Dunraven House and Lodge

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 were not always supported and treated with dignity and respect; and not always involved as partners in their care.

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 empathy and compassion and did not always respect their privacy and dignity. Staff did however treat colleagues from other organisations with kindness and dignity. People told us staff treated people with kindness.

During the assessment we observed mixed interactions between staff and people. For example, we saw 5 staff on different occasions who were not interacting with people in an engaging manner. These staff members did not speak to people when walking past them in communal areas. We saw one person calling out to a staff member but the staff member did not react. The person told us, “See they don’t listen to me”. Another person told us, “Staff only talk to us if they want something.” This meant people did not always receive warm or meaningful interactions, and some may have felt unnoticed or unsupported in communal areas. However, we also observed a staff member spending time with a person talking through the process of getting a job, what an employer would expect and what sort of work they would be interested in doing. This kind approach meant the person was supported to build confidence, understand their strengths and feel more prepared to take steps towards employment.

People’s privacy and dignity was not always protected. We saw people’s personal health information was displayed in a communal area where other people could see it. This meant people’s sensitive information was available to anyone entering that area.

People we spoke to told us they felt staff treated them with kindness. Comments included “Staff are good to me” and “[Manager] is great – I said it before I’ll say it again – put that in your report!”

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

People were not always supported to participate in things they enjoyed or had an interest in. For example, an activity session was organised by staff. Staff requested people to go to an indicated area, however, did not explain what was happening or ask people whether they wanted to take part. There was no previous conversation with people to gain their opinion or choice on what activities they would like to be involved in that day. This meant people were not being supported as individuals in the care environment.

People told us there were limited areas for people to socialise in the manner they preferred and they were not always supported to socialise with friends in comfortable areas of their home and when they did they were told they were being too noisy, This meant people did not always feel supported to spend meaningful time with friends.

Some people had been supported on individual day trips and holidays. Staff told us they supported people to go on holiday. However, they told us that large numbers of people went all together with staff. This meant some people were not always supported to have an individual holiday tailored to their own specific preferences.

However, since the previous assessment, the provider had made some progress in delivering care that was individualised to people’s choices. We saw people accessing their local communities. People told us: “I now have a job which staff support me to attend” and “I like to go and look around the shops – sometimes I like staff with me and other times I do not – staff listen to this”.

The provider did not always promote people’s independence, so people did not always know their rights or had choice and control over their own care, treatment and wellbeing.

People were not always supported to be independent where possible or given the opportunity to learn new skills in line with Right Support, Right Care, Right Culture. For example, we observed a culture where staff did not enable people to make drinks for themselves or complete day to day tasks when they had the potential ability to be supported to do so. However, a manager told us the provider was working to improve independence and choice for people.

We also saw quizzes were delivered in a way that focused on completing the activity rather than adapting it to people’s interests or abilities, meaning opportunities for meaningful engagement were sometimes missed. Most people involved did not engage in the quiz. One person told us, “I did not like the quiz because I did not like the questions”.

People were being supported to understand they could have more independence and choice. For example, we saw some people asking for permission to access communal areas such as the kitchen. During the assessment, 6 people at different times asked if they could access the kitchen to make drinks or to access food. One manager confirmed there was still work to be done to ensure people fully had control over their independence. People told us they thought they had to ask permission to access some areas. This meant people did not always realise they were now able to access shared spaces freely and some continued to seek staff approval for everyday tasks.

At the previous assessment, concerns were raised regarding a GP coming to the home rather than people being supported to choose when they wanted to see a GP. During this assessment the registered manager told us: “We have a GP who visits the service”. As part of promoting people’s independence, we expect where possible people to be supported to independently access the GP when they required medical support. Comments from people included, “I would rather go to the doctor when I want” and “I don’t know why the doctor comes here, they always have”.

This meant people were not always being supported to take control of their own healthcare or make routine decisions about how and when they accessed medical support. It also showed that staff had not fully considered how long‑standing routines could limit people’s independence, choice and control.

However, people chose what meals they wanted and, in some instances, staff supported people to cook. We saw a person receiving support to cook who spoke happily about what they were cooking.

Staff told us they supported people to be as independent as they could. This included arranging regular communication with the mental health team, to help support people access ongoing treatment. For example, one person’s wellbeing improved. The provider organised referrals and assessments from professionals so that the person was able to start doing more for themselves. Managers confirmed this by informing us they were looking to support a person to move from the residential setting into the provider’s supported living service.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

For example, work had begun to look at supporting people in a more flexible way. One person who had chosen to cook for themselves was receiving support to achieve this. This was in contrast to other situations we had witnessed. We saw a person cooking spaghetti bolognese in the newly built kitchenette area. They told us, “I like cooking for myself and I like deciding on the day”. Managers confirmed that since the provider had installed a kitchenette area, people had begun to use it more frequently. This meant people were supported to develop practical skills and take more ownership of their day‑to‑day decisions and immediate needs, which promoted greater independence and well-being.

Staff provided support to people in the moment. This meant emerging concerns were responded to without delay, ensuring people remained safe, comfortable and confident that support was available when needed.

The provider cared about and promoted the wellbeing of their staff and supported them to deliver person-centred care. Staff told us they received the support they needed to do their job well.

Staff told us they felt valued, listened to and well supported in their roles, and this helped them maintain motivation and provide consistent care to people. Staff also told us the registered manager and another manager were open, and they were able to share any concerns they had. All staff said they were confident the registered manager would act on any issues raised.

We saw staff working collaboratively, communicating openly and supporting each other during busy periods. Staff said most managers were approachable and made time to check in on their wellbeing. Comments from staff included: “I always feel I can talk to [manager] if I’m stressed or unsure, they never make you feel like a burden”, and “They look after us here. They fit shifts in around what we can do”.

Managers had systems in place to support staff health, wellbeing and development, including regular supervision, and job catch ups. Staff confirmed these were used consistently and helped them feel confident in managing the emotional demands of the role. One staff member told us, “Supervisions are helpful, we talk about how I can develop in my role”. Managers confirmed this by speaking positively about opportunities to develop. “We support staff with their NVQs, we pay for these”.

This meant people received care from a stable and well‑supported workforce, who felt empowered, motivated and equipped to provide compassionate and person‑centred support.