TLC Rehab

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

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. This key question has been rated requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect. We found breaches of regulation in relation to this key question.

Staff treated patients with compassion, empathy and respect, promoting positive interactions and person-centred support. However, some clients stated senior leaders had a lack of awareness of client care and were dismissive. Staff did not gather information on client's strengths, abilities, aspirations and culture. The service internally was mostly accessible for disabled clients, due to the access of a lift and ground floor en-suite bedrooms and living spaces. Staff ensured that clients could obtain information on treatments, local services, clients' rights and how to complain. Clients could make hot drinks and snacks, however had restricted kitchen access, which was disproportionate to their low risks, and prevented the rehabilitation of life skills. Clients stated the food choice and quality was poor. Staff did not always respond to specific risks, such as falls in a timely manner. Clients told us they felt listened to but missed the opportunity to discuss the service in a weekly community meeting or keyworker session. Staff felt positive about working for the provider. However, due to the lack of resources in place, senior leaders did not always support staff to deliver person-centred, high-quality 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 service treated people with kindness, empathy and compassion and respected their privacy and dignity, however, did not always support clients to engage in activities that were meaningful to them.

Staff attitudes and behaviours when interacting with clients showed that they were friendly, respectful and responsive, providing clients with help, emotional support and advice at the time they needed it. We also observed positive and kind interactions amongst staff.

Staff supported clients to understand and manage their care, treatment or condition. We observed a new client medical assessment. The doctor was kind, caring and supported the client to understand their care and treatment. Therapy staff provided one-to-one sessions with clients.

Most clients said staff treated them well, were kind and supportive. However, some clients stated that senior leaders had a lack of awareness of client care and were dismissive.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards clients without fear of the consequences.

Staff mostly kept client information confidential. Information held on the provider’s electronic systems was protected. Staff entered a personal username and password to access this information. Client information recorded on paper was held in filing cabinets, however we saw occasions where these were not locked.

The service did not always treat people as individuals and made sure their care, support and treatment met their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff did not gather information on client’s strengths, abilities, aspirations and culture, and therefore were unable to ensure these needs and preferences were included in their support and treatment.

The service adjusted for disabled clients – for example, by ensuring disabled people’s access to the premises by a lift and ground floor bedrooms and an accessible bathroom. The service had step free access through a side door. However, the lift did not reach the top floor, where urine tests are carried out. Since the service opened, they have not had a client with a physical disability, so we are unable to comment how this would be mitigated. However, staff told us that urine tests would take place in another part of the service if a client had mobility impairments preventing them from using stairs.

Staff ensured that clients could obtain information on treatments, local services, clients’ rights, how to complain and so on. The service has only admitted English speaking clients so far but stated they would use a translator and make information leaflets available in different languages if spoken by clients.

Clients did not have a choice of food and were not involved in the planning or preparing of the menu. However, there was an allergies and intolerances board in the kitchen with client names, food allergy posters, and allergen stickers, to be used on food packaging.

The service did not always promote people’s independence, so they know their rights and have choice and control over their own care, treatment and wellbeing.

Clients were mostly supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. We observed team leaders to demonstrate a person-centred approach, shifting away from the traditional 12-step model in favour of promoting individual self-realisation and the development of personal responsibility. Clients were also allowed their phones and laptops from day 1, apart from during sessions. However, Staff did not always support clients to engage in meaningful therapeutic activities. Or understand their personal, cultural, social and religious needs. Although there was a walk and talk group and a nutrition group, we did not see evidence that staff had explored with clients, activities that were meaningful to them, or what their personal needs were and how this could be supported.

Staff made sure clients could access information on how to complain. Information about making complaints was displayed on a notice board and in their welcome pack.

Clients could make their own hot drinks and store and prepare snacks, from the drinks, fridge and microwave available in the dining area. However, clients had restricted kitchen access, which was not detailed as a blanket restriction in the client treatment agreement.

The service had employed chefs to plan and prepare meals. Most clients stated the food choice and quality was poor. Clients told us that food at the weekend was poor, which led one client to pay for and prepare breakfast for all clients weekly. Other clients told us about an incident where cooked chicken was still pink. Clients told us there is a lot of food wastage.

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

Staff were aware of but did not deal with any specific risk issues, such as falls or ulcers and care plan for these accordingly. For example, we saw documented in the incident log and staff meeting minutes, that multiple clients had experienced falls, both at the service and in the community. However, there was minimal information of how staff were specifically supposed to respond to these fall risks, as most had nothing noted in the learning or outcome section.

People told us they felt listened to and their feelings were respected. Clients said they felt able to approach staff with concerns and could voice their feelings in their one-to-one counselling sessions. However, clients stated that weekly community meetings no longer happened and were previously hit and miss. Clients felt these were a good opportunity to discuss concerns they had, such as the menu.

The service cared about and promoted the wellbeing of staff, but did not support and enable them to always deliver person-centred, high-quality care.

Staff said they were positive and proud about working for the provider and their team. They told us that the managers were approachable and hardworking. However, due to the lack of policies, procedures, risk assessments, supervision and training, senior leaders did not always support them to deliver person-centred, high-quality care.

The service’s staff sickness and absence were like the average for the provider, at just 1%, however the service’s turnover raise was higher, at 11%.

The service had not yet completed staff appraisals as it had been opened for less than one year. Senior leaders told us these will be completed annually.