The Shrubbery

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

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 were not always supported and treated with dignity and respect; and involved as partners in their care. The service was in breach of a legal regulation in relation to person-centred care.

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 always support people to uphold their rights around consent and respect their decisions did not always foster an environment where people were treated with kindness, empathy and compassion. Staff did not always empower people to make their own decisions about their care and support. When we arrived at the service at 9.00am in the morning, we saw that 13 people were in the lounge area. Daily notes for some people had evidence of them being woken very early in the morning. One person told us “I am woken at 4.00am to get up, I am on a round. I would prefer to stay in bed.” We saw that a member of staff was on the rota to start work at 4.00am. This was the time daily records showed that several people were being got up. This indicated a culture of people been assisted to rise out of bed very early in the morning. We raised this with the registered manager. The registered manager acknowledged this and assured us that a review of the morning routine will take place.

However, relatives told us, “The staff are kind, they always speak nicely to my relative and they respect their dignity.” Another relative told us, “I visit the home often and the staff are always welcoming and caring.’’ Staff told us they treated people with dignity and respect. One staff member said, “Each person is treated with dignity. Visiting professionals told us they had observed staff treating people respectfully and kindly. One visiting professional told us, “We have a great relationship with the service, the staff are caring and transparent.” We observed staff treating people kindly and respectfully.

The provider did not always treat people as individuals and make sure their individual preferences were being met. People’s history, preferences, likes and dislikes were clearly recorded in care plans and risks were assessed for each person’s ability. However, routines put in place by the management and staff meant that people were being woken up earlier than they would have liked. People consistently told us they didn’t like the food and there were not enough activities. People told us there were limited opportunities to engage socially. One person told us, "I would like to have more things to do." People’s individual wishes, likes and dislikes were not routinely being met.

Relatives told us staff knew their family member well. One relative told us, “They [staff] know my relative well and know their likes and dislikes and respect their choices.” Staff told us they respected people as individuals. One staff member told us, “Everybody is not the same. We offer a choice. It's also important we spend time getting to know the people we care for.’’ Staff asked people about their preferences and encouraged people to take part in day-to-day activities. We observed staff treating people individually.

The provider did not always promote people’s independence. People did not always have choice and control over their own care and wellbeing. People told us staff did not always support them to maintain their independence. One person told us, “I’ve fallen a lot, but now they [staff] take away my independence, they don’t let me choose when to walk.’’ Improvements were needed to ensure people were offered regular choices around when they woke up, their food, mealtimes, independence and activities. One person said, “There is not enough to do and even though there are sometimes residents’ meetings, ideas were not always acted on.’’ Staff told us they respected people’s choices and encouraged people to do as much as they could for themselves. Care plans detailed people’s choices. However, there was limited information regarding how people's independence was being actively promoted.

Improvements were needed to ensure staff consistently responded to people’s needs in the moment and acted to minimise any discomfort or distress. People told us staff did not always respond quickly when needed to concern over health or wellbeing. We saw when people requested immediate assistance staff were often busy with other tasks. This meant staff were not always available to meet people’s needs in communal areas. Staff told us how they would respond to emergencies such as falls or when people presented as being unwell. However, where people appeared bored and restless, staff were often busy carrying out other tasks. Although, when staff did interact with people, they did so kindly. The provider responded to our feedback by increasing observations of staff interaction and sharing their plans to increase daily activities.
Care plans detailed how to respond to people in emergenciesand positive behavioural support plans were in place to guide staff in how to respond to behaviours that they may find challenging.

The provider cared about and promoted the wellbeing of their staff. Staff told us they felt supported by the provider. One staff member told us they received regular support in the form of supervision. Another staff member told us, ‘’The provider has an open-door policy.’’

The provider shared several wellbeing initiatives aimed at improving and maintaining staff wellbeing, these ranged from health cover to staff rewards for going above and beyond. Staff told us about the reward system and shared examples of when they had received a reward.