Charing 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 assessment we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement. This meant people may not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Although there was an atmosphere of kindness, compassion, respect and dignity, we did not find this was consistent across the whole service.

Staff did not always demonstrate a person-centred or sensitive approach as in one person’s daily notes, staff referred to them as being, “moody” despite this person having a diagnosis of depression. There was no indication that staff had considered whether the person’s mental health might have been deteriorating or whether professional input was needed.

The environment may not always be suitable for people with a learning disability. The call bell was loud and rang frequently throughout the day. This could be distressing or overstimulating for people, especially at night. Additionally, the lounge area on the top floor was used as a thoroughfare to access a storage/archive room. We observed several staff, including the maintenance person (carrying a mattress) walking through the lounge without acknowledging people. This meant the lounge was not a personal or private space for the people living there.

We also observed a lack of dignity in how some care was delivered. For example, when people received their PEG feed (delivery of food into the stomach through a tube) this was done in communal areas without the use of a privacy screens. We raised this with the registered manager who told us there was a screen available for staff to use and they confirmed following our inspection the screen was now in use.

In addition, staff on the top floor were wearing clinical-style uniforms. This contributed to an institutional feel and was not in keeping with the RSRCRC guidance, which promoted homely environments for people with a learning disability and autistic people.

However, people told us they were treated with care and kindness. One person said, “The staff are all very nice. They’re kind here. It’s very nice here.” Others told us, “I have a lovely room,” “I think it’s great here. They’re (staff) very good,” “Very happy here. Happy with everything” and, “The staff are very good. It’s taken me a while to settle, but I have now and I’m happy.”

In spite of the shortfalls above in relation to dignity and respect we observed kind interactions between staff and people. There was a lot of laughter and light-hearted banter. We saw staff knocking on people’s doors and waiting for a response before entering. A staff member commented, “I always knock on people’s doors. I always explain what I am going to do and ask for their consent.”

Relatives were happy with the way care was provided to their family member. One relative told us, “Management came in during the night (as their family member was upset). That’s dedicated.” They added, “All reception staff are very helpful and all very helpful on the unit.”

People were not always treated as individuals or their care, support and treatment met their needs and preferences.

Care plans had limited information about people’s life histories, particularly for those living on the top floor who had a learning disability. Recording a person’s life history is especially important when they are unable to share this information themselves. In addition, information around people’s likes and dislikes was limited in some instances. For example, in one person’s care plan, apart from details saying for staff to engage with them in conversation, there was very little else.

People living on the ground and first floors of Charing House were being treated as individuals. Some people had a strong faith and a local clergyman visited them once a week to take Communion. Other people went out independently or undertook their own care or care tasks within their rooms and their living areas. However, people living on the top floor were more isolated and not always being given the same opportunity. Staff had no access to communication aids to help communicate or try to understand people’s vocalisation. Staff knew very little about people’s life histories and as such how they liked to spend their time and people had limited opportunity go out. Staff said, “We can only take 2 people out as we don’t have a vehicle.” Therefore people did not have the opportunity to go out regularly on an individual basis with staff to participate in activities of their choice. None of this was in line with the RSRCRC guidance. A staff member said, “I would prefer it we had a dedicated room downstairs for people on this floor to have activities.”

People in the other living areas within Charing House had more positive experiences. One person told us, “From my point of view it’s helped me after a few rough experiences. I am able to get around. Staff help me with what I need. This is my home.” A second said, “Staff take the time to get to know you as a person.” A relative said, “She is getting all the care she needs. They do things like puzzles. She needs to be occupied. Yesterday I called and they gave her the phone and we had a chat.”

The provider did not always promote people’s independence, particularly for those people with a learning disability or autistic people.

Although one person (on the top floor) had requested receiving a copy of the weekly activities planner, staff told us this person did not often get to go out and they were unable to give us examples of how they supported this person with their independence.

People living on the top floor were not being given the opportunity to learning daily living skills or to increase their independence.

‘For example, although people were occasionally offered the opportunity to engage in cake making, there were no adapted facilities such as a kitchen area on the top floor where people could be supported to contribute to making their own meals’ and people were unable to choose meals from a menu tailored to their preferences. They were offered the same options as the rest of the service, which were typically traditional meat and vegetable dishes. As people on the top floor were generally younger, their dietary preferences may differ and this had not been fully considered. The registered manager told us, “Some people can go to the pub for lunch and we do get in takeaway meals.” Immediately following our inspection, we were told a ‘set day’ would be allocated where people could order in takeaways, rather than the current ad-hoc arrangement.

Other people however, were supported with their independence choice and control. One person told us, “I can use the microwave and I make my own cups of tea. I strip my own bed.” Another person said, “I don’t need help all of the time. I’ve got the help when I need it. I can get around with my wheelchair because the corridors are wide.” A third person told us they went out to the park opposite on their own and that they helped staff plant out the garden and a further person took a taxi to go and watch their favourite football team.

The registered manager listened to and understood people’s needs, views and wishes and people said their needs were met when they needed it. One person said, “I need help with getting up and getting ready. Staff get to know you and they support me with this when I need it.”

The registered manager said there had been a change to the rota’s recently, but due to people’s comments and views, this was being reverted as several people had been upset by the change. This demonstrated a responsive approach to people’s needs.

The registered manager cared about and promoted the wellbeing of their staff.

Staff said they enjoyed working at Charing House and felt fully supported in their role. One staff member told us, “The appraisal process is fair and transparent and I felt like my voice was heard.” Another said, “We support each other and we work well together. There is an open-door policy within the home.”

Management ran an on-call service so there was always support available for staff working on the night shifts and the registered manager told us they came in early in the morning so they could see the night staff before they finished their shift.

An employee of the month award was held and the registered manager was a mental health advocate, telling us, “My door is always open and we have counselling available for staff.”