London Care (Rochester)

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 requires improvement. At this assessment the rating has remained 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. It did not consistently consider individuals’ emotional wellbeing, the factors contributing to their distress, or the support they needed.

This service scored 60 (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 always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

One person told us, “I think the carers have a good personality. We are always having a chat from the time they arrive to the time they leave. They are very caring in all areas.” Another person mentioned, “Most of the carers who come are quite friendly and my regular carer is a nice person. They understand that this is my home, and they respect my home too. They ask my permission before they do anything, and they always give me a choice.”

Whilst we received positive feedback from people about how caring and kind staff were, we also received comments that not all staff were compassionate and kind. One person commented, “There is one staff that just gets on with what they are doing without communicating much or thinking about what they are doing and how it might make me feel. They focus on the job and that makes me feel very anxious.” People told us staff discussed other people’s matters in front of them and they were worried their personal matter would also be discussed with others without consideration for confidentiality.

One relative stated, “There is a massive difference with other carers, for example; other carers will not wash my relative properly and just hand them a flannel with cold water without any thought or consideration and virtually no communication.” Another relative mentioned, “Some carers offer no warmth or kindness. It’s just about the job and not the person.”

Staff had received training and induction on the core principles of care which included respecting people’s dignity and privacy. Staff gave us examples how they promoted these values in their day-to-day work.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff understood and promoted equality and diversity amongst people. One staff member told us, “I take into account people’s religious and cultural requirements when supporting them and adapt the way I care for them to meet their specific needs.”

Records indicated people’s protected characteristics such as religion, culture, gender, sexuality, disability and race were covered as part of their needs assessment. Where people required support to attend places of worship, staff supported them. People were addressed by their preferred names and titles, and people’s preference as to the gender of staff to deliver their care was respected.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. One person told us, “I feel much more independent, the carers enable me to do what I can do while they get on with other things like cooking and cleaning.” One relative stated that, “The main carer always encourages [person] to do what they can do for themselves. When they are moving from one chair to another, the carer stands back to give them space but will be there to help if needed. The carer encourages them but never bosses them about.”

Care plans outlined individual’s abilities and highlighted where they required assistance. Staff described how they promoted people’s autonomy by allowing people to choose how their daily care was provided. One staff member mentioned, “I offer people choices and promote independence by trying to get them to help with things. I would let them choose what they would like to wear and how they want to be washed, and choices of food.”

The provider did not always listen to or 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.

Care plans included observations on individuals’ behaviours and emotional needs but lacked insight into potential triggers for changes in mood or behaviour. Two care plans identified individuals living with anxiety yet failed to detail what might cause them stress or offer guidance to help staff recognise when they were anxious or distressed. Similar gaps were found in the care plans of people experiencing depression. For example, there were no indicators to help staff identify early signs of low mood or emotional decline. We were concerned that without this crucial information, staff may struggle to recognise when someone needs emotional support or is in distress, limiting their ability to respond appropriately.

People and their relatives expressed concerns that emotional needs were not considered when planning staff rotas. One person shared, “I feel very anxious when I don’t know who’s coming. It worries me and makes me upset. I’ve mentioned it before, but they don’t always inform me when a new carer will arrive, they just show up.”

A relative commented, “My [relative] has dementia, and different carers visit each day. I understand consistency isn’t always possible, but efforts should be made to minimise disruption. They also frequently change visit times without notifying us, which is particularly distressing for someone with dementia.” Another relative stated, “We don’t receive any kind of rota. As a result, my [relative] lacks a consistent routine and has become resistant to accepting help. It’s not right to keep sending unfamiliar carers to someone with dementia.” A third added, “My relative doesn’t always feel safe or comfortable with the carers. They don’t know who these people are and feel frightened.” This meant that the provider had failed to ensure people’s immediate and emotional needs were always planned and met in a person-centred way.

The provider cared about and promoted the wellbeing of their staff and supported.

Staff told us their well-being was promoted. They told us they had regular contacts with their supervisors to check they were doing well and if they had any concerns. They told us they felt supported in their roles through training and supervisions. Staff felt motivated to continue delivering effective care to people. One staff told us how they had been supported to improve in their role and how the provider had recognised their commitment and hard work. Another member of staff told us the provider had been very supportive and offered them flexibility so they could continue to balance work and their other commitments.

The provider had various programmes to support staff’s wellbeing including regular wellbeing checks, supervisions, reward events, and employee assistance programme which all staff had access to.