Archived: Lyme Regis 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 requires improvement. At this assessment the rating has remained requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (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 always ensure that people’s privacy and dignity were respected, particularly in relation to how people’s belongings and personal care items were managed.

Staff were kind and caring in their interactions with people. However, we observed that people’s belongings were not always treated with care. In several rooms, clothing was crumpled and piled in wardrobes, personal items were covered in dust, and some belongings, including gifts and food items, appeared unused or out of date.

We also saw personal care items, including incontinence pads, stored in full view within people’s rooms. This did not consistently respect people’s privacy or dignity. These findings demonstrated that, while interpersonal care was compassionate, people were not always supported to maintain their personal environments in a way that upheld dignity and respect.

The provider did not always ensure that care planning was sufficiently person‑centred or responsive to people’s individual needs, preferences and circumstances.

We identified an example of a person who was newly admitted to the service, experiencing anxiety, episodes of incontinence and receiving end‑of‑life care. Their care plan directed staff to complete four‑hourly checks throughout the day and night. This did not reflect the person’s known anxiety, personal care needs or the increased level of support required during admission and end‑of‑life care.

Although staff were still getting to know the person, the care plan was not reviewed or updated in a timely way to ensure guidance was person‑centred and reflective of the person’s needs and preferences. This limited assurance that care and support were planned and delivered in a way that treated the person as an individual.

The provider did not always ensure that people were supported to maintain independence, choice and control over their care and wellbeing.

A call bell system was in place to enable people to request support. However, we identified several occasions where people who were cared for in bed did not have their call bells within reach. Call bells were positioned at the bottom of beds, hung on wall hooks at the foot of beds, or trapped under furniture, meaning people were unable to summon help when needed.

In addition, one person was unable to operate the call bell when it was placed in their hand, and there was no evidence at the time of inspection that alternative arrangements had been assessed or implemented to ensure they could request support. These findings demonstrated that systems were not consistently implemented or individual needs adequately assessed to promote people’s independence, choice and control.

The provider did not always ensure that people’s needs, views and wishes were listened to and responded to promptly, or that distress and discomfort were minimised.

As set out in the previous quality statement, people did not always have access to a suitable call bell. Some people who could potentially use a call bell did not have one within reach, while others had a call bell available but were unable to operate it. This limited people’s ability to request support when needed.

Care records showed that people were routinely checked approximately every four hours. For people who were anxious, required personal care, or were unable to summon help independently, this meant there was a risk they could be left in discomfort or distress between checks. A relative told us that their family member could not operate the alarm system and that staff had been asked to visit every half hour. They also raised concerns about whether their family member was receiving sufficient fluids, as they required support with all drinks.

While staff were present within the service, these findings demonstrated that systems were not consistently implemented or evidenced to ensure people’s needs were responded to in the moment.

The provider did not always ensure that staffing arrangements and support structures enabled staff to consistently deliver person‑centred care or promoted staff wellbeing.

Staffing numbers were the same as at the previous inspection. This meant that, particularly at night, staff had limited capacity to spend quality time with people or respond flexibly to individual preferences. For example, a care plan stated that a person liked to sit out at night and have tea with staff, which was not happening in practice.

A number of staff lived in onsite accommodation. At the time of inspection, the provider advised that three night staff could evacuate people safely with support from staff living onsite. However, we were not provided with evidence at the time of inspection to confirm how this arrangement was agreed or assured, which limited assurance that emergency arrangements did not place additional expectations on staff during off‑duty time.

We received limited feedback from staff, although one staff member spoke positively about the manager’s efforts to secure resources to support the team.