Heywoods Grange

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 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 dignity.

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 treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect. People were supported by a stable staff team who knew them well and demonstrated kindness and compassion in their day-to-day interactions. Relatives consistently spoke positively about the care provided, with one describing staff as treating their family member "like family", and a further relative describing staff as "incredibly sensitive" to changes in their family member's wellbeing. One person told us, “The staff are nice to me and make sure i am safe.” Staff were observed interacting warmly with people and responding positively to their needs. However, staff sometimes used terms of endearment such as "darling", "sweetheart" and "love" rather than people's preferred names, and records did not consistently demonstrate how privacy and dignity preferences were formally planned, reviewed and embedded into practice.
 

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. The provider recognised people's individuality and had developed personalised support documentation which reflected people's histories, preferences, interests and aspirations. "About Me" documents were written in people's own words and supported by photographs, Makaton symbols and personal information that helped staff understand what was important to them. One person's support plan concluded with their aspiration of receiving "a knighthood from the Queen". One person was keen to show us their bedroom and told us, “I decorated my bedroom with help from the staff. This is how I like it.” However, the language used within daily records did not always reflect the same level of person-centredness, strengths-based practice and individual focus demonstrated within care plans and support documentation.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. Relatives described examples of people being supported to pursue their interests, maintain family relationships and access activities within the community. One relative told us staff had successfully encouraged their family member to go swimming, whilst another described support to access local radio stations and community activities. However, during our out-of-hours visit at 18:30 pm, all people were either in nightwear or preparing for bed, and staff told us this was the usual evening routine. Whilst staff explained this reflected people's preferences, records did not consistently demonstrate how individual choices regarding daily routines, independence and lifestyle were reviewed and supported. Opportunities remained to further evidence personalised approaches to choice and control.

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 generally knew people well and relatives described them as understanding changes in people's moods and behaviours. However, records did not consistently demonstrate that expressions of distress, changes in presentation or incidents affecting wellbeing were formally assessed, monitored or escalated. For example, a daily care record documented a person becoming distressed during a telephone call with a relative and subsequently refusing their evening meal. Although this was recorded in daily notes, no incident report was completed and there was no evidence of further assessment, monitoring or escalation to relevant healthcare professionals. This limited assurance that people received timely support when experiencing emotional distress or changes in wellbeing.
 

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care. Staff demonstrated genuine commitment to the people they supported and spoke positively about the relationships they had developed with them. Relatives also consistently praised staff for their kindness, compassion and understanding of people's individual needs. One staff member told us they "See the guys as my family", whilst another explained, "We are trying our best, but it's hard when you have to pick up extra shifts". However, the provider did not consistently demonstrate that staff received the support, supervision and professional development needed to sustain high-quality person-centred care. Supervision and appraisal arrangements were not consistently maintained, and regular competency assessments had not been completed in key areas such as medicines management. This limited assurance that staff wellbeing, performance and development were being effectively supported.