Social Care Solutions Ltd (Herts & Bucks)

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 were not always supported and treated with dignity and respect; and involved as partners in their 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.

Staff did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. During our onsite assessment visits, we observed occasions where members of staff providing 1:1 support, did not always engage with the people they were supporting in a dignified manner. We observed a member of staff spoking to a person in a negative tone, telling them to pick their things up from the floor as people could trip up. However, when the regional director arrived their tone completely changed, and they started singing to the person. The inspector fed this back to the regional director on the day and to the managing director during a feedback call, however on both occasions neither senior manager provided assurances of any action, like additional training or supervision with the member of staff to address the concern we raised. The lack of provider oversight meant that poor practice was not always picked up and managed to ensure a caring culture.

Despite this negative observation, the majority of people and relatives we spoke to told us staff were kind and caring. Comments included, “I do think staff respect [name of person’s] dignity and privacy, they are well cared for", "When I am there staff always talk to [person] in a caring way” and “I think most staff are caring.”

People’s individual needs and preferences were not always understood, and were not always reflected in their care, treatment and support. For example, we observed a member of staff providing 1:1 support by following a person around the service at close proximity and at pace with either their arms crossed, or hands in their pockets. On observation this showed a sign of disinterest which may affect how supported the person feels, following someone too closely or at an uncomfortable pace can feel invasive or controlling, especially for individuals with sensory sensitivities or anxiety.

Staff were aware and understood the importance of meeting people’s personal, cultural, social and religious needs where possible. People and relatives told us, “They (staff) have parties and presents for people’s birthdays they make a big thing of it,” and “‘Sometimes [person] doesn’t want to do things, but they (staff) do try, they take [person] to Church but again sometimes they do not want to go.”

While people expressed general satisfaction with their care and or treatment, our assessment found elements of care did not meet the expected standards to demonstrate that leaders and staff consistently enabled people to achieve their hopes, goals and aspirations, maximising people's quality of life.

People were supported to access their local communities. These included attending day centres, visits to the local shopping centre, art classes, cafes, pantomimes and cinema. We saw people being supported by staff to maintain family relationships, whether that be family visiting or people going out to meet up with members of their family. A relative told us, “They (staff) will always take into account what [person] wants to do which includes playing puzzles and going out for a coffee. They (staff) encourage [person] to go out.”

Staff told us how they supported people’s independence. A member of staff told us, “I have recently shared with staff that [name of person] can take off their clothes independently and put them in the laundry basket. I have seen staff undress [person], so I tell them no, do not take away their independence, encourage [person] to do it for themselves, we are here to support people and not to take over. The staff do listen.”

The service had not always responded to people’s needs in the moment or acted to minimise any discomfort, concern or distress. Where people were reliant on staff to anticipate their care and support needs staff as they may be experiencing discomfort, pain or distress, and may not be able to communicate this, staff had not always identified a potential deterioration in the health and wellbeing of people and had not escalated concerns appropriately and in a timely manner, as described in other sections of this report.

The provider did not always demonstrate how they cared about and promoted the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care. There was an inconsistent approach for staff to have regular opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. Records did not demonstrate that when concerns were shared, they had been actioned or considered. Staff told us the lack of provider support and change of managers had impacted on staff wellbeing and morale, although they shared that current managers within the service were supportive and staff felt their experiences were listened to.