Yew Tree Holdings Limited

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 did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of the legal regulation in relation to people’s dignity and respect.

This service scored 55 (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. People’s dignity while they were supported to mobilise was not always protected. During our inspection we observed people’s clothing was not always adjusted by staff to maintain their privacy and dignity. Staff did not always explain to people what they were doing when they were supporting them. For a person it was recorded in their care plan that they could become distressed and needed their care explained while it was happening but this did not happen consistently in practice during our inspection, and we observed the person was distressed. Relatives gave examples of people’s previous negative experiences while being transferred using the hoist which supported our observations.

Staff did not always communicate with people in a dignified way. We observed staff shouting across the room to people about their wants or needs and discussed people’s care in shared spaces in-front of other people living at the service.

When people were upset or distressed staff did not always treat people with compassion. For example, when a person was upset staff offered them a tissue, before the person responded staff had begun to put the tissue up their sleeve, the person then said they did not want the tissue, but staff continued anyway. When another person became upset, we heard staff saying, “[Person’s name] isn’t happy with you [are they]."

However, staff told us they treated people with dignity and respect and gave examples such as knocking on doors or covering people’s bodies while supporting them with personal care. Staff treated colleagues from other organisations with kindness and respect. A healthcare professional told us, “The staff are always friendly towards me and follow any instructions I give. The residents always appear to be treated with kindness when I am around."

The provider treated people as individuals. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.People told us they liked being at the service. A person said, “My friend is here.” Another said, “The food is good.” Relatives told us staff knew people well and were mindful of their preferences. A relative said, “[Staff] know how [person’s name] likes tea and biscuits, know what foods to avoid as [person is] not keen, and [person’s name] is always dressed like they would choose when we visit.” People were offered choice of activities and engaged in things they enjoyed. Staff gave examples of how a person liked to support them with day-to-day tasks such as folding linen. A relative told us, “The entertainment side is good and the lady that runs it is excellent.”

Staff were also aware of people’s communication needs. A staff member said, “Communication is different for everyone here. Care plans give you guidance, for example, to speak slowly, use simple language with [person]. [Another person] used to be verbal when they first arrived but is not speaking anymore, so we use pictures and photographs, or they will point."

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. We observed people were offered choice throughout the inspection for example, staff offered choices of food and drinks. Relatives confirmed people were supported to make choices about their care. Staff gave examples of how they supported people to make choices. A staff member said, “I ask people what they like or don’t like and always ask for consent before helping them. I say, ‘Will you allow me to help you?’” Another said, “It’s about protecting the right to make your own decisions. It’s important to make decisions, no matter how small. Some people have advocates.”

Staff supported people to be as independent as possible with tasks or activities they were able to. We observed people mobilising freely around their home, engaged in activities if they wanted to be. There were no restrictions on visiting and we observed visits taking place during the inspection.

Staff did not always act to minimise any discomfort, concern or distress. We observed mixed staff responses to people’s discomfort or distress during the inspection as reflected under the safe and caring domains. Records of the daily care people received showed numerous gaps which meant the provider could not assure themselves that people’s needs were being immediately responded to. For example, gaps in people’s personal care records.

However, the provider listened to and understood people’s needs, views and wishes. A professional told us, “There is awareness [of people’s needs] within the home, and if supporting staff are not aware they will direct to senior management.” During the inspection we observed staff responded to people’s physical needs in the moment such as supporting people to eat, drink or move around their home. The service had a call bell system which allowed people to summon help when required: this rarely sounded but when it did it was answered promptly.

The provider did not always support or enable staff to deliver person-centred care. Staff training was not all up-to-date although training was being scheduled to better enable staff to safely meet people’s needs and deliver more person-centred care. Staff competencies had not always been assessed to ensure staff were delivering safe, high-quality care. The deputy manager of the service was working on a formal supervision schedule for staff supervisions at the time of our inspection.

However, staff were positive about working at the service. A staff member said, “It is excellent, I am doing my level 3 here.” Another staff member said, “Everyone I work with is nice and helpful. It’s very easy to get support."