The Amwell

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

Staff members usually spoke to people with respect and kindness, however we did observe an instance where a senior carer referred to a person as ‘her’ and ‘she’ to other staff in front of the person, rather than speaking directly to the person and using their name.

A visiting professional told us they did have concerns about staff members using their personal phones to take photos of people’s wounds when the workplace phones were not working correctly. This had an impact on people’s privacy.

Relative feedback about staff working in the service was positive. One said, “The staff, they are lovely and caring.”

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.

A number of care records contained conflicting, out of date, or incorrect information, which meant staff did not always have appropriate guidance to care for people as individuals.

Some staff had worked at the service for a long time, which meant they knew people well enough, however new staff who had recently joined the service needed correct information about people to enable them to care for them in a way that met their individual needs and preferences.

We did observe a lovely interaction of a staff member dancing with a person to music they liked, and another person’s distress had subsided significantly since our last inspection as staff had been providing them with a variety of books to read.

We also saw a designated space for a person who found the floor they resided on to become too overwhelming on occasion. This space had all of their favourite things in, items they liked collecting, and activities they enjoyed doing. Staff reported when the person used this space, they became calmer and more relaxed.

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, treatment and wellbeing.

People did not always experience care that emphasised their choice and control. One person preferred their own company, and a relative told us, “[Loved one]’s not in [their] room all day and [they] would prefer to be in [their] room. [Loved one] is left all day in [their] transit wheelchair, usually with a pressure cushion, but the wheelchair is not designed to be sat in all day.”

Another person who was mostly cared for in bed, was to have regular time with staff in their bedroom, to ensure they did not feel lonely and had social interaction. However, records showed this was not always taking place.

Another relative questioned staff’s understanding of people’s needs, and response to them trying to be independent. They told us, “One [person] keeps standing up and [staff] call across the room for [them] to sit down – [person] can’t understand!”

The activities team did a good job of organising a range of different activities for people. Activities were praised by relatives, and everyone spoke highly of a recent VE day celebration which the service had put on. One relative said, “[Staff] send photos of activities; baking, bingo, a music thing, a lady Singer, gym, manicures, VE day, and a pantomime.”

People experienced delays in having their needs met and this meant staff could not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

When people experienced distress or agitation, the provider did not routinely complete an analysis to understand the root cause. This meant any potential triggers could not be identified and future incidents were more likely to occur.

Where people could use call bells, there was sometimes a delay in staff being able to respond if they were supporting other people at the time.

A relative told us, “I am in regularly and [staff] leave residents in the dining area with no carers. It is slightly better now but it is still happening. They are still ignoring people who are calling out. I can’t relax.”

Another relative explained, “People have to wait to go to the toilet.”

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.

Staffing levels had been raised as a concern by staff at a team meeting in May, with staff stating they were short staffed. The home manager had explained the dependency tool was being followed, however staff raised concerns this was not correct and that people’s needs had changed. At this inspection, we found no changes or improvements had been made, and this meant staff were rushed and having to juggle competing priorities. This then directly impacted on the quality of care they were able to deliver to people, despite their best efforts.

Staff did not receive regular supervisions to give them a regular opportunity to share feedback and receive support from the provider.

A significant number of physical and verbal incidents had been recorded where staff were the victims.

The provider had implemented a new recognition scheme for staff since our last inspection. This demonstrated efforts to ensure staff felt valued.