Miles House - 4 Hentland Close

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 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 ensure people were consistently treated with kindness, empathy and compassion, or respect their privacy and dignity. We observed occasions where staff did not interact with people in a positive or meaningful way. One person who should have received one to one support was sitting with a staff member who remained on their phone and did not engage with them, and staff did not always initiate conversation or respond to people’s emotional or social needs. These shortfalls meant people did not always experience compassionate, attentive or dignified care. Despite these concerns, we also observed staff who engaged with people in a caring, patient and respectful manner. Some staff knew people well and supported them with warmth and understanding. A healthcare professional also told us, “Everyone [staff] is really approachable and professional. The staff are fantastic and know the service users [people] really well”.
 

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 did not always support people to achieve positive outcomes. On occasions staff did not acknowledge or engage with the person they were supporting. This failed to acknowledge the person’s individual needs. The registered manager told us people’s religious needs were considered as part of the admission process, although none of the people currently living at the service or their families had expressed specific religious preferences. Staff demonstrated knowledge of people’s likes and preferences, and care records contained information about some of their interests.
 

The provider did not always promote people’s independence or ensure they had choice and control over their daily lives. Records did not evidence consistent engagement in daily activities. Activity logs reviewed over a 6-month period showed days where no activity had been recorded. This meant the provider could not demonstrate that people were routinely supported to participate in meaningful activity or develop their independence. Staff told us they were led by what people wanted to do, and we observed occasions where staff asked people about their preferences, including offering options to go out. However, this was not consistent across the staff team, and people did not always experience choice in practice. One person told us, “I go to bed too early, staff don’t ask, I just go along with it”. This meant staff did not always respect people’s wishes or promote their dignity and autonomy. We fed this back to the registered manger to investigate further.
 

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. Staff did not always respond appropriately when people became anxious. They did not consistently follow the de-escalation guidance set out in people’s care records, which meant they did not always use strategies designed to reduce distress. On 2 occasions, we observed staff fail to follow the guidance for managing 1 person’s anxieties. Had staff applied the correct approaches, the person may not have required PRN medication to relieve their anxiety. This did not reflect an approach to ensuring care and support was provided in the least restrictive way.
 

The provider cared about and promoted the wellbeing of their staff. Staff told us they felt supported by the registered manager and described a positive team culture. Staff said there was a culture of kindness within the team, and they had regular supervision with the registered manager. One staff member told us, “Supervisions are productive and I can discuss anything that is an issue”. Staff also told us they felt confident raising concerns and believed that action would be taken when they did so.