Archived: Fitzwilliam Care Centre

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, dignityand respect. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to 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 personalised care and failing to consider people’s individual needs.

This service scored 35 (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. The manager did not always treat relatives or colleagues from other organisations with kindness and respect. Feedback from people and relatives about the quality of care and how people were treated was mixed. Some people told us they were treated well and staff were lovely. Other people told us some staff were disrespectful and dismissive in how they spoke and neglected their care needs. For example, positive feedback from people included, “The [staff] here work hard, look after us well and will sort out most problems they are more like friends.” A relative said, “They have got all new [staff] and they all seem very good; they seem a lot more caring. [My family member] loves the staff; they laugh and joke with them.”

Other people and relatives did not feel so positive. A relative said, “I visited one day and my [family member] was lying horizontal spooning food into their mouth. They need assistance to eat as don’t have full use of their hands; it was such a choking hazard.” This would suggest the person had been left without staff support during meal times. Another relative told us, “Another concern and most importantly; my [family member] was told by 1 member of staff that if they continued their behaviour they would be sent to the dementia ward. We told another member of staff; that’s the only thing that has been sorted.”

While staff came across as kind and patient, care notes showed staff responses to people's distress was often dismissive and disrespectful with no follow up actions noted and no monitoring or analysis of people's responses, highlighting staff's lack of training, skills and experience.

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, unique backgrounds and protected characteristics. A relative said, “There has been a lot of upheaval which has been on-going for a long time, lots of staff have left. Some of the old staff knew how to [support] [my family member]. They knew their ways; it was much more personal. Staff now don’t know who I am or who I’m visiting. It has changed a lot since they have begun taking on [people with mental health conditions] upstairs.”

Staff were not always aware of people’s needs and preferences or how to encourage them to learn. A staff member said, “Nothing is done to support [people who are] neurodivergent. We are not given any brief about people to know how to support them. I wouldn't know if someone was neurodivergent as not given information.” A person told us, “I would like to be treated like an adult and be trusted but I feel I need support with my choices. [Staff] can't be controlling you or stopping you but they should be supporting you. I get annoyed if I get treated like a baby.”

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing. We observed some positive interactions but a lot of missed opportunities for staff to teach or motivate people to learn skills such as cooking and cleaning. Staff took a ‘do for’ approach rather than encouraging people to do what they could for themselves. A person told us, “The support is not great, staff are taking me to places but they are not helping to prompt me to do things like clean my bathroom or my room. I am pretty sure I am supposed to have 1:1 and I used to know who is my 1:1 but [staff] don’t ask if I need help with anything they are just leaving me to it.”

One relative was concerned about the impact of staff not supporting their family member to learn the skills they needed. They told us, “[My family member] likes to get out and do things but could never go anywhere as they have no staff. My family member’s hair is matted, their clothes are filthy, their bedroom is a mess, there is just no care at all. The [staff member] who seems to care is a [member of the housekeeping team]. They listen to [people] when they are talking.”

People's daily care entries demonstrated very little meaningful activities on offer to provide occupation, develop skills for independence and maintain self-esteem and self-worth. People’s care plans did not include hobbies, interests or aspirations.

For 1 person cared for in their bedroom, activities were limited to loved ones visiting and taking them out, the television, occasion visits to the lounge area and staff providing personal care for brief moments. A relative told us, “[My family member] wanted to go swimming but couldn’t as not enough staff, they leave them in bed all day as it's easier. I go there in the late afternoon and tell them to get up and shower and do something and pick them up and take them out otherwise they wouldn't get out.” Another relative said, “[My family member] knows that they have to get up and get themselves a cup of tea. There was a bit of treating staff like a slave when they first went there but it is easier for the staff to just leave them all in bed.”

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. Records showed no evidence of staff trying to reassure people in distress or seek to establish any solutions with people which could have reduced their levels of anxiety.

Staff completed daily care records which demonstrated a lack of responding to people's needs and concerns. This included on 1 occasion a person being dismissed by staff for raising a concern about sexually inappropriate behaviour of others in a communal living space. Staff had not considered already known risks and triggers to distress, for the person reporting the concern, and for the people involved in the behaviour. Staff records dismissed the person’s concerns, recording this in someone else’s care notes and informing them to stop making assumptions, despite evidence to the contrary. This placed people at risk of abuse.

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 told us they didn’t always feel safe at work due to the distress expressed by some of the people who lived in Fitzwilliam Care Centre. Staff told us they had not received training in how to deal with such situations.

Staff feedback about how they were treated was also mixed. Some staff told us they felt well treated and were supported in their roles and other staff told us there was no support and they were placed under a great deal of pressure resulting in them becoming mentally unwell themselves. For example, positive comments included, “No [well-being initiatives]. But if I had a problem, I could speak to the manager and get some time off or something. Team building would be a good one, would be fun.” And, “I feel supported. Always an open space to speak to the manager any time you feel like you have any views or concerns and want to improve services.” However, other staff felt less supported. They said, “I Don't feel supported, everything is turned back on staff and being staff at fault. Staff morale is really low. There is a climate of fear for staff to speak out, particularly as staff are on sponsorship.” And, “No, well-being support doesn't exist. Never had a wellbeing call or anything. Not aware of other staff offered support after incidents.”