Cheshire Support Services

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 the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first comprehensive assessment for this newly registered service. This key question has been rated 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.

Staff treated people with kindness, empathy and compassion and respected their privacy. Through our conversations with people, staff and our review of care records, we were assured people were treated with respect. Comments from people and relatives included, “They are nice people, they are professional, they are respectful,” “They are so helpful, they make me happy when they visit, I get on with them all, they do everything I ask” and “They speak to [Person] and make her feel at ease, if she is having a bad day, they talk to her.”

A relative described how staff ensured their loved one’s dignity was upheld. They said, “When our [Relative] visits the carers make sure [Person] is provided with privacy when they are carrying out personal care."

The provider did not always implement effective processes to make sure people were treated as individuals or to make sure people’s care, support and treatment met their needs and preferences. For example, the widespread shortfalls found with the quality of people’s individual care plans did not always assure us people's individual preferences and wishes were planned for and delivered.

We received mixed feedback from people in relation to effective communication. Some people told us they had no issues communicating their needs to staff whereas other people told us about communication barriers that affected the clarity of information shared during care calls. Comments included, “I think it is a language barrier sometimes” and “There is a language barrier, the carers do not understand what [Person] is saying, things get lost in translation.”

However, based on the overall feedback provided, we were assured this did not have a significant impact on people’s care needs being met. We shared our findings with the registered manager who committed to undertaking reviews with people to gather their full experiences of the care provided.

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. Staff did not have access to adequate information about people’s health and wellbeing needs or guidance to ensure people’s care remained safe, supportive and enabled people to do the things that mattered to them. We received mixed feedback from people and relatives regarding promoting people’s independence. For example, a person told us, “I do the exercises the Physio gave me, the carers watch me and encourage me.” However, a relative told us, “They don’t encourage [Person] to stay out of bed, they should be doing more, it is doubtful that they know [ Person’s] likes and dislikes, I keep prompting them."

Staff responded to people's immediate needs and took appropriate action to minimise any discomfort, concerns or distress. People received care and support from a consistent staff team. Our conversations with staff found they knew people well. Our review of care and incident records showed staff supported people effectively in the moment and took the right action to minimise the impact on their health and emotional wellbeing.

The provider did not implement effective systems to promote staff wellbeing. Staff were not always provided with the necessary information about risk or training to equip them to carrying out their roles. In addition, rotas were not managed effectively so staff could meet people’s needs while ensuring their own wellbeing.

Community based staff described the negative impact ineffective rota management had on their wellbeing. Staff described how they did not always receive their rotas in a timely manner which affected their work life balance. They described how they had to work through their breaks to complete the care calls they had been assigned. Our review of call data corroborated staff feedback as care calls were not well planned to ensure travel time to reduce the risk of staff rushing. Records showed some community-based staff had not been effectively supervised as supervisions had not taken place for several months. For staff new in their role, their first supervision had not taken place in a timely manner to ensure they felt supported in their roles. The registered manager was honest about supervision shortfalls, and we were assured recent action had been taken to meet with staff to discuss their role and support needs.

Staff who were usually based in the office told us they regularly covered care calls and described how this impacted on their governance roles. Our review of the call data showed they covered many emergency calls with one person’s rota showing they worked for 19 days consecutively without a day off. This increased the risk of ‘burn out’ and did not promote positive wellbeing.

We shared the themes with the registered manager who committed to improving current working practices. They provided assurance additional staff were being recruited to ease pressure on existing staff and that discussions would take place to identify where further improvements could be made to support staff.