Garsewednack Residential Home

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 provider and registered manager was in breach of the legal regulation relating to safe care and treatment and dignity and respect.

This service scored 45 (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 always treat people with, kindness, empathy and compassion or respect their privacy and dignity.

We observed a person being supported with their continence needs in a communal lounge, which did not promote dignity or respect.

Parts of the service were cluttered, poorly maintained, unclean, and had a strong smell of urine. This environment did not reflect a respectful or dignified home for people living there.

Although individual staff were seen to be kind and caring, we observed several instances where people and their home environment were not respected, and their dignity was disregarded.

This contributed to a breach of regulation relating to dignity and respect.

One relative told us, “They treat him with respect”. Another said, “Staff are kind, patient and understanding and give her plenty of time if she is in her confused state”.

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.

The service used a shower and bath rota to indicate when staff should offer a person support with a bath or shower. We raised this with the registered manager and provider. The registered manager told us it would not be practical for everyone to have a bath or shower daily, demonstrating a lack of understanding that this approach reflects institutional practice and does not promote individual choice or person-centred care.

This contributed to a breach of regulation relating to dignity and respect.

People’s bedroom doors displayed information about what was important to them, and people we spoke to confirmed this information was accurate,

One relative told us, “They (Staff) know each resident well and they do their best”.

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 and treatment and wellbeing.

The registered manager did not always act in line with the Mental Capacity Act 2005 or the provider’s policy, which may have resulted in people’s human rights being infringed.

While on site, we observed people choosing where to sit, and staff interactions showed they knew the people they supported.

One relative told us, “Staff always try to encourage him to participate; that is the best they can do”.

The provider did not always understand people’s needs. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

For example, one person's records showed multiple instances of respiratory distress. Although oral medication was administered to this person, the registered manager had not identified that the person was not receiving their food and medication as prescribed by IDDSI (International Dysphagia Diet Standardisation Initiative) guidance.

A staff member told us, “If someone has a fall, we ring the bell and the senior would assess, so we would ring 999 if there is an injury, but if not and we were able we would help them up with equipment we and ring for advice”.

One relative told us, “Staff seem knowledgeable enough to look after him”.

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.

The registered manager and provider told us that, due to staff sickness and other recent staffing issues, some staff had been unable to carry out their intended roles. As a result, processes to improve the service had been delayed. For example, the development of an exemplar care plan intended to be used as a template to improve other care plans had not been completed.

During our inspection, we observed the registered manager addressing concerns with staff and did not take the opportunity to ensure their communication had been received as intended, which left the staff upset and unhappy during their shift. For more information in relation to the registered manager responsibility see freedom to speak up quality statement.

Staff gave mixed feedback about morale and working at the service. One staff member told us, “The morale varies, sometimes we are happy but sometimes we are stressed”. Another told us, “I love it, that is why I am still here”.

Staff spoke positively about the training provided. Comments included, “The training is very good here and last month we had manual handling and I love it,” and “With training, (Registered manager’s name) makes sure our training is refreshed regularly like manual handling is every year and it is good to have those refreshers and the first aid is every 3 years. The training is good here”.