Tilford Care & Nursing 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 service was in breach of legal regulation in relation to people’s 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 consistently treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

Although we observed some staff speaking kindly to people, meaningful interaction between staff and people was limited. At lunchtime, despite some staff supporting people to eat we did not hear them make any effort to engage the person in conversation. We also observed 1 staff member supporting 2 people to eat at the same time. This demonstrated an undignified approach, meaning the staff member was not focused on 1 person individually and ensuring they had their sole attention.

We saw examples where staff displayed a lack of dignity and respect to people. One person came into the lounge/dining area with their trousers not fully pulled up, leaving their buttocks exposed. This placed the person at risk of embarrassment and compromised their dignity.

Although a staff member showed the person to a seat for lunch, they did not take any action to adjust the person’s clothing to preserve their dignity. Another staff member was seen going into a person’s room. They said, “Wake up please” to the person, but without waiting took the bed remote, laid the bed flat and started to reposition their legs. Throughout the whole time, the staff member did not say a word to the person or explain what they were about to do.

Despite these concerns we received good feedback from people and relative’s in relation to how staff looked after them. People told us, “They are very fond of me. They are amazing. I am very lucky”, “I am very grateful for the care”, “I’m happy here. I don’t have any concerns” and “They are friendly.”

Relatives were in agreement, telling us, “He is happy to be here”, “Whenever we visit we see all residents being cared for with dignity, kindness and compassion” and “Generally staff are caring.” One relative told us their family member had commented, “This hotel is very nice – the food and staff are very good.”

Staff told us they would respect a person’s privacy when carrying out personal care. One staff member said, “When we are talking to people we will talk slowly. We close the door and the curtains during personal care. We make sure only the staff are in the room, not family members.”

Professionals told us they felt staff were caring. One told us, “I have always been welcomed to the home during visits by residents and staff alike. I have found that staff are knowledgeable about the residents. I have witnessed the care and kindness shown to residents.”

The provider did not consistently treat people as individuals or ensure care, met needs and preferences. They did not always take into account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Whilst staff were generally aware of people’s needs, they were unable to share details regarding people’s life histories, which limited staffs ability to build meaningful relationships and deliver personalised care.

Staff also did not always demonstrate a respectful approach to people, recognising them as individuals. One person told us, “What irritates me is that 2 of them (staff) stand in front of you and talk in their own language. It’s rude and I’m sure they are not talking about me, but how do I know?” We also observed this during our visit. Staff were heard speaking to each other in their own language in front of people, which did not demonstrate consideration for those present and may have left people feeling excluded.

We saw an example of staff not responding to people’s preferences. One person, who had declined their main meal, asked for “a ham sandwich” when prompted by staff; however, this request was not acted upon. In addition, when desserts were served, some people were offered custard while others were not, without any clear rationale.

Staff made limited efforts to engage with people. This reduced opportunities for meaningful interaction and may have contributed to people feeling excluded from conversations taking place around them.

We observed 2 staff members transferring a person using a hoist. Throughout the process, the staff made very little effort to communicate with the person, other than to ask if they were okay once they had already been lifted in the hoist. There was no reassurance or ongoing communication provided during the transfer, despite being moved using a hoist, which can be a potentially vulnerable experience for a person.

This also occurred at lunch time when people were shown the stand-aid hoist and guided through the process but were not told where they were going or why they had to move.

Despite these concerns we observed staff understanding where people wanted to spend their time, accepting when people did not wish their lunch but wanted fruit instead or supporting people to sit in an area where they felt comfortable to eat their lunch. This included 1 person who liked a box of tissues beside them on the table. A staff member said, “There are your tissues. Wake up darling, try and eat something.” This person needed an adapted plate to eat independently and we saw they had a plate guard on their plate. A relative told us, “They will always say hello to my mum. I never feel she is left and she is recognised. I feel staff know her.”

The provider did not consistently promote people’s independence, or ensure people had choice and control over their care and support. This meant people were not always supported to do something that was important to them.

At lunchtime, we observed staff placing clothes protectors on people without asking whether they wished to wear one. This demonstrated a blanket approach and meant people were not always given the opportunity to make their own choices.

One person told us they liked to sit in the garden. We were told on the day prior to our visit, staff had said they could not sit in the garden as they were the only person who wished to be outside and they could not spare the staff (as people had to be accompanied by a staff member outside).

Another person was recorded in their care plan as ‘really’ enjoying showers and that staff should ensure they offered these often and yet, in April 2026, records showed this person only received a shower on 4 occasions which did not reflect their expressed preferences.

Despite these concerns, some people told us they had choice. One person said, “I eat in my room, that’s my choice. I don’t like the TV. I only like music.” We saw the person had no television in their room and only a radio. Another person liked to receive their personal care earlier in the day and following their relative raising this with management, we were told this had improved. A relative also said, “[Family member] viewed the home before we moved dad here and they chose this room as the view is lovely from the window. Management we happy to give us the room we chose.” Another told us, “[Person’s name] likes to stay in her own room and doesn’t like to mix.”

The provider did not consistently listen to or understand people’s needs, views and wishes. This meant people were not supported to remain engaged or stimulated.

Staff did not consistently monitor or respond to people's engagement with their surroundings and activities. We sat in a small lounge area for the morning. There were 12 people in here, of which 7 were asleep. Staff came in and out of the lounge area, although no one stayed for any length of time. The television was on, but at 11 o’clock it switched itself off. When we left the lounge at 13:00, the television had still not been switched back on by staff, despite 2 people having been watching the programme that was on. When going into the lounge on 1 occasion, we found 16 people in here and 2 staff. Despite the staff being present, they were sitting together at a table rather than interacting with people.

At lunch time we observed 1 person receiving their lunch at 12:35. This person’s care plan recorded they need reminding of mealtimes and needed prompting. This did not happen and at 12:55 this person had still not touched their meal. A staff member did notice at this time the person had not eaten, but instead of offering to reheat their meal, they removed the plate and said they would get them a pudding instead. Another staff member brought meals to 2 people in upstairs rooms. They cut the food up for 1 person, but left them sitting in an awkward position not able to eat properly. Both people had hot puddings brought with their meal, which meant meals were not always provided in a way that supported people to eat comfortably and enjoy their food. We alerted staff to the person who was struggling to eat because of the position they were in and they told us they would report this to a staff member.

Despite these concerns there were examples of staff responding to people’s individual needs.

A relative told us, “[Person’s name} was unable to use the call bell successfully. She kept losing it around her bed. So staff provided her with a Bluetooth call bell which she now wears around her neck. It means it is always to hand for her.”

The provider supported staff wellbeing and provided systems to enable staff to deliver person-centred care. This helped staff feel supported in their role and contributed to the delivery of consistent care for people. Staff were supported through supervisions and appraisals giving them the opportunity to meet with their line manager on a one to one basis regularly. A staff member said, “They will ask us questions about things like safeguarding and if we are feeling supported.” In addition, the provider had an employee welfare scheme which staff could access, and they had arranged a minibus shuttle to collect staff from a nearby town or the local train station to bring them to the service.

The registered manager told us, “I think we are very supportive. We support staff in different ways, and we held a competition which was judged by some of our residents. It was a bit of fun, and the winning staff member got a voucher.”