Tandridge Heights

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

Staff treated people with kindness, empathy and compassion and respected their privacy and dignity.

We received positive feedback from people about staff. They told us they were kind and caring. One person said, “Staff are very nice. They know me. I am comfortable here.” Another told us, “I was against coming here at first, but I can honestly say I wake up every day and I have no regrets. Sitting here, I don’t feel alone. The carers are great.” We also heard, “Staff are very good. I get on with them well”, “Generally speaking they (staff) are good. They all show you respect. They are always happy when they come in”, “They are very kind. I’ve got no complaints there”, “The staff are lovely. I always thank them for what they do” and “The staff are most respectful.”

Relatives reiterated this sentiment with 1 telling us, “They are very kind and caring and that goes without any question.”

Our observations on the day were where staff interaction with people did take place, it was kind and compassionate.

Staff may not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences as staff were unable to tell us about people.

Although it was evident there was a good rapport between staff and people, staff were not always able to tell us about people’s individuality or background. We asked 1 staff member to give us some information about 2 people, but they were unable to do so, despite having worked at the service for 3 years. Although they were able to tell us what care people needed, they could not provide us with any information on their background, work history or medical needs. Knowing this information helps staff how understand how people’s experiences may shape their needs and behaviours. Without this understanding, there is a risk that care becomes task-focused rather than person-centred.

We reviewed the care plans for 14 people and there was a mixed level of detail in people’s records about their life history, work experience and family information. Some people had detailed information listed, yet others lacked information such as the names of their family members and other important information which would help staff to get to know a person as an individual.

We heard from a relative that their family member’s clothes repeatedly went missing which demonstrated a undignified approach towards people, rather than treating them as individuals. The relative said, “His clothes go missing and he ends up wearing other people’s clothes. They put a room number stud in the clothes, so I don’t know how they end up in the wrong place so often.”

However, we also received positive feedback. One person told us they stayed in bed due to their health conditions. They said staff were attentive to their needs and, “If I need something, they are very helpful. I don’t want for anything.”

We also heard staff discussing with each other people’s individual needs. For example, how 1 person liked their tea. In addition, some people had had their rooms repainted and refurnished with items of their choice, given them the autonomy to choose themselves. This included hanging a television on the wall of 1 person’s room wall to give more space as well as enabling them to watch the television more comfortably.

Staff 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 did not always receive their care as planned. Records showed people were not receiving baths or showers in line with their individual wishes and choices. We reviewed the daily notes and care plans for 12 people. For example, one person’s care plan clearly stated they would like a shower once a week. But having reviewed their daily notes for 14 days staff had not recorded they had offered them any showers in that time. Another person’s care plan stated they would like a daily shower, but on 7 of the 14 days of daily notes we reviewed for them they had only received a full body wash. There was no record to show people had been offered a bath or shower in accordance with their planned and agreed care or that they had declined. This meant that people were not always being supported with choice and control over their care.

People were given choices of meals and drinks at lunchtime and although staff told us they had previously selected their meals, they could change their minds if they wished something different. We saw this when 1 person opted to have alternative and staff contacted the kitchen to arrange this.

We also had some positive feedback from relatives. One relative felt their family member was supported with their independence and staff supported them to continue to do what they could, telling us, “They don’t undermine him.” Staff said, “You reassure them that they’re safe and once they feel they’re safe they will try to do an activity” and “I will take clothes out of the wardrobe, show them what they want to wear. If they can’t say, they will point. They may have to feel it and then they’ll say.

Staff did not always respond to people’s needs in a timely way.

We’d received mixed feedback from people on how long they waited to receive staff support, with some people telling us staff came quickly and others saying they had to wait a long time.

Our observations supported these points of view.

We were aware of 1 person who was still in bed at 11:30. They told us they were unhappy about this as they had been waiting for some time for staff to support them to get up. We had also witnessed 1 person and their family member become frustrated when staff did not respond to their request in a timely manner. Other people felt their needs were not met in line with their expectations. They said, “Every room has an alarm button. Sometimes you press it and nothing happens (no staff come). It’s so frustrating”, “There are not enough of them (staff) to meet my needs, you can wait ages” and “I yell out - there are no staff around at all.”

In turn though we did observe some staff supporting people promptly. One person was finding it difficult to walk independently to the dining area and a staff member approached them and said, “Do you need a hand? Come on, let’s go together. You’re doing really well, you’ve got this.” Later, we observed this same staff member used appropriate touch to comfort and reassure people (for example, an arm around the shoulder of a person who needed support). We also saw 1 person attempt to get up from their wheelchair at times when they were not able to mobilize independently. We saw staff responding quickly to the person asking what they needed to avoid the person falling.

The provider cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Senior management told us staff were supported in their role through supervision session with their line manager, annual appraisals and access to the provider’s ‘We Care’ portal which had GP, counselling and pharmacy services availability.

Staff confirmed they received the opportunity to meet with their line manager on a 1 to 1 basis and said they found this useful. One staff member told us, “They ask if we need anything; if we have any problems.”