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 inadequate. At this assessment the rating has changed to requires improvement. This meant people were not always treated with compassion and there were breaches of dignity.
 

This service scored 40 (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 failed to consistently deliver care that was respectful, dignified and in line with people’s assessed needs. For example, a person’s care plan required staff use a ‘retreat and return approach’. We heard the person telling staff in their room to ‘go away’ multiple times. However, staff remained in the person’s room.

Staff did not always take time to communicate with people and respond to their distress with compassion. For example, when a person was visibly distressed due to feeling anxious about plans for the day, a staff member spoke with the person, they continued to walk around in distress and staff failed to offer any further support.

In response to findings at our previous inspection, the provider confirmed staff had received training in relation to dignity and respect. To check learning, the provider planned competency checks, where interactions between staff and people would be observed to assess how dignified and respectful they were. However, the provider had failed to implement the observations consistently and meaningfully. For example, records did not always confirm observations were completed in line with the provider’s schedule and where observations were documented, information was incomplete. When poor practice was identified, the provider had failed to act to drive improvement. We raised these concerns with a member of the management team who said, “Observations are ad-hoc really, this week a member of the leadership team is here 3 days and will do some more observations, we try to take anything forward in the staff meeting.” Meeting minutes we reviewed did not contain feedback for staff in relation to care observations.
 

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

The service did not consistently promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.
Care plans did not always provide staff with consistent information and guidance about how to promote people’s independence, choice and control. We found conflicting information in people’s care plans. This increased the risk people may receive inconsistent support from staff who could not be sure about which guidance would maximise positive outcomes for each person. The manager was directed by inspectors to make safeguarding referrals for 3 separate serious concerns where care was not provided as outlined in people’s care plans.

In response to findings at our previous inspection, the provider had displayed posters throughout the service outlining the ‘powerful and positive language’ staff should use when describing people. However, at this inspection we found staff continued to use stigmatising language that failed to consider how people’s health conditions resulted in behaviour that may distress others. Language included references to people being ‘challenging’ and aggressive’.

Health and social care professionals told us, “Documentation of people’s activities and care continues to be inconsistent even though the provider says their audits are identifying this” and “There appears to be little evidence of meaningful change.”
 

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

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

At our last inspection, staff told us tension had escalated, and this was now having a detrimental impact on the service provided to people.

Staff told us team morale remained extremely low. Comments included, “We are so scared and stressed all the time”, The new manager is really trying but it’s a hard time” and “Things are really difficult. We have lots of agency staff as we do not have our staff here, but everyone is trying to do their best.”

Staff were unaware of the improvement plan and were therefore unable to contribute to identified actions. For example, staff with line management responsibilities, had failed to complete immediate actions, including undertaking supervision with staff about best practice. Records reflected 12 staff member’s supervision meetings were overdue. This demonstrated the providers action plan was not always being implemented effectively, and the provider was not consistently identifying these shortfalls.

Staff had been given factually incorrect information by leaders of the service and concerns raised by staff during team meetings and supervisions had not always been acted upon, a number of supervision records viewed did not demonstrate a two-way dialogue with staff. The provider had failed to identify these shortfalls. Following our feedback the provider arranged to meet with all staff and provided evidence staff were encouraged to share their views.