Bishop's Cleeve Care Home

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.

This service scored 50 (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 dignity.

Staff were inconsistent with caring interactions and compassion with people. For example, during observations in one of the dining rooms, some staff were seen to enter and leave the room without engaging with people. People were not supported to leave the dining room once they finished their meal for long periods of time. However, we did observe some staff have good interactions and engaged meaningfully with people. Feedback from people and relatives was positive. One person told us, “The staff are good. You get the odd one who is short tempered. Some are pushed for time.”

The provider did not always treat people as individuals or make sure people’s care and support met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds.

There was an inconsistent approach to supporting communication and choice. The service did not always ensure people living on the dementia floor were involved in making decisions about activities. People were not encouraged to use the large lounge, and the provider had not ensured the balcony could be used safely with staff supervision. However, the provider had a varied activities programme with a mixture of passive and active opportunities for people. We saw the service had a newsletter and there were regular residents’ meetings. There was a church service for people who wanted to attend and there was a ‘Spanish’ activity on one of the days of the assessment which we observed.

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 always supported to make their own choices and remain as independent as possible.For example, we observed some people were not encouraged to come to the lounges after meals on the dementia floor, and when they attempted to leave the dining room, they were escorted back into the dining room outside of mealtimes. Staff did not always offer people choices or allowed them time to make decisions. People were offered a choice of meal; however, staff did not always wait to hear what the person chose before serving them. Alternatives were not always offered unless the first meal was left untouched.

Staff on the dementia floor were not observed encouraging people to maintain their own independence and did not support them to engage in dementia friendly activities in line with best practice guidance.

People’s experience day to day was variable depending on which floor they lived on and the staff on duty. Some people had choice and could make independent decisions, however other people were not supported with their independence. People’s mobility needs were not being adequately supported as was evidenced by the lack of investigations after falls. People were supported in the dining room to eat independently, and eat independently in their rooms, however sometimes food was left on tables next to people’s bedsides which was not always safe, for example, left on a table which was at an angle and not in front of them.

People were not given sufficient choice and control over their care and support, and care was task focussed. People could not always make choices about when they wanted personal care, what activity they wanted to do or if they wanted to go out in the community due to staffing levels.

The provider did not always 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 with dementia were not supported by staff who understood dementia principles and were not working in line with current best practice guidelines. For example, we observed one person living with dementia walk out of the dining room calling out for help. When a staff member approached them, they led them back into the dining room. The staff member did not attempt to ascertain the root cause of their distress and did not recognise the person was attempting to leave the room they were then led back into. Outside of mealtimes, people were not encouraged to use the large communal lounge, access the outdoors or engage in meaningful activities. Staff were scheduled to attend a 1-day face to face dementia training course shortly after our assessment.

The provider 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 did not always feel supported by managers. For example, one staff member told us on a day they felt unwell; they were told by their senior they were not allowed to leave as it would leave the service short-staffed. The staff member told us they felt they could not leave. This demonstrates a culture where staff well-being is not considered relevant when staffing levels would be impacted. Staff working via sponsorship licenses told us they felt they were treated unfairly by the provider and did not receive the same opportunities as other staff. We signposted them to appropriate services.