Palace House 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 service 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 remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

Care plans held a record of people’s preferences and a wide range of activities were available to keep people occupied and prevent social isolation. Staff knew how to communicate with people and relatives felt people’s needs were responded to.

Staff told us they were treated well by the management team and felt the care people received was of a good standard.

Concerns were found in relation to ensuring people’s dignity was maintained, however, we observed staff to be kind and considerate towards people.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service always treated people with kindness, empathy and compassion, however, there were times when people’s dignity was not maintained. We witnessed staff on several occasions assisting people with their meals by standing over them rather than sitting at eye level. We also witnessed people’s bedrooms doors being left open when their dignity was not maintained. We spoke to the registered manager about this during the site visit and this was rectified immediately. We did observe staff to be helpful and welcoming. There was a calm atmosphere and people appeared relaxed around the staff team.

People felt staff treated them well. One person said, “I cannot fault it here, I can’t complain at all. All the girls (care staff) are nice. They have a lot of patience; the staff look after me well, they are very caring and treat you with respect.” Relatives told us staff interacted well. One relative said, “All [person using the service] wants is a kind word and a kind hand and they are very good at that here. The care is amazing.” Staff told us people were treated well. One staff member said, “It’s a very nice place to work. We talk to people during mealtimes, activities and whenever we can. There is a good culture at this service, everyone is kind and happy.”

The registered manager said they oversee care delivery by regularly going into communal areas and observing how staff interact with people. The importance of treating people with kindness and compassion was discussed at daily handovers. Partners said staff were kind to people. One partner said, “From what I have seen, staff treat people well. I have never witnessed anything unpleasant, and staff are always gentle towards people.”

The service treated people as individuals and made sure 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. People felt staff knew them well and respected their individual needs. One person said, “The food is amazing. [They meet my particular needs with regard to meals]. The staff are great. I like to have a laugh and a joke with them, they are very kind and attentive with me and look after me well.” People also felt staff treated them as individuals. One person said, “They are like my family (staff). You only have to ask for something and they will get it for you. It’s a good place to be.”

Staff told us people’s individual needs and preferences were adhered to. One staff member said, “Some residents don’t speak English as their first language. We have staff that can speak to them in their native language. Dietary requirements are adhered to and special occasions are celebrated for all religions such as Eid parties and Christmas parties. We invite families as well.” We observed staff to be kind and considerate towards people. When people were experiencing periods of distress, staff were on hand to provide comfort and divert the person to another activity such as going outside for a walk or having a chat with them. This supported the person to feel safe and calm.

Care plans held a record of people’s religious and cultural needs. Life history sections of care plans were detailed and prompted conversations such as what the person liked to do, their previous work history and important people in that person’s life.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. People told us they were always offered a choice. One person said, “If you had a preference of male or female carer I think you could say.” People also spoke about being offered a choice at mealtimes and felt comfortable asking the staff or the management team for anything they may need. One person said, “It’s very easy going here we can do what we want really.” Staff spoke about promoting people’s independence. One staff member said, “We encourage people to be independent, we reassure them and help them to do things for themselves. We make sure they feel safe.”

We witnessed a range of activities taking place during our site visit including a singer in the lounge interacting with people and staff dancing with people. We also witnessed staff throwing a ball to people and more relaxed 1-1 stimulation including people colouring or reading. Staff told us activities were planned by asking people what activity they would like to do and obtaining the resources to do it. Care plans held a detailed account of how people liked to spend their time and what their preferences were. However, daily notes had limited information on what activities people had attended. A weekly activity calendar was on display in the lounge as well as pictures of people joining in with activities. Visits of loved ones were actively encouraged and we witnessed many relatives visiting during our site visit.

The service listened to and understood people’s needs, views and wishes. People and their relatives felt staff responded to their needs well and that they would be kept informed of any changes. Other relatives told us staff ensured regular checks were done on their loved ones who could not use their nurse call bell to alert staff they may need assistance.

Staff felt people’s needs were responded to and knew how best to communicate with people. One staff member said, “If someone cannot communicate verbally, they use facial expressions or gestures. We know them (people) well and can sometimes anticipate their needs. We also reply using gestures so they understand us.” We observed staff to be attentive to people’s needs. However, there was one occasion during our site visit where a person was shouting for help and staff did not respond in a timely manner. This was rectified during the assessment process.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. Staff told us they were treated well by the management team and did not feel under pressure. One staff member said, “They (management team) treat us well here. I have no complaints. I like working here. There is no pressure to work extra shifts.” The registered manager explained how staff were encouraged to become a trainer for various subjects such as oral care or pressure care so they could train other staff in this area. There was also a champion scheme where staff were encouraged to take the lead in different areas including infection prevention and control. The staff member then becomes the go to person for staff to raise any concerns and to complete auditing processes. A range of training courses were available for staff to enhance their skills and knowledge. The directors visited the service regularly and when staff bonuses were given, this also included agency staff.