Muscliff Nursing 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 service 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 inadequate. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.

The service was in breach of the legal regulation in relation dignity and respect. This meant the provider did not ensure people were always treated with dignity and respect when receiving care.
 

This service scored 35 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not treat people with kindness, empathy and compassion or respect their privacy and dignity.

Staff did not treat people with kindness, empathy and compassion and did not support people to retain their independence. Although we received many compliments about some staff during our inspection, we found staff delivered care without engaging with people, listening to them or responding to people’s needs. For example, care plans were not always followed; staff did not always engage with people, listen to people’s requests for help or assistance and staff failed to give people time to understand or consent to care. Therefore, the provider could not be assured people were always treated with dignity and kindness.
The registered manager and provider had been made aware of the shortfalls in staff practice and had engaged with investigating authorities to address the concerns.
 

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

The registered manager and staff team explained how they treated people as individuals, but this was not always people’s experience. While some staff demonstrated an awareness of person-centred care, others did not, and people had been subject to abuse and harm as a result.

However, health and social care professionals told us from their observations, staff knew people’s preferences, had enough information and understood the importance of ensuring they met people’s needs.

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

People did not always have choice and control over their lives. Care plans detailed people’s abilities, however, we found some staff did not always encourage them to maintain their independence. Staff had told us they knew how to support people to ensure their rights were respected. One staff member told us, “Of course, our residents and their family are always encouraged to share their preferences and their concerns. We are always ready to correct any mistakes based on what they share with us." Another member staff said, “I believe residents at Muscliff Nursing Home have a voice and are listened to.”

However, observations made during the inspection demonstrated these principles were not applied in practice. For example, people’s requests for staff to support with maintaining their personal appearance such as wiping their face or brushing their hair were not always responded to.
 

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.

Although records stated people and their relatives were consulted about their needs, outcomes and wishes, the provider could not be assured these were actioned in practice. Staff told us, “There is not enough time or support to read through care plans properly during shifts, and handovers are often rushed or incomplete”, “Information is not communicated clearly between staff” and “The team often struggles to respond effectively to residents’ needs, especially in emergency or challenging situations.”

During an observation of care, a person asked a staff member for assistance. They then made the same request to a second staff member as the first staff member had walked away, finally a third staff member came to support them. The person told us, “It’s always like this, they will stand around looking at each other.”
 

The service did not always care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

Staff spoke openly of a divide within the team. Some staff indicated this was linked to religious and cultural differences, others felt it was due to shortfalls in leadership. Comments included; “There is a lack of professionalism, and often, people are spoken to inappropriately - this includes both residents and colleagues. There is little sense of teamwork or mutual respect, which affects both morale and care quality.” And “Some residents don't get proper care…all the residents are affected really, some agitated residents don't get the care if they can't talk, sometimes staff don't use the hoist. But staff fear consequences if you raise anything.”

Multiple staff told us they felt unable to raise concerns, as when they had raised concerns previously these were dismissed or ignored by the leadership team including senior staff members and registered nurses. Other staff reported they had raised concerns about the day-to-day challenges of working at Muscliff Nursing Home and generally staff reported these were addressed by the registered manager.

Staff felt tension had escalated and this was now having a detrimental impact on the service provided to people.