Christopher Grange Residential Care

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• 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 the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment under the provider. This key question has been rated inadequate. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.

The provider was in breach of legal regulation in relation to dignity and respect.

This service scored 25 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity. For example, records reviewed showed some people had only received a shower once a month. One person told us, “I would like a shower more often but only get one every few weeks now as I need support from staff.” Podiatry care had not been provided to people for a prolonged period; one person had not received chiropody treatment for over two years and was in pain and discomfort due to overgrown toenails. A podiatrist visit was arranged by the provider on the same day after we raised these concerns. Hygiene charts showed some people were left for long periods without support for their toileting needs. One person told us, “I am left at times soaked through in the lounge, it’s so uncomfortable.” Staff told us, “We just do not have the time to care for people properly no more.”

However, we observed some positive and caring interactions between staff and people.

The provider did not treat people as individuals or make sure people’s care, support and treatment met their needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds. For example, people did not receive person-centred care to meet their wishes and preferences. Multiple people told us they were not consistently supported to attend morning religious services, something they had expressed was important to them. One person’s care plan recorded daily attendance at mass as a clear preference yet delays in daily routines and mealtime support led to the person missing the services. The person told us, “I often miss morning mass because staff don’t assist me in time to get down there for 11 am.” Another person told us, “They don’t always know what I like especially the agency staff.”

The provider did not promote people’s independence, which meant people did not always know their rights or have choice and control over their own care, treatment and wellbeing. For example, many people told us they had not been involved in discussions about their care and had not seen their care plans. One person said, “I am on lots of medication, but I don’t know what they are and why I have to take them.”

Activities were available; however, a review of the activity programme was unit-specific, limiting opportunities for people to access daily and stimulating activities of their choice.

People expressed a wish to access the outdoors, but there was limited opportunity to do so. One person told us, “I’d love to go outside but there is not enough staff to take me because I need help being in a wheelchair.”

One person’s care plan stated their preference to shower was on a particular day prior to attending the hairdresser. However, their daily care records and feedback showed this preference had not been met.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not consistently respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. For example, people gave us mixed feedback about staff responsiveness to their call for assistance. One person told us, “The staff are lovely and come as quick as they can.” Another person said, “I cannot choose what time I want to go to bed because I need two carers to help me, so I might have to wait a while after I press the call bell until they have the staff.” A staff member told us, “We do not have time to provide people with the personal care they need in line with their care plans.”

We observed prolonged call bell response times. The call bell log system indicated that 18 calls were waiting for assistance at one point. Additionally, the log showed one call remained unanswered for 44 minutes and 48 seconds.

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. For example, the registered manager told us, “So many staff are leaving due to the added pressures caused by staffing levels on each unit being cut.” A large number of staff told us they did not feel supported by the management team and described feeling, “Under huge amounts of pressure.” With many telling us this contributed to them seeking alternative employment. Staff reported reduced staffing levels had a direct impact on people’s care needs not being met and negatively affected their own wellbeing. One relative commented, “The staff are so busy and morale is low, they never get a minute. There were limited opportunities for staff to discuss their support needs and wellbeing.”