Archived: Purbeck House Care 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

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this service. This key question has been rated inadequate. This meant people were not treated with compassion and dignity.

At this assessment we reviewed all the quality statements for this key question. We found the service was in breach of legal regulation in relation to dignity and respect. Our findings detailed in this quality statement also supported the breach of the legal regulation in relation to person-centred 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 provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

People were complementary about the staff and told us they were treated kindly and with respect. People’s comments included, “The staff are all lovely”, “The staff are great, they really help” and “I have no concerns, I’m very happy. If there was anything I wasn’t happy with I would tell them.” A relative told us, “[Provider] and [Nominated individual] are great and really helpful.”

During our visits we observed the provider and nominated individual (who was also a member of the care staff team) were keen to engage people in meaningful conversations. However, we found care staff appeared more reserved to do this. Although we heard staff talk to people with kindness and respect, we found most conversations between people and staff were about specific care tasks. Apart from a conversation with two people about shopping for clothes and later about a lunch outing they were having, there was limited conversations with others about their interests, hobbies and personal experiences.

We could not be assured staff knew the people living at the home well. People’s care records contained very limited information about people’s personal history, backgrounds and goals, and some staff members were unable to tell us about people’s likes, dislikes and things they enjoyed. Throughout our visits we observed staff had opportunities to engage people in activities they may enjoy and potentially build positive relationships with people; yet these opportunities were not acted upon.

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.

Some people and relatives told us they felt they or their loved one was treated as individuals and their wishes, choices and abilities were respected. However, we could not be assured this was the case for all people, particularly those who had limited communication or a cognitive impairment.

People’s care records lacked information about people’s likes, dislikes, interests, abilities and wishes and did not contain detailed information of how they liked to receive care and support. Care plans did not always contain sufficient guidance for staff to manage specific conditions and enable them to provide consistent and effective support to people. For example, people living with dementia had no detailed information in their care plans to support staff to understand how their dementia impacted them as a person and how to support them through their dementia journey.Within two people’s care records it was noted they were living with a learning disability, however when this was discussed with the management team and staff, they were unaware of these learning disabilities and how they affected these people. This meant we could not be assured these people would be provided with individualised care to meet their needs.

People had little to occupy them on a day-to-day basis. There were no records of activity provision, and we did not observe any activities taking place throughout our visits. Other than assisting people in practical tasks, we observed little interaction between staff and people other than the television being on most of the time.

The activities board described weekly visits from the local school however, we were told this had not taken place in almost a year. Whilst the provider told us that they did take people out there were no records to demonstrate that people who needed more support to access the community were included in this.

Feedback received included, “There is not enough to do” and “there needs to be more activities as there is nothing to do unless I go out. There was a singer at Christmas which was good but nothing since.” We were not assured that people received daily stimulation which placed them at risk of social isolation.

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.

We could not be assured people’s choices and wishes were respected or that they were supported to be independent. This was because people’s care records did not contain personalised and up to date information, lacked detail about their likes and dislikes and the level of support they required and did not include personalised information of what was important to them.

We observed staff not offering choice at mealtimes for those who found it difficult to choose verbally and when the meal was provided, staff did not always check the person was happy with what had been given. Although we observed staff supporting people with their meals, the engagement from staff to provide verbal prompts and encouragement at mealtimes was lacking.

People were not always given the opportunity to choose how they spent their time. Throughout our visits there were no activities provided to people unless the people had the ability to sort these independently, for example if they were able to request a game to be set up or could access this themselves. Where people were unable to do this, they were left with the television on, although showed little interest in this and given limited choice about what to watch.

On a number of occasions, we observed a person standing from the chair they were sat in, they were frequently told by staff to ‘sit down.’ Staff did not make any attempts to consider why the person was standing or give them the opportunity to move around.

Staff had not received training on promoting independence.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Most people and relatives told us staff responded to changes. However, records demonstrated staff had failed to identify, act on and escalate concerns to partners in a timely manner where required. For example, no records were available which demonstrated action had been taken when people had experienced periods of constipation or pain, excessive weight loss or weight gain and showed signs of potential impaired swallowing. This meant people were at continued risk of serious harm and ill health.

The management team failed to provide evidence that effective processes were in place, to demonstrate people’s immediate needs were responded to in a timely manner. For example, the call bells were not always appropriately positioned to allow people to summon assistance in an emergency. Although the provider had taken steps to address this by issuing some people with call bell wrist straps these were only used by people who requested them and had the ability to use them. This meant, some people’s welfare and safety was dependent on observation checks carried out by staff or people calling out for staff if they needed assistance. Additionally, people could not always call for staff to support them in a timely way with their continence needs which impacted on their dignity.

The provider did not always support or enable staff to deliver person-centred care.

The management team told us supervision was provided regularly to staff and staff confirmed they received this. However, when we requested supervision records the provider was only able to provide these for one staff member. On review of these they reflected the last supervision for this staff member was February 2024. Therefore, the provider was unable to demonstrate formal supervision was provided frequently to staff.

Due to the limited information within care records in relation to people’s specific needs, lack of effective training provided to staff and basic and limited inductions we could not be assured staff were supported or enabled to deliver person-centred care.

Staff were positive about working at Purbeck House and felt supported, respected and valued by the provider and nominated individual. A staff member told us, “I feel respected and am treated well by the management team. If I did have any issues or concerns, I would feel more than comfortable going to them, I’m sure they would listen and act if I needed them to.” Another staff member said, “I love working here, [Provider] and [Nominated individual] are trying so hard, they are passionate about care and really want to get it right for people. They are very personable, always listen to us and if something is needed, they will act straight away.”