Blythgate Manor

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 service involved people and treated them with compassion, kindness, dignity and respect.

This is the first inspection of this service. This key question has been rated outstanding. This meant the service is exceptional at maximising the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

This service scored 90 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff treated people with kindness, empathy and compassion. Staff communicated with people in a caring and compassionate way. They gave people time to respond, listened to them and provided sensitive support to ensure people's needs were promoted. Regular staff knew people very well and recognised any changes in their well-being and advocated with relevant professionals where needed. Staff always treated colleagues from other organisations with kindness and respect. Professionals’ comments included, “I have found the registered manager and deputy manager to be most welcoming and helpful”, “Staff are consistently friendly on arrival at the home” and “All staff typically seem knowledgeable, pleasant and motivated and are a pleasure to work with.”

Staff treated people as individuals and ensured people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Detailed person-centred information was collected about people's religion, likes, dislikes and any cultural preferences. Staff were aware of and had an in-depth understanding of people's needs, anxieties and aspirations. Staff established consistent and trusting relationships with people which enabled people to relax with the support provided. Staff had received training in equality and diversity to emphasise the importance of treating people as unique individuals with different and diverse needs. People received their care and support from a service which was entirely flexible and able to respond to individual requests and changes. Some people had complex needs and staff worked very well to improve the quality of life for individuals. A professional commented, “The team manage some exceptionally complex residents and consistently strive to meet their needs, working closely with professionals.” Another professional told us, “The staff demonstrate thoughtful and empathetic ways of dealing with difficult situations.” We observed some staff interactions with people. These included where a person was wandering around in and out of people's rooms and the staff member supporting them was unable to stop them. However, the nurse showed the staff member an effective intervention and the person returned to their own room. For another person we observed a staff member successfully de-escalate a situation and calm and reassure a person who had become disorientated and distressed. Another person, who had a very little appetite and did not want fluids was encouraged and supported to eat more. They eventually chose meals from the menu, so their appetite and strength increased. A professional commented, “For [Name]’s team, staff have excelled at understanding them as an individual. They have made a concerted effort to learn about [Name]’s complex needs and regularly tailor their responses accordingly. Staff are proactive in engaging with [Name] and display outstanding skill at de-escalating situations when [Name] is upset.”

There were several examples where people had been supported to enjoy a more personalised quality of life. For example, a person was reluctant to move into care, having experienced several personal losses. They preferred to stay in their room and avoid socialising. However, over time they developed strong and meaningful bonds with staff members. The person had an interest in dominoes and staff started a domino club that they attended in communal areas. This started their interest in joining other activities and coming to events held downstairs in the café. They were then supported by staff to go out into the community and follow hobbies they had enjoyed before moving into the care home. After the death of their relative they were supported by staff to make a memory booklet containing photographs and information of the people, places of meaning to them. The person is now confident in joining in with activities and makes friends easily, finding common interests with others during sessions. For another person who was suspicious and consistently distressed at any staff intervention, staff worked with professionals to build a care plan that supported them in the least restrictive way. Staff did this whilst maintaining the person’s safety and the safety of those around them. Staff were aware of triggers which enabled them to anticipate the person’s needs. They knew [Name] preferred to have a ‘lie in’ in the morning and were respectful of their wishes. Staff worked at [Name’s] pace, meaning they now accept personal care and other interventions. This has enabled the person to become more settled. Staff told us they are more relaxed and trusting and will now smile and nod and engage with people and staff. Staff also worked with, and supported, the person’s loved one to focus on building their own interests outside of the home.

Staff at the service were exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. Independence and autonomy were promoted, whatever the level of need, and this was at the centre of the care and support that people received. People were supported to achieve a level of independence and to be fully involved in decision making and control in their lives.

Detailed care records documented how people's independence was to be promoted. People were supported to aspire and to achieve a level of independence and to be fully involved in decision making and control in their lives. Staff empowered people to be in control of these choices which led to a wider range of experiences for people and positive outcomes. There were examples of where people had flourished and become more independent in terms of physical or emotional well-being. For example, a person who had been cared for in bed became more independent with staff support and physiotherapy and occupational therapy intervention, to assist them to start spending time out of bed. When a person whose first language was not English moved to Blythgate, staff arranged for a translator to assist with communication. Through improved communication, staff were able to gain a deeper understanding of the person’s emotions, behaviours, cultural background, personal wishes, and hobbies. Staff were also able to understand the signals and triggers when the person became anxious. The person was supported to continue with community visits. When their mobility reduced, staff collaborated with the occupational therapist and physiotherapist and with constant encouragement and support this person was able to walk independently with very minimal support. This support championed the person’s dignity and significantly improve their confidence. Other people had become less socially isolated as they were supported to build up trust and ventured from their room into other areas of the home to mix with staff and people. Some people chose to visit the local community. There were several examples where people were supported to manage their anxiety and distress, through individualised distraction techniques unique to them, which promoted their emotional well-being as they expressed themselves.

The activities co-ordinator sourced a wide range of individual and group activities and entertainment for people. This included pamper sessions, gardening, crafts, themed events, art, baking, dominos, music, pet and doll therapy, reminiscence sessions, quizzes and darts. A relative told us, “There is plenty to do but [Name] chooses to spend time in their room where they watch TV and does puzzles.” A person commented, “I have got a lovely view from my window, and I like to watch the world go by.” A professional fed back, “Blythgate Manor provides support for people living with an advanced dementia who can present with a range of often quite distressing and, at times, challenging needs. Staff make significant efforts to give reassurance and comfort where it is needed and work hard to provide people with meaningful activities that are suited to their individual preferences.”

Staff listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. Relatives confirmed this was the case. Staff worked calmly, compassionately and responded to people promptly. Staff worked very closely with people. They invested time in ensuring they were given the right level of support to promote their understanding. A person commented, “Staff come quickly if I need anything.”

The provider cared about and promoted the well-being of their staff and supported and enabled staff to always deliver person-centred care. The organisation was a caring and supportive organisation that had several initiatives and support groups in place to benefit staff. These included an employee assistance programme that offered a counselling service, programmes of health screening, financial and legal support, housing information, and a rewards and recognition scheme giving rewards to employees and training and development. A series of revalidation workshops were held to support nurses in preparing their applications to revalidate their nursing qualifications with the Nursing and Midwifery Council (NMC). Staff told us they felt valued and supported by the management team. Staff comments included, “I am happy working here” and “There is good teamwork.”