The Flowers Care Home Limited

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 breaches of dignity; staff caring attitudes had significant shortfalls.

The service was in breach of legal regulation in relation to promoting privacy and dignity for people.

This service scored 25 (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. Staff did not treat colleagues from other organisations with kindness and respect.
While we observed some kind and caring interactions from individual staff, overall the quality of care provided to people was poor. Staff were not consistently supported to improve their practice, and management did not provide clear guidance or oversight of care delivery.
On the first day of assessment, 1 person repeatedly asked staff for a personal item; their request was ignored, and they subsequently stopped asking. Around 07:00 the same morning, another person, who was visibly upset, asked to be returned to bed. Although staff attempted to support them to sit, they were not returned to bed as promised.
On the second day of assessment, a person reported night staff had turned off a movie they were watching and told them it was time for bed. The person was distressed and expressed they did not want this to happen again. While the concern was recorded on an incident form, it was not discussed at handover or acted upon.
Throughout all 3 days onsite, we observed people who were cared for in bed were not always positioned in a way that appeared comfortable or supported their safety. This placed them at potential risk of pressure damage and discomfort.
A staff member also reported to us, “I got to work early and found [person] was swimming in urine, it was disgusting. Night staff said they had been busy with breakfast. I am upset I did not report this.”
 

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 were not consistently treated as individuals or supported to maintain their dignity and privacy.
During the inspection, we observed people were not always appropriately supervised. In 1 instance, a person accessed another person’s bedroom without staff awareness and interfered with personal belongings and the bed. While no one was present at the time, this demonstrated a lack of safeguarding and respect for people’s privacy.
Staff told us people were not consistently supported during the night, and some were left in soiled clothing or bedding for extended periods, compromising their dignity and comfort.
On another occasion, a person was observed to have swollen legs with skin breakdown, which had not been identified or reported by staff. The issue was only noticed by a senior agency staff member later in the day. This demonstrated a failure to recognise or respond to individual health needs in a timely way.
 

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.
People were not consistently supported to make choices about their daily lives or to maintain independence.
There was limited choice in food and drink. People were not offered options for meals, and snacks were not readily available for people to access independently.
Opportunities to participate in meaningful activities were restricted. Activities were primarily scheduled in the lounge, and there was little consideration of individual preferences or whether people wanted to take part. People were not consistently offered alternatives if they did not wish to join in.
People did not have control over their daily routines. Night staff reported that everyone was expected to be awake and ready for breakfast before day staff arrived, removing choice over when to get up.
People who smoked often experienced long delays in being supported to go outside for a cigarette due to low staffing levels. This meant people were unable to make timely choices about their personal habits and routines.
 

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.
People’s immediate needs were not consistently met, and staff did not always respond in a timely manner to changes in comfort or wellbeing.
During the inspection, some people were observed spending long periods of the day sitting in chairs in uncomfortable positions, appearing hunched over, and were not supported to go to bed to rest.
People were not always offered enough food at mealtimes. Some people appeared hungry yet were not offered additional portions or alternatives to meet their nutritional needs.
The service’s call bell system was unreliable. On 1 day of assessment, call bells only sounded downstairs, and on another of assessment they only worked for some people upstairs. This meant staff were sometimes unable to respond promptly to people requesting assistance, causing delays in care and potentially leaving people in discomfort or at risk.
Some relatives informed us they also believed there was a delay in their loved ones getting a response to request for support, with 1 relative informing us, “[Person] waits about 10 to 15 mins for support when they call for support.”
Staff did not reliably monitor or act upon people’s day to day requirements, but there was also limited oversight from management to ensure that these needs were met promptly.
 

The provider did not care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.
Staff were not consistently supported to maintain their wellbeing, and there was limited evidence of systems to promote a positive working environment.
One staff member told inspectors when they experienced severe health issues and required time off work, they were not offered any support or guidance on returning to work. They described being pressured by the then registered manager to return to work without any formal support.
Staff also reported they did not receive paid breaks during 12-hour shifts and that they sometimes worked for more than 7 consecutive days without a day off. We saw no evidence of provider- or registered manager-led support or guidance for staff over the past 6 months.
Feedback from staff indicated low morale, and they were not consistently supported to maintain their health and wellbeing, placing them at risk of fatigue and stress and limiting their ability to provide safe, compassionate care.