Care Staff Services Ltd

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 45 (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.
We received mixed feedback from people and relatives using the service. One person told us, “6 months ago I had a carer I did not like, I did not trust him, he wandered around looking at my stuff. I told the office not to send him again.”
People were positive about their experience with staff. One relative told us, “They involve my wife in what clothes she would like to wear…When they are washing her, they cover her up with a towel”. Another person told us, “I am very lucky and very fortunate, they are marvellous to me, they do what they can for me”.
 

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.
People were not always treated as individuals. For example, one relative told us, “[They] treat her a bit like a child which is a bit disrespectful. They talk down to her, this annoys my mum”.
The provider also did not demonstrate how staff were trained or supported to understand and meet the needs of people with learning disabilities or autism. There was no evidence of person-centred information, tailored care guidance, or Health Action Plans for individuals with learning disabilities. This raised concerns over staff competence in providing appropriate, respectful, and safe care to this group. Furthermore, hospital passports were not available on people’s care records to ensure accurate information was shared to ensure appropriate treatment. This did not ensure people’s individual needs and information would be quickly and easily available to share with other services.
 

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 told us they did not always have access to their up-to-date care plans, and some people told us they had not seen their care plans for 4 years. This meant people were not always supported to be in control over their own care and treatment.
Furthermore, we found some people’s care records contained notes from staff and leadership which demonstrated people’s independence, choice and control was not promoted or exercised. For example, one person’s record noted, “In her lunch call [please] give her only one slice of sandwich if she will ask anything others to eat don’t give her.” We also found a note in another person’s care record which stated, “Please give [person] dinner even if she refuses”. This did not demonstrate people were always supported with independence, choice and control during care delivery.
 

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.
People told us staff did not always remain present for the full care call time. One relative told us, “They are supposed to spend 30 minutes with [the person]. Some [staff] are in such a rush, they are looking at their watch, so desperate to get to their next call.”
Staff told us, “[People] tell us what they want. Care plans – some people have them and some people don’t.” This did not provide assurance staff understood there was personalised guidance in place to support the delivery of people’s care, and how to best provide care according to people’s individual needs. Not all staff we spoke to were able to tell us how they were informed and what happened if people’s needs changed. This did not demonstrate the provider was always able to understand people’s needs and ensure staff were supported to respond to those without delay.
 

The provider did not care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.
We received significant whistleblowing information from staff with concerns around workforce wellbeing. Some staff we spoke to described the workplace as “hostile”, “toxic”, and “unethical working conditions”. Staff frequently told us they were threatened with withheld work shifts. This demonstrated a closed culture and lack of care for staff wellbeing.
Staff told us they did not have effective support including training to be able to deliver safe and person-centred care. For example, one staff told us although they worked with people with dementia, they had not had training in dementia.