Sandholme Fold

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 55 (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 respect people’s privacy and dignity.

The way in which some staff spoke about people was not always appropriate or respectful. For example, staff sometimes used people’s room numbers, rather than their names when sharing information about tasks to complete. Information for staff was sometimes displayed in people’s rooms without discretion or respect. For example, one person had a notice attached to the outside of their wardrobe door to state what size continence pads they needed.

Staff interaction was kind and caring when they engaged with people, and they used good eye contact and tone of voice when speaking with people. However, staff appeared focused on tasks and often missed basic interactions like acknowledging people as they passed them, either in their own rooms or communal areas. We observed a member of staff calling out across the lounge/dining area very intimate details about a person they were supporting in the toilet. This was not picked up on by staff in the vicinity.

Some improvements were needed to ensure people received dignified personal care. We saw examples of people who had not been supported to have clean fingernails or assisted to freshen up after meals. Communal bathroom windows had frosted glass, but no window blinds which potentially compromised people's privacy and dignity.

Relatives were generally complimentary of staff, describing them as kind, caring and responsive. However, several relatives raised concerns about missing dentures, glasses and hearing aids.

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

Care records included 'who I am' and 'about me' sections. These, when completed, helped staff to know and understand the person, their history, life experiences and likes and dislikes. However, we found many of these documents held no information or were incomplete.

Staff had little understanding of protected characteristics and care records were not always detailed enough to provide specific information on people’s culture, background or any specific requirements. Work was ongoing to update care records with more person-centred information.

Staff appeared to know people well and relatives confirmed this. One relative said, “They know (person’s) little quirks.”

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.

The manager told us one person living at the service was hoping to move on to more independent living. The care plan for this person did not include any detail of how this was to be achieved or what activities they were being supported with to promote independence.

The provider was aware improvements were needed to ensure people had appropriate activities to support their independence and wellbeing. People did not have enough opportunities to engage in meaningful activity, or to make choices and decisions about how to spend their time each day. Staff brought the majority of people into the downstairs communal lounge, although there were other areas inside and outside the home which were not used and people were not given the choice. There were very limited opportunities for people to access the community or to develop their independence in daily living skills. There were missed opportunities to celebrate events, such as special birthdays and VE day.

The provider started to address the quality of activities before the inspection was complete and was considering ways to involve local groups, such as the school. They also told us how they were supporting one person to go swimming on a weekly basis. The provider sent us a new activities timetable after the inspection to show how they had considered some daily activities throughout the week. This showed some improvements were planned. However, the timetable was limited and included ‘hairdressers’, hand and nail care’ which is personal care to support dignity, identity and self-esteem, rather than activities.

Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Call bells sounded continuously during all of the days we visited the home. There were delays in staff responding to these as they were attending to other people. The sound of the continuous call bell affected all people living in the home and the provider was in the process of upgrading the system to ensure this did not happen and to improve staff response. There was mixed feedback from people about how quickly staff attended when they used their call bells.

The provider told us they had a staff wellbeing site which included GPs, counselling, financial support, wage stream, shopping vouchers/ discounts and eye care vouchers. They said there was a staff nomination scheme, and they rewarded staff with vouchers and certificates for identified good practice.

We saw evidence of an improved supervision format to use within future individual supervisions and this had a clear focus on staff well-being and development.

Staff told us the management team were flexible with staff rotas when they needed to accommodate their individual circumstances.