Choice Supported Living - East

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.
 

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 always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

During our visits to people’s homes, we found the spare spaces and rooms were dedicated for staff. For example, there was a large fridge in people’s dining room with a label on it to say ‘staff only’. We also found staff were using a bedroom as an office. This meant there were no ‘quiet spaces’ for people to use, and where spaces could have been better placed for people’s sensory needs, they were being used as staff rooms. This reduced the space available for people to use within their own home and did not reflect the principles of Right Support, Right Care, Right Culture.

Relatives told us items were not securely stored for people. One family member said, “I have to keep checking [relative’s] inventory, I find pots and pans in the communal kitchen. They don’t make sure things are returned. This happens quite frequently.” Another relative told us staff did not support people to engage in meaningful conversations. One relative said, “It bothers me [staff] don’t communicate. When I have a phone call, they are around in the background they don’t support [relative] to respond so it is me talking at [relative].”
 

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

We found people were not always supported in line with their individual needs. For example, 1 person’s care record stated after 9:30pm, they usually had a cup of tea or a milky drink at the dining table. We reviewed the person’s care notes for a 1-month period and found the latest the person went to bed was 7pm. We also found the person was only offered a hot drink on 11 occasions in the month.

One relative told us care plans were not person centred. The relative said, “The care plan does not give any examples about how to deal with [person’s] behaviours. I read it last week. That is quite a worry. I raised that there is no mention that [person] has autism, but they blanked me about this. Doesn’t mention what [person’s] conditions are. Not come back to me at all about this.”
People’s bedrooms and independent spaces were personalised to their preferences. One person told us about the activities they attended. Some staff were able to demonstrate clear knowledge about people, their history and their preferences. However, this was not consistent with all staff we spoke with.
 

The provider did not always promote people's independence or support people to have choice and control over their care, treatment and wellbeing.

During our visit to people, we found due to staff shortages they were not supported to go out and enjoy their individual activities. For example, we reviewed 1 person’s activity timetable, and it showed they would go on a ‘local walk’. However, at the time of our visit, there was only 1 staff available. The staff member confirmed they could not support this person to go out because there were not enough staff available. This was also a consistent issue in other visits we made to people. This did not demonstrate people could participate in their activities and have choice and control over their care and wellbeing.

Additionally, in 1 house we visited, people required support from staff to complete their food shopping. We found there was a limited amount of fresh food available in the fridge considering 4 adults lived at the home. We also found food shopping was frequently completed collectively rather than always supporting people to choose and purchase food individually, which may limit opportunities for personalised meal choice and independence.
 

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.

During a visit to meet people, we observed people experiencing distress and anxiety due to incompatibility with other people in the home. Although staff recognised when the volume of conversation was too loud, the person was not supported to minimise their discomfort. Additionally, when the person experienced distress around another person, staff did not demonstrate they responded to the person’s needs immediately. We observed the person appeared distressed for some time and eventually removed themselves from the room.

During another visit to people, we observed 1 person sat facing the floor speaking to themselves for the most of our visit. Staff did not demonstrate they engaged with the person to understand whether they were experiencing distress or support them to engage in an activity they enjoyed.

Some relatives told us how the service contacted people’s doctors when they required treatments for healthcare problems.
 

The provider did not ensure staff received appropriate support to carry out their roles safely and effectively. They did not support or enable staff to deliver person-centred care.

Staff were not always provided with appropriate guidance to support them to safely manage people’s needs. For example, staff told us they were not adequately trained on how to use the care recording system, this meant they were not completing all required information which was expected of them. Staff told us they had tried raising concerns about the short staffing and the impact this had on them and people. Staff told us their managers informed them nothing could be done about this. One relative also told us staff were not adequately trained with the care recording system. This relative said, “I have read the [person’s] care plan. The new [staff] was reading the care plan but wasn’t the new one on [care system]. I said shouldn’t [staff] be reading the latest one and they said I don’t know.”

During our assessment and site visits, we found staff were often left in vulnerable positions, impacting theirs and people’s safety and the quality of life for people receiving care. Staff also told us they felt nothing would change anymore because of the number of times they had spoken about this issue.On 1 occasion during a visit to people’s home, inspectors had to contact the provider due to the safety concerns of 1 staff being left alone with people who had high risk needs.