Mount Ephraim House

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.

This is the first 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 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 kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

We had mixed views from people and relatives about the care people received. Relatives commented, “I just think that they could do better. For example, when I last visited, I found Mum lying on her bed with her shirt partially done up and it looked as though the staff could have done better with washing her face and dressing her. I don't think the staff have found enough techniques to do what is best for her” and “I think they are very kind and respectful. From what I have seen, they are very respectful in the way that they interact and communicate with the residents.”

Although the feedback included that people liked some care staff and thought they were kind and caring, this was not consistent, and people told us some staff appeared to do only what was needed. People and relatives overwhelmingly commented that the numbers of agency staff and therefore lack of consistency impacted their experience of living at the service.

Some relatives told us they had overheard conversations about other people between staff in communal areas.
We saw some staff acting with kindness. During an activity that was female focused, 2 gentleman who did not want to join in were sitting in the same communal area. Staff kept going over to check on them and make them cups of tea.
 

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People did not always feel they were treated as individuals and said they felt some staff, but not all, were task orientated and did not always spend time with people, chatting or taking time to support people with interests or hobbies.

Some relatives told us their loved one was happy with the activities available to them to be able to pass the day, but others felt people did not get the opportunity to engage in activities to stimulate and interest them. The comments we received included, “The activities team try hard, they do the best they can. I have a lot of time for them, but it is all a bit samey”, “The permanent staff know him and what he likes, and they do try and accommodate that. It is mainly the agency staff who don't know him. We very rarely see the same carer there on his floor. I think there is quite a high turnover of staff.” A relative told us they had raised their concerns with the management team in relation to meaningful activity for their relative and wanted them to be supported to go outside to get some fresh air. However, this did not happen.

Some people’s care plans were focused on the individual and included their previous lifestyle and their likes and dislikes through their life. This meant staff, including agency staff, would be able to refer to this to encourage people to take part in activities that may interest them. However, not all people had this level of detail in their care plan to encourage staff and agency staff to engage on an individual basis.

There was a selection of magazines available in a communal lounge, covering various interests such as gardening, business and cars, and DVD’s and board games.
 

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.

People and their relatives told us people were not always encouraged to maintain and increase their independence. Although some people had access to a physiotherapist when their mobility was poor, for example after a fall, people and relatives told us encouragement to complete exercises was not supported by staff. A relative told us their loved one’s mobility was not improving as they did not have a clear plan to increase independence. They said improvement in mobility only happened for their relative because they kept complaining.

Some people’s care plans detailed their choices and preferences. For example, a person's night-time care plan stated they had chosen to have bed rails at night. It was clear the person was able to make this decision themselves and felt safer using this equipment. A relative told us, “They are very much able to give them a choice, but they forget what the question is because of the dementia. They (staff) won't force them to do anything, but that limits them as to what he does.”
 

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

People and relatives told us their needs were not always attended to as quickly as they would like. A relative told us their loved one had told them they were often left sitting on the toilet waiting for assistance to go back to bed, particularly during the night.

Another relative said, ‘’One of the problems of getting mum down to the dining room is that she says that she is left there after lunch has finished as nobody is free to take her back to her bedroom. That is Mum’s perception which has made her feel very agitated. It is the same when she is in the bathroom, as she says no one ever comes.” Some people also told us they often saw people sitting in the dining room after lunch was finished and everyone had gone, waiting for staff to take them where they needed to go.

Other comments from people and relatives about the lack of a timely response from staff to provide assistance included, “I have used the call bell but not much, sometimes it takes over 10 minutes, but it can be quicker than that it depends what they've got on I suppose”, “Mum has a call button, and she has said that at weekends if she does use it, it can take a long time for somebody to come” and “I don't think there are enough staff. Every time I go to visit, there are staff around, but I don't know who does what. My Mum is always saying that if she uses her buzzer, nobody ever comes.”

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.

Staff had not always had regular opportunity for one-to-one supervision with a manager which meant they did not always have access to a route to raise concerns and receive formal support and direction. Information provided by the provider evidenced limited staff meetings had been held to enable staff support, development and team building. Over the last 6 months only 1 staff meeting had been held and that was for activities staff only.
The staff team had to contend with a number of staff vacancies for a period of time. This meant a number of agency staff were used to cover shifts. Although agency staff were skilled and some attended the service regularly, there was a risk the lack of a permanent staff team may impact on staff well-being.
The provider had not evidenced they prioritised staff well-being and job satisfaction which carried the risk that staff may not always be in a position to provide good quality safe care to people.