Archived: The Chase

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 Inadequate. At this assessment the rating has remained 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 legal regulation in relation to person centred care and dignity and respect.

This service scored 30 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

Although we saw and received feedback of caring interactions by individual members of staff, the culture at the home did not treat people with care or compassion. People lived in an environment that smelt heavily of urine which had previously been identified but not addressed. We saw examples where people were not treated with dignity, for example 1 person had previously shared a room with another person. Despite having passed away a significant time ago, their empty bed remained in the room which acted as a constant reminder of them as well us taking up a large amount of space which the person could not use. The registered manager told us that they had discussed this recently, however had not taken action. People were recorded as going significant periods of time before being offered a drink or something to eat, or breakfast and lunch being offered in quick succession. We heard from a relative an example of person leaving the service with no underwear and relatives reporting concerns about how staff were not encouraging them to do so.

However people and relatives spoke positively about the staff who supported them, and we saw certain staff treated people with particular kindness. One person told us “The staff are lovely” and another added “Staff here are wonderful they can’t do enough for you”.

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.

People did not receive care that supported them to participate in activities that were meaningful to them, or aligned with their culture or faith. Multiple people were recorded as religious and their care plan emphasised how important their religion was to them, and that they wanted to support to continue to follow their faith. People were not supported to access organised worship either at the home or off-site, and the provider had not explored any other alternatives such as people joining a service virtually. Staff were not always knowledgeable about people’s wishes with one staff member stating “At the moment there aren’t any people who are particularly religious”.

Where people had hobbies they were keen to continue, there was no record that this was happening or opportunities to do so were missed. Four people were recorded as interested in gardening but although there was a small courtyard, the rear garden was heavily overgrown and access to people restricted by a coded door. The activities coordinator only worked on weekdays and though we were told staff would support with activities on a weekend, records showed no significant evidence of this. This was recognised by relatives with one stating “I have never seen activities on the weekends. People just sit there. There needs to be more consistency.”

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

There was inconsistent application of the Mental Capacity Act, and the provider could not always demonstrate that restrictions had been put in place such as restriction of items, equipment with a restraining effect or covert medications with an appropriate mental capacity assessment being undertaken. There were elements of choice present within the service, including around food options and a flexible activities schedule. But people were not being supported consistently to explore things that were meaningful to them, and were restricted from accessing certain areas of the premises such as the rear garden.

Leaders failed to ensure people had choices around their preferences of care. We noted from 6 people’s care notes over 2 weeks, that they were provided all of their morning personal care by night staff between 05.00 and 05.30 on the majority of days. The records stated that in addition to having a wash and their continence aids changed they were also having their teeth cleaned, hair brushed, finger and toenails checked and the ‘curtains adjusted for the time of day.

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.

We could not be assured that staff would be able to respond to people’s immediate needs, as there were concerns with staff deployment within the service and staff competency. Multiple people were cared for in their rooms on the upper floor and could not summon help if needed, yet there were no staff based on this floor. Where people had rescue medications such as for epilepsy there were instances where there were no staff on duty assessed as competent to administer this during a seizure. People were recorded as regularly going long periods in the morning before being able to access food or drinks. Another person was recorded as needing to have their mouth refreshed regularly due to their declining health, but there was no record of this happening.

The provider did not always care about or promote the wellbeing of their staff.

Although staff we spoke to stated they felt supported, we found that they were not given the training or skills to allow them to deliver care safely. Where incidents happened that increased the risk to them such as violent behaviour directed at them, these were not always appropriately monitored or learned. There was a system of supervisions to monitor staff welfare, but this has not led to staff being able to deliver high quality or person-centred care.