Lucketts Farm

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 good. At this assessment the rating has changed to requires improvement.

This meant people were not always well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to dignity and respect and person centred care.

This service scored 40 (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. We saw caring interactions between staff and people. Whilst we were visiting people in their own homes we observed staff speaking kindly to people, including supporting people at their own pace to make decisions and actively involve them in tasks such as cooking. People and families feedback that staff were kind and knew them well. One relative said “My relative loves spending time with all their care staff”.

However, the provider was not always ensuring it was meeting their duty of care to people because there was a lack of clear information or knowledge on how staff should meet people’s health needs. Where people had complex conditions such as epilepsy, constipation or a greater risk of falling there was no clear guidance on what actions the service would take manage these safely, or when they may need to request medical advice if people’s condition deteriorated. There were no clear plans to demonstrate how the service was supporting people to be independent, and live their life in the way they wished to.

We also saw language used in documentation or in person which was not dignified or did not reflect people as individuals as adults with their own strengths and rights in society. This included references to people having “tantrums”, as well as being “silly” and “fussy”. The service referred to people as having “social leave”, which didn’t reflect people had the right to visit family or friends at any time and did not require leave.

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. Staff we spoke to knew the people they supported well and explained they had processes in place to enable people to have choice on how they wanted to live their lives. One staff member told us, “We involve people in making decisions, and there are weekly house meetings where people plan together what food they would like to have and activities they would like do in the next week”. In practice we found these systems weren’t always individualised. We asked what would happen if people wanted to eat different food to the other people they lived with. In one supported living setting staff could clearly explain this occurred regularly, but in another staff told us, “The meals are planned in advance and everybody has the same meal. They pick things that everybody wants, I’ve never known anybody to have something different”. This didn’t respect that people are individuals and may sometimes wish to have different food than their peers.

People’s care plans did include information on personal preferences, likes and what was important to them. But where people’s skills strengths were detailed these were based purely on household tasks such as “I can put plates and cups in the dishwasher”, rather than reflecting people as being unique individuals or how the service could empower people to build on their strengths.

The provider did not promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. We identified that restrictions had been put in place on people’s lives without considering if these were proportionate, the least restrictive approach or had been consented to by people. For example, the provider had installed CCTV in people’s homes which they explained was to monitor staff and any incidents but had not recognised this was also an invasion of people’s privacy or ensured appropriate consent was documented. People living in their own homes had “house rules” put in place which restricted their rights to drink alcohol or smoke if they wished to, and if people wanted to receive visitors then this had to be notified in advance. One relative told us, “I used to just arrive but were asked in December last year that should we want to visit to email and arrange all visits prior”.

Whilst people had goals documented in their care plans which explained how they would be supported to be more independent, these were mostly restricted to undertaking tasks within their house (for instance to have more independence with washing or dressing) rather than any broader ambitions or life goals. These goals provided no information on how staff should support people to achieve them, or how the provider would regularly monitor them to see if they were being achieved. While the provider informed us about some additional goals people had and how they were supporting them, these weren’t recorded in people’s care plans. This meant there was no clear or consistent plan for how individual people were being supported to be independent.

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 observed that where people expressed wishes in the moment, that staff were responsive and support people in doing things they wanted to do.

However, we could not be assured that they would be able to respond in a timely way when people’s health may deteriorate, as there was a lack of clear guidance on how they should respond to ensure people received the treatment they needed. One person would not communicate if they were in pain as they had a fear of medical appointments, but there was no guidance for staff on when they might recognise this person was in pain or reassure them if they were in poor health and may need to see a health professional. This meant there was a higher risk of delay in identifying any health concerns as staff would not be able to quickly recognise this person was in pain.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care. We received positive feedback from staff about management, with one staff member telling us, “The staff team are fantastic and management are always approachable. You can always make suggestions and they actively listen to staff”. Staff we spoke to enjoyed working for the service and explained they could always get time off when they needed for personal circumstances. However although staff explained they did not feel pressured to work additional hours, by allowing staff to regularly work 7 day weeks without a rest day the provider was exposing staff to a significant risk of harm. The provider had not effectively balanced requests for staff to work additional hours, with their duty to safeguard both people and their staff by ensuring working hours were safe. They had not ensured that sufficient staff were in employed and relied on staff working unsafe hours to be able to meet people’s care needs.