Lillibet House

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 inspection we rated this key question requires improvement. At this inspection the rating has stayed the same. This meant people were not always treated with compassion, dignity and respect.

The service was in breach of the legal regulation in relation to dignity and respect. Staff did not always speak with people in a kind and dignified manner. When people were feeling upset or anxious, staff did not always support them with respect and 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.

Staff did not always treat people with kindness, compassion and dignity. We observed staff to not speak with people and make sure they were happy when being supported with moving and handling such as using a hoist. When people became upset or anxious staff did not always respond to them in a kind and compassionate way. People were not always treated with dignity. For example, when 1 person was showing how they were feeling by vocalising loudly staff did not attempt to see if there was something they could do to help. They did not see if other people in the same room were okay or if they wanted to go to another room. People were left for long periods of time without social isolation. Sometimes where people had one to one staff support staff did not speak with them for long periods of time. People were not always supported with kindness and dignity at mealtimes. People’s meals were left for extended periods of time and would have gone cold. However, staff did not see if people needed support or if there was something they could do to support people to eat their meals.

However, we also observed some instances where staff spoke with people kindly. They approached people gently and made sure people felt relaxed when they supported them, for example by being at their eye level. Staff supported people when they needed personal care to maintain their dignity. People and their relatives were positive about the staff team. One person said, ‘‘The place has good care and the staff are excellent. There is nothing I would change.’’ A relative told us, ‘‘I think [staff] are the right people for this kind of job. They have 100% my relative’s health and wellbeing in the heart of whatever they do.’’

The provider did not always treat people as individuals and make sure people’s care, support and treatment met their needs and preferences. At some times of the day, people were left for long periods of time without meaningful engagement. Care records did not detail how or when people were being supported to follow their individual preferences and social pastimes. People’s care plans did not contain detailed information about their individual needs and in some cases, people did not have care plans in place for their specific support needs such as epilepsy. There were opportunities for people to be engaged in social pastimes at the service. However, if these did not interest people as individuals, there were often no alternative ways for people to spend their time. One person said, ‘‘I like to do my own thing but other people like a routine, so it is the same stuff again and again. I am not really interested in them. It would be nice to have something new to do.’’

Staff wanted to treat people as individuals, and we observed staff talking with people about things that interested them. People had been supported to personalise and decorate their rooms, and staff knew what people liked to eat and drink. One person said, ‘‘[Staff] know the food I like, that I like a bath and not a shower and what I like to do. They have got to know me.’’

Staff did not always promote people's independence, rights, choice and control. For example, people were not always given the choice as to whether to have personal care or not. Staff knew how to support people to be independent, however did not always enable this. For example, 1 person was not given the correct cutlery meaning they were unable to eat their meal independently. Some people had equipment in place to monitor when they moved in their rooms however, they actively avoided this equipment as they did not want staff knowing they were moving independently. This was a known support need, however alternatives to promote people’s independence had not been considered. People had limited choices in relation to how they spent their time if they did not wish to take part in the social engagement on offer at the service. One person said, ‘‘I used to go out a lot and do things myself but not so much anymore.’’

We also observed staff supporting people to make choices in their day to day lives. For example, what drink they would like or which room they wanted to spend some time in. Staff supported people to be independent at mealtimes by verbally prompting them and enabling them to eat themselves. One relative said, ‘‘I think staff know how important it is for [family member] to be their own person.’’

Staff did not always respond to people's needs in the moment or act to minimise any discomfort, concern or distress. For example, when people were upset or anxious, staff did not always respond to them in a timely manner. Peoples care records were not being reviewed effectively to reflect any immediate support they may have needed. Changes in people’s care needs were not always being reported by the staff team to help make sure changes could be made if necessary.

However, we did see occasions where staff were attentive to people’s needs in relation to personal care or making sure they had something to eat and drink One person said, ‘‘[Staff] are always about and get me anything I need. I never have to wait for anything.’’

The provider did not always make sure staff were effectively enabled to deliver person-centred care. Some staff told us they did not feel as well supported at the service as they would like. For example, they did not feel they had enough opportunities to speak up in team meetings and did not have the training they needed to support people with their specific support needs. Staff were not supported to discuss and debrief if they were involved in an incident where a person may have been upset with them whilst they were supported.

However, some staff also told us they enjoyed working at the service and felt that as a staff team they worked well together. The registered manager was working on supporting senior staff to become more skilled in supervising and supporting staff members.