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 remained requires improvement. This meant people were not always treated with compassion, dignity and respect.

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.

Despite our findings in other areas for the most part the staff team treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Despite our findings at this inspection, staff wanted what was best for people and treated them with kindness, compassion and dignity for the most part. Staff made an effort to speak with people and tried to engage with them. They spoke with people in a kind and respectful manner and people were visibly happy and relaxed being supported by the staff team. Staff promoted dignity and respect, for example by subtly asking people to step away from a communal area of they needed support with personal care or if they felt unhappy.

People and relatives were positive about the staff team. One person said, ‘‘I like all the staff here. Everyone is really friendly.’’ Another person showed us how they felt about the staff team by signing at them to show how happy they were. A relative told us, ‘‘Staff are all kind, helpful and incredibly attentive to every one of [family member’s] needs.’’

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.

We observed staff to be deployed to work with people on a 1 to 1 basis when they had not worked at the service before. As a result, they did not know people’s individual support needs. This led to people and staff expressing frustration and anxiety due staff’s lack of understanding about how to support people as individuals. There continued to be a lack of social engagement for people if they chose not to sit in the communal area of the service. Social engagement was not always tailored to meet people’s individual needs and interests. People’s care plans contained variable information about individual support needs, strengths and preferences.

Most of the staff team knew people well and knew how to support them to discuss their individual likes. We observed some staff to effectively support people to feel better if they became upset, in line with the person’s individual preferences. A relative said, ‘‘[Staff] really make an effort. I gave them information about [family members] interests and they really took this on board.’’

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’s choices continued to be limited in areas such as how they spent their time, if they were not interested in the social engagement available in the communal areas. People who needed support to make choices by using methods of communication that were not verbal were not being supported consistently with these. This limited the opportunities for people to make choices and be in control of their support.

However, staff did offer people choices in their day-to-day support such as what to eat and drink or where to sit. Staff knew how important independence was to people and supported them to do things by themselves as far as possible. People’s care plans made it clear where people could be independent and where they may need more support. A relative told us, ‘‘I am very impressed with the degree of freedom [family member] has and they are able to come and go into different areas as they please.’’

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.

We could not be assured changes to people’s care and support needs were being noticed effectively as care records were not being effectively reviewed. It was more difficult for staff to respond to people’s immediate care needs as they sometimes went for extended periods of time without meaningful engagement.

However, staff responded to call bells in a timely fashion. Staff responded quickly to people’s request for support, for example for food and drink. One person said, ‘‘You never have to wait long for staff to help you.’’ A relative told us, ‘‘It is reassuring to see so many staff around.’’

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

Staff told us they did not feel well supported at work. They told us when they made a mistake or spoke up about how they felt things could be improved, this often resulted in negative consequences. For example, when staff made an error or spoke up, they may be put on written warning notices immediately. Some staff told us and evidence showed that the provider may change the way staff were paid if they did not complete their job roles or make an error. The pay would change from a monthly payment to weekly cheque payments causing considerable delayed payments, stress and worry for staff. Staff also told us some members of the senior management team spoke with them unkindly. We could not be assured staff were being supported with regular discussions about their job role. Evidence of these discussions were not always available for us to review.

The provider had recently stopped paying staff by cheque if they made a mistake and staff told us this had made them feel better about working for the provider.