Ambleside

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. This is the first assessment for this newly registered service. 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.

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.

During our assessment we observed some compassionate, reassuring and positive interactions between staff and people. We saw 1 member of staff chatting with a person as they supported them. When the person demonstrated frustration with their situation, the staff member reminded them of what they had achieved in life and how valued they were. Another person sought physical reassurance from staff and staff responded with warmth and supportive words. Staff conversations with us showed that they worked in a way that made people feel they mattered and respected their privacy and dignity. One staff member told us, “I just want them to know they are safe and loved and to enjoy their life whilst they are here." When we asked 1 member of staff what was important when caring for people, they responded, “Patience and you have got to care for the people. Perseverance because it can get quite tricky at time. Being respectful and giving them dignity when you are giving them care." However, we found some records did not demonstrate the same level of dignity and respect. For example, 1 person with dementia had started to display disinhibited behaviours in communal areas. Detailed information about these behaviours had not been amended in the person’s care plan once they were no longer mobile and mainly cared for in bed. In conversations with staff, we found staff comments were not always dignified. For example, 1 person found their way into another person’s bedroom and put themselves to bed. We asked a staff member how this happened, and they said, “It’s their dementia.” There was no consideration to the person or their relative who was present, how this could make them feel.

Systems were not always supporting people to be treated as individuals. Care reviews and other tools used to describe a person’s care needs did not support an individualised approach, especially when needs had changed. For example, 1 person’s behaviours had recently changed and there was no written guidance to tell staff, what to do to manage the person’s anxieties. We looked at care plans for people living with dementia. All of these care plans assessed people as being at risk of choking. Staff and management said this was not the case, yet records were not changed. Out of those people we reviewed, we found 3 people were checked hourly through the night, with no evidence to show the person, their family or representative had agreed to this. Staff conversations showed this was more a generic than tailored approach. Some people’s comments showed them not treated as individuals. One person said, “If they’ve got time, they can cope with my needs. Half the time they rush in and rush out again.” Other comments included: “I need to be served on one side (due to limited sight), do they ever do it, rarely” and “Whenever I ask for something to be done it rarely happens. Sometimes I ask for tea because it helps my breathing, a lot of times the tea doesn’t turn up.”

We did see some positive examples of people treated as individuals. One person was becoming anxious and upset. The staff member providing support used their knowledge of the person to distract and divert them from their anxiety which had a positive impact on the person. Another person was offered a cup of tea and company when they became distressed which had a calming effect on them. Staff told us it was important to recognise the uniqueness of each person to provide care that met their individual needs. One staff member told us, “We are all different and unique in our own way. If you know who they are, they feel more comfortable with you." Staff consistently used people’s names to give them a sense of identity and belonging.

The provider did not always promote people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. We found people experienced differences in how their independence and choice was promoted. Some people were not involved in managing their risks, some people were not involved in how frequent checks at night were undertaken and some people told us they did not always get the support when needed. However, for others they were encouraged to engage in activities, celebrations and social events to promote their mental, emotional and social wellbeing. A member of the lifestyle team explained how they planned events to celebrate significant dates in the calendar, bring variety to people’s lives and share different cultures. They told us, “I want to give them a bit of fun and a bit of focus. To lift their spirits and help them socialise. There are lots of tea related activities this week because it is food and hydration week. We have a calendar which shows all the special weeks and special days of the year, and we will do things to celebrate that." Some people were cared for in bed or chose to spend most of their time in their bedroom. A staff member told us, “There is something called ‘Forget Me Nots’ for people who don’t leave their room very much and don’t join in the activities. They will get special time when we focus on them." This was a new initiative, and more work was required to roll it out to everyone.

In this report, we have provided examples where people were not confident their concerns would be listened to and staff were able to respond to their needs. In some cases, people told us they waited around 30 minutes or in 1 example, the person took it upon themselves to do something that they said put them at risk. We have referred to examples where people have shared feedback, and they told us it had not been considered or responded to their satisfaction. We heard 2 staff comments that were not considerate of people’s feelings and when we shared these with management, they said those comments did not display the cultures and behaviours expected at Care UK. However, we did see some good practice of staff responding to need. We saw staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. There was a system for arranging appointments that ensured people with immediate needs had access to services. During our assessment, the emergency bell sounded in 1 of the communal lounges. Senior staff from different units in the home responded promptly to ensure the person’s safety.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. Most staff felt supported and listened to. They told us there were processes in place to support their workplace wellbeing and named staff they could go to for guidance and support. One staff member told us, “We have mental health heroes here so we can always chat to someone if you need to.” Another staff member told us they were paid to complete training if it was done in their own time. A third staff member told us about the financial bonus paid by the provider at Christmas. However, 1 staff member did not feel reasonable adjustments to support staff in the workplace were consistently adhered to and another described difficulty accessing the systems to claim the provider benefits.