Houndswood House Care Home

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• 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 inadequate. At this assessment the rating has changed to requires improvement: This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 55 (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 treat people with kindness, empathy and compassion. The provider was in breach of regulation regarding dignity and respect at our last assessment. At this assessment we found there had been some improvement and they were no longer in breach of regulation.

People gave mixed feedback about staff. We were told, “Some are brutal they are not gentle; couple give you a hard time. They do not talk to me. They throw me around to what they need to do. They do not talk and are not friendly.” Another person said, “Its fine here, some [staff] are nicer than others. Some we talk and we joke. Some are not in a good mood.” We were also told, “The staff, I have not got fault with anyone. There is 1 staff member, [they are] the only 1 I do not get on with. Apart from that the staff talk to me, and they listen.”

We observed interactions between staff and people to be kind. Staff knew people by name and used them when talking with or about them. At our last assessment people had referred to people by their room number. We saw staff knock on people’s doors before entering and ensure they were covered to protect their dignity. However, some staff felt what we observed during our visit was not an accurate reflection of the service. A staff member said, “I see the staff talking over people across the room, across each other and not concentrating on the person they are feeding. Today is just a performance for you.”

People’s relatives gave positive feedback about staff. A relative said, “There are some excellent staff, they are caring attentive, we feel the care is really good.” Another relative told us, “I think the staff are kind and caring.”

Therefore, whilst we were not assured all people received kind, compassionate care at all times, we found it had improved since our last assessment. The clinical nurse had identified concerns over dignity and respect and was taking practical action to support staff to improve in this area, this work was still in progress at the time of our assessment.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff did not always meet the needs of people with communication needs. People had communication care plans. These stated whether people were able to communicate verbally and whether they had any sensory needs such as wearing glasses. However, we found a person with poor eyesight did not have anything in their room to support with this. Another person had communication cards, but we were told they did not really respond to them.

People’s care records included details of their preferences. This tended to relate to practical things such as how to support them with personal care or what they liked to eat. There was very little information about people’s background and any protected characteristics. However, they did list people’s social interests.

People’s care records included guidance for staff to promote people’s independence. Care plans described what people were able to do for themselves, such as eating and drinking and where minimal support was required with personal care there was very detailed guidance of people’s routines.

People were offered activities most days. We observed the activities coordinator engage some people with them. This included reading a book to someone in their room, doing an interactive game and quiz. We reviewed the activity logs and saw people who engaged with the group activities tended to participate in something most days or go for a walk with staff.

People said they were doing things of interest to them; most people who did not participate seemed happy doing other things. A person told us, “I don't like to go up to the communal area, no one talks to anyone, no contact so I avoid, I sit in my chair and watch TV. I am going for a walk in a while with the activity [staff]. I am past all the different activities I don’t really want to do them. I am happy, I feel safe.” Another person said, “I am happy here, happy relaxing.”

However, 1 person said the activities presented were not of interest. We reviewed their care plan and found they required encouragement to participate but preferred to stay in their room. It also said they enjoyed listening to the radio, but the person told us their radio was not working. Their wheelchair was too big for the lift, and they found it uncomfortable. Therefore, we were not assured they stayed in their room by choice or due to a lack of other options.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff did not always follow care plans of people with complex health conditions. We observed staff appeared not to know how to respond or protect themselves when people displayed distressed behaviours.

People’s care tended to be task focused. Staff had not always provided activity and engagement in line with care plans to prevent isolation. We observed staff responded to people’s requests, such as for drinks or assistance to re-position themselves but did not take time for more social interactions with people. A person told us, “I am happy, I can speak and ask for things, so I think that helps…I get everything I need.” They also said, “I feel safe here. If I am in my room, I press my buzzer, and they come within 5 minutes.” This was less clear for people who may not be able to ask for assistance. A relative told us, “[Person] is getting withdrawn so difficult to get [them] to do much now. But the activities people are doing as much as they can. I think now there being less people, there are more staff around. [Before person] was being neglected because [person is] not good at calling for help.”

A staff member realised an inspector’s presence was causing a person to feel anxious and asked them to move as the person was unable to eat whilst they were there. This showed the staff member listened to the individual and was confident to advocate for the person. We observed 1 staff member talking about the food to a person, it was a very nice interaction and was encouraging the person to eat.

The provider cared about and promoted the wellbeing of their staff.

Staff received supervision. We reviewed some of these and found they were personalised to address areas of development for staff with actions to support them to improve. There was not always clear input from staff to show they had an opportunity to raise what they wanted to discuss. However, most staff gave positive feedback about working at the service. A staff member told us, “I feel supported in my role, and I know exactly who to speak to if any concern arises. Management is approachable and responsive.” Another staff member said, “We’re encouraged to keep developing professionally, and there’s always someone available to offer guidance or advice when needed.”