St Margarets Care Home

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 dignity and respect.

This service scored 35 (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.

The provider failed to properly implement and embed important policies and procedures at the care home. This meant staff did not have clear guidance to work to, and underpinning knowledge of expectations and best practice. We found people did not always receive kind and compassionate care. For example, we observed 1 person ask to use the toilet during mealtime, and staff told them to eat their dessert first. Another person relied on staff support to eat their meal, and staff stood whilst assisting them, which did not reflect a supportive, dignified and social experience. Staff referred to people as being like “children” in their discussions with us, and this was not dignified.

People who required a soft diet, due to their risk of choking, were not provided with dignified support. We found all food items of their meal were mixed and served in a bowl. This did not look appetising, and this did not demonstrate a compassionate or dignified approach to care as people were not able to taste nor distinguish between individual foods.

However, despite our findings, 1 person told us, “I need full help, but they [staff] are tremendously patient with me”. Another person said, “I’m looked after well. I’m encouraged to be independent with personal care, but help is there if I need it”. One representative told us, “The care is marvellous, and the staff brilliant. We couldn’t ask for anything more. I never tell [staff] when I’m coming to visit, but [person] is always clean and tidy when I arrive”.

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

People had little to occupy them on a day-to-day basis. On the first 2 visits to the care home, the activities co-ordinator was on holiday and the provider had not arranged for suitable cover. People sat for long periods in the lounges, some people ate their meals in the same chairs and most only moved when using the bathroom. Through spending time with people, we found out they had previously enjoyed writing poetry and colouring; however, we found no evidence these activities had been encouraged with people on a regular basis or were known by staff as activities of interest.

People’s birthdays were not celebrated as an individual occasion. Where more than 1 person had a birthday during a specific calendar month, we found joint birthday celebrations took place. For example, during April multiple people had birthdays and 1 celebration was held. Two of our visits to the care home fell on 2 people’s birthdays, and we found very little celebration took place on these days. We found this approach to birthdays, especially where people wanted to celebrate, did not acknowledge people as individuals.

There was a dining room at the care home, however, we saw many people remained in their chairs in the lounge. This offered little opportunity for a change of scenery, and for mealtime to be a specific occasion during the day. We found tables were not laid with cutlery, and condiments were not available. Some meals were given to people earlier than others, and people told us this made them feel uncomfortable, as they liked to eat together.

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.

People, particularly those with reduced mobility, were not supported to be independent. Staff did not always ask people how or where they wanted to spend their time. We observed staff supported people to mobilise into the lounge, without first asking where they would like to go, or what they would like to do. We did not see people being encouraged to participate in running the service, such as setting tables, or folding laundry. We saw staff wanted to be kind in their approach, however, we found there was a culture of low expectations for people.

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.

Staff were not effectively deployed to enable them to respond to people’s immediate needs. We were informed of an occasion where a person had called for staff but had not been heard for a period of time. The person was heard by someone on the street, who raised concern with staff.

We observed 1 person needed individual attention, and there were not always staff available. On several occasions inspectors made sure the person was safe, as they were at high risk of falls. On 2 occasions another person was distressed, and staff did not respond appropriately to them. The staff member left their bedroom and brought them a drink and food, they had not offered this to them or offered choices. We brought this to the providers attention and asked them to review the person.

The provider did not promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

Staff told us they felt supported by the provider. However, our assessment identified significant shortfalls whereby the provider failed to adequately support staff. For example, staff rotas were completed a week in advance, which did not demonstrate staff were given ample time to know their working patterns. We found staff regularly swapped their shifts, and shift start, and finish times could vary.

Staff were not familiar with the providers policies as they had not been given access to them. This meant staff were not supported, nor clear in their roles and responsibilities to deliver person-centred care. Furthermore, the office at the care home was not appropriately used, and this meant a quiet and confidential area was not always available for meetings, such as supervisions, to take place.

Specific rest areas were not available for staff to use. The provider told us during the assessment ‘sleep in’ staff used a specific staff room to rest when they are not working. We were later told staff who undertook the ‘sleep in’ role would rest in a communal area of the care home.