Baobab Care UK Limited

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 inadequate.

This meant people were not treated with compassion and staff caring attitudes had significant shortfalls.

The service was in breach of legal regulation in relation to dignity.

This service scored 35 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

The lack of audits and checks completed meant the provider failed to identify and address the on-going concerns we found during this assessment. Systems to assess, monitor and mitigate risks to people, including risks associated with the medicines and finance management, environmental risks and support planning were not robust. This did not demonstrate the provider adopted a caring and dignified approach. Guidance for staff on people’s increased risks and changing needs was not updated, in a timely way.

Support plans lacked detail in people’s personal histories and preferences, this was somewhat mitigated as staff we spoke with appeared to know people well. Relatives also told us that staff knew people well and how to support them.

The training matrix indicated that just 18 of the 83 staff had received training in relation to dignity and respect.

Most people and relatives told us they felt staff were caring. One person told us, “Most staff are kind, but some just ignore me and don’t interact.” A representative told us, “[Name] is happy, there is nothing that concerns me about their wellbeing, they present very comfortable around people and appears happy.” We were also told by one person there is not enough support overnight to safely support a person with their continence needs and they were often left for several hours until the day staff arrived. This practice did not support the persons dignity. Although the provider and registered manager were aware of this, they had failed to follow up on the health professional’s advice to arrange a further assessment of needs, in a timely way.

Feedback about communication was mixed. Whilst some felt it was good others told us that there needed to be improvement particularly when concerns had been raised.

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The provider had failed to ensure all people's support plans were personalised to reflect their individual care needs and preferences for how their care was delivered. People overall felt their care was responsive to their needs. Some people and their relatives told us they felt their individual needs were not always respected and met.

Three relatives we spoke with told us how they did not feel their loved ones were encouraged and supported to access the community and engage in meaningful activities. This included people who had 1:1 or 2:1 care with little engagement and interaction from staff with the person. A relative reported often visiting to find the staff member providing 1:1 support sat in the doorway of the persons room and not engaging. We also observed a staff member sitting outside the persons bedroom during our visit. This did not demonstrate that people’s needs were always met.

When carrying out reviews of care, the provider did not ensure they had considered and addressed people’s individual communication needs. The quality of these reviews needed to be improved as we identified areas where required changes and updates to care plans had not been made. The provider was unable to evidence that they had consulted effectively with people who had communication barriers. They had not fully considered or used alternative tools or methods of communication to demonstrate they were meeting the individual’s needs, ensuring this was an inclusive experience.

Feedback from people and relatives on the extent to which they were treated as individuals was mixed.

The provider did not consistently promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

Whilst some people and relatives told us they were offered choice and had control over the decisions being made by care staff others were not. We were told where representatives had the legal authority for making decisions on behalf of people and being involved in the planning of their care, they were not always involved or contacted in relation to their loved one’s health and welfare. For many people there was no evidence of consultations or meetings taking place to include the person in the decision-making process. This included significant events such as moving from one supported living location to another. This demonstrated a lack of choice and control around where people lived.

There was no evidence to demonstrate staff had received training on promoting independence. Staff we spoke with could explain how they supported and encouraged people to maintain independence. Staff told us they had enough time to promote independence and rotas demonstrated this too.

Where staff were required to support people to access the community and take part in activities to uphold their interests and hobbies, we saw this was taking place. However, feedback demonstrated that this could be significantly improved which would have a positive impact on people’s wellbeing and reduce boredom.

We found that there was a lack of meaningful and achievable goals and aspirations discussed and worked towards to enable people to become more independent. Whilst we observed this had been commenced for some people there was a lack of structured approach to driving and enabling all people to achieve their goals and aspirations in a timely way.

One person we spoke with told us they felt they were encouraged to maintain independence and were given choices and their decisions were respected.

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.

The provider failed to operate a robust system to ensure staff always attended people’s homes at the times they required, to ensure their safety and well-being were maintained. One relative told us how their loved on became anxious when the care staff were late, but this had not been identified by the provider and monitored to prevent this from recurring. One person told us how they had requested support in the mornings to get ready to go out but they were often told they would have to wait for the day staff. This made the person upset and anxious about not being ready for their appointment. This did not demonstrate a dynamic approach to ensuring people were treated as individuals. However, most people were happy with the times of their support.

People and relatives, we spoke with felt that the service was accommodating and when people had appointments, where appropriate, staff attended appointments with them.

We were told by staff that when people’s health deteriorated, they would report this to the management, and this would be escalated to the appropriate health professionals. Staff would also liaise with relatives and health professionals directly.

People and relatives told us staff knew them well and overall responded to their needs and wishes. However, records needed to be improved as they did not clearly demonstrate this was the case.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff rotas we looked at demonstrated that some staff were working long hours supporting people with complex needs without any provision to take a break. Staff worked 12-hour shifts and the provider had failed to make any arrangements for staff providing 1:1 or 2:1 support to take breaks. This placed staff at risk of fatigue.

Staff meetings and supervisions took place; however, not all staff members were included in these, and they were according to records provided, infrequent.

The registered manager told us they had sought feedback from staff members; however, there was no evidence that the analysis of this and action plan to share and drive improvements had been shared with all staff. Staff told us they felt listened to and valued by the registered manager and provider and they felt they could raise any concerns they had.

We were told by the registered manager that the provider had introduced a staff recognition programme to recognise staff performance and achievements to enhance their well-being.