The Garth Care Home with Nursing

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 inadequate. This meant people were not treated with compassion and there were instances where people’s right to privacy, dignity and compassionate care was compromised.  We found the provider was in breach of the legal regulation in relation to dignity and respect and person-centred care.

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.

Whilst the provider had aims to provide the best care and the statement of purpose detailed “We will aim to maintain relationships which are warm and trusting between staff and service user; enabling choice and focusing on outcomes.” This was not demonstrated in how care was delivered. There were no clear aims or objectives for people, no structure or opportunities for people and a lack of warm and trusting engagement from staff. People we spoke with told us they were unhappy. We saw where staff did not appear to acknowledge other people in the area and there was a lack of awareness of people’s lack of satisfaction with the care being provided. One person had a toilet door open which faced into a communal area, staff walked past this and did not close the door until prompted by an inspector. We were not assured people were always treated with kindness, compassion or dignity.

The provider did not have an open, proactive and positive culture towards safety. They did not listen to concerns about safety. Where concerns over the care being provided had been raised by visiting professionals the provider had failed to identify the actions needed to address the concerns. Lessons were not learnt to continually identify and embed good practice.

The provider had not been effective in identifying the areas of improvement in the home environment to reduce the risk of people injuring themselves.

Accidents and incidents were documented; however, information was not clear or accurate showing differing accounts of incidents to what was recounted by people in the service or what was witnessed by other professionals. The clarity in the records needed to effectively detail, review and monitor the frequency of accidents and incidents in the service was not there. This meant opportunities to learn lessons from incidents and take action were missed.

There was no effective mechanism to gather and then act upon feedback from people in the service and their family members. This meant that opportunities to learn from people’s experiences and improve the outcomes for people were being missed.
 

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 had their bedrooms personalised and some people told us they were involved and had choices in their care on a day to day basis. Staff understood the principles of providing people with choices and control; however, our observations did not support that this was put into practice.

The environment did not promote person centred care. There was insufficient space for people to be sat or positioned in a way that encouraged interaction. Staff would position people in areas of isolation and would not proactively engage with people. Our observations through all of the days of inspection have shown people continued to be isolated and lacking in structure, activity or engagement from staff or others.

There was a lack of direction towards aspirations or meaningful activities in both the planning for and the delivery of care. Staff were task focused affording no time to positively engage with people. The registered manager did not demonstrate knowledge or an approach to speak with people in a way that was engaging or promoted healthy interactions and choices.

People told us there were no systems to enable them to have a voice or involvement in the planning and delivery of their care. There was no documented evidence to support people being involved in planning their own care or making decisions relating to their care and support. The provider did not demonstrate any mechanism or system to encourage feedback from people using the service.

The provider did not have an open, proactive and positive culture towards safety. They did not listen to concerns about safety. Where concerns over the care being provided had been raised by visiting professionals the provider had failed to identify the actions needed to address the concerns. Lessons were not learnt to continually identify and embed good practice.

The provider had not been effective in identifying the areas of improvement in the home environment to reduce the risk of people injuring themselves.

Accidents and incidents were documented; however, information was not clear or accurate showing differing accounts of incidents to what was recounted by people in the service or what was witnessed by other professionals. The clarity in the records needed to effectively detail, review and monitor the frequency of accidents and incidents in the service was not there. This meant opportunities to learn lessons from incidents and take action were missed.

There was no effective mechanism to gather and then act upon feedback from people in the service and their family members. This meant that opportunities to learn from people’s experiences and improve the outcomes for people were being missed.
 

Staff told us they had support and supervision relevant to their roles and no issues were raised by staff about how they were supported by the provider. However, our observations showed no encouragement or support to improve people’s outcomes. Information in people’s care records which should provide staff with the information to enable them to provide the right care for individuals lacked detail and contained links and information that was not relevant or centred on the person it was concerning. We were not assured there was adequate provision of information or guidance to staff to enable them to provide the best care and treatment to people in the service.