Herondale

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 were not always well-supported, cared for or treated with dignity and respect.

This service scored 50 (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 dignity and respect. The provider had addressed some of the issues we found at the last assessment, However, improvements had not been made to the repair of the bathroom facilities and there were not always enough staff available to support people when they needed it.People told us the staff were kind and caring. Staff knew people’s personalities and likes and dislikes well. A person told us, “I really like [name of staff member], they help me make my lunch.” Another person said, “Staff treat me well and they help me when I need it.”

People were comfortable around staff and able to approach them. We observed people chatting, laughing and participating in lunch preparation. Personal care support was provided discreetly as and when people needed it. A staff member told us, “You always know when [name of registered manager] is around as they are very humorous, and you can hear staff and people laughing together.” The new key worker system was starting to work well, and staff took responsibility for updating people’s care plans. A staff member said, “I really enjoy being with [person’s name] and getting to know them better. I try to capture all what they say and changes to their needs.”

The provider did not always treat people as individuals as some systems in the service appeared institutional and not progressive. For example, having the kitchen locked at certain times without consultation with people, sleeping in staff not being available to support people individually after 9.30pm until 7.00am and people going to the office for their medicines.Whilst people’s bedrooms were decorated according to their preferences, there was no evidence of people’s individuality in the shared space of the service, such as photographs, artwork or decoration of any special events having taken place.

People had the space to do what they wanted around the house and to access the community independently if they were able to. Meetings of people who used the service were now more regular and held every month. People’s ideas and views were discussed; however, full notes of each meeting were not always documented as a record of the meeting. It was not always clear what had been actioned and what the outcomes were.

Most of the care plans we viewed were written from the person’s individual perspective with some good examples of person-centred care noted, whilst others did not always evidence people’s views about their care and support. Improvements to the daily care records were still needed to record people’s feelings and views of their daily lives.

The provider did not always promote people’s independence, and have choice and control over their own care, treatment and wellbeing. People had mixed views about the support they were given. A person said, “I like to go out for a walk, but I can’t often go out when I want.” Another person said, “I have my lunch and dinner, it’s usually a set time, but I can choose what I want.”

Most information about people’s personalities, backgrounds, communication needs and protected characteristics such as their culture and religion were recorded in their care plan. However, risks to some people’s safety and people’s capacity to make decisions and how to support them with this were not always assessed and documented.Staff were aware of the effects of the cleanliness and hygiene of the service and had involved people in how to be part of making their home more comfortable. The rota for specific areas of the service was working well, with people and staff taking responsibility and working together. A staff member said, “People are starting to do more, like making a sandwich with help, doing more chores and chatting with each other. It’s good that everyone gets on together.”

People were supported to maintain relationships and had access to their families and friends. People had visitors to the service and families were actively encouraged to visit. There were no restrictions on visiting.

Staff responded to people’s requests for support and took time to communicate and engage with them about their immediate needs. A person told us, “I do my own washing, they give me a washing tablet but everything else I do myself, but if I need help, they do help me.”Staff knew people well and could anticipate what they needed and how they liked their support to be provided. They responded to people’s needs quickly enough to avoid any preventable discomfort, concern or distress. However, staff were not always proactive in finding alternative and positive outcomes for everyone when their needs could not be met.

We observed staff providing genuine gentle exchanges with people which were affirming of what people were saying or doing. Any changes to people’s needs such as a deterioration in their health were escalated to the appropriate agency for action.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care. People did not always receive safe, effective and person-centred care as the provider did not recognise and meet the wellbeing needs of staff. These included the necessary resources and facilities for safe working practices. Adequate support was not provided to the registered manager and staff after the findings of the last assessment. A staff member told us, [Registered manager] does a lot more admin now, but not really supported by anyone in the company.”

Whilst regular team meetings had been put in place, there was a missed opportunity for the provider to support staff to be fully engaged in improving the service. Processes to manage staff wellbeing and take the necessary action were lacking. This had an impact on the care being delivered to people. The provider lacked some aspects of having a diverse workforce to meet the diverse needs of people.