a person walking around with only one shoe on which staff had not identified. We also observed staff did not always know what to do when people displayed distressed behaviours. This may be due to a lack of training in this area.

Staff told us they knew people well and their preferences. People felt staff knew them well and relatives told us staff took an interest in people’s lives. One relative said, “Yes, they (staff) know [person] well and they take an interest in us and make us feel welcome.”

The service did not promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. Although we witnessed activities taking place during the site visit, records indicated this was not a regular occurrence. Some people’s care records evidenced activities had not taken place for some time and there were no records of what people liked to do or how people liked to spend their time. There was no designated activity co-ordinator and staff told us activities were not always a priority. One staff member said, “There is not always time to do activities. There are 4 staff on today, that’s unusual, it’s probably because you are here.”

Staff advised there had been cutbacks and entertainers were no longer coming into the service which people once enjoyed. Staff told us they used their own money and time to ensure people were occupied. One staff member said, “We do activities in the afternoon. We used to have singers on that people really enjoyed but we don’t have that anymore because of cutbacks. We did baking last week and cooking but I had to buy the ingredients. There is definitely a lack of stimulation.”

Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. The lift was broken on the 2nd day of our site visit. People who were unable to come down to the communal areas had no additional checks in place which was a concern at the last assessment. We found one person had spilt a cup of fluid on themselves and we alerted staff. The manager told us nurse call bell times were monitored; however, we saw no evidence of this despite requesting it.

Staff told us how they would recognise signs of people needing assistance. One staff member said, “Most people are verbal. We recognise people’s needs by changes in their behaviours.” Relatives felt staff engaged with people well. One relative said, “Absolutely, they (staff) engage with me and [person], they sit next to me, and we have a chat about [person], we have a good rapport with them.”

The service 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. Staff told us morale is low. Staff were concerned about their working hours being reduced with no contract amendments taking place or consultation. One staff member said, “Staff morale is low. We are getting our hours cut and people aren’t happy about it, we haven’t been given new contracts. We haven’t been officially told by anyone about hours being cut.” Staff raised concerns about higher management and felt they were shouted at rather than spoken to.

The manager told us staff wellbeing was promoted through employee assistance programmes and wellbeing checks. However, we saw no evidence of regular communication with staff to check on their wellbeing.