Hales Group Limited - Norfolk

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 did not rate this key question. At this assessment the rating is requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 40 (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 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.

Regular and experienced care workers were well thought of and valued but people said they felt that there was a high staff turnover and regular management changes. They felt this had impacted on staff retention and communication between care workers and the office staff. Whilst most people felt staff upheld their privacy and dignity a few expressed concerns mainly when being supported by new and, or unfamiliar staff. One person told us, “They (care workers) are most definitely respectful, and I feel comfortable with them.” However, another person said, “It’s not a problem with intimate care. They close the bedroom or bath door and close the curtains. I don’t feel undignified. Two or three of them say they don’t know or are not sure (of what to do) and maybe give a sharp reply. It happens frequently. They don’t ask. It’s just set things that they have to do. I prefer it when they come in, get it done and go."

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’s individual risk assessments were often generic and not personalised to peoples specific needs. For example, 1 person’s care plan did not have a personalised fire risk assessment, considering their needs and the person being unable to mobilise independently. The information given for care staff to follow would not have been specific to this person in an emergency situation putting both staff and the person at risk.

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.

Not everyone had access to their care plan or felt that they had the opportunity to respond to it. People did not feel their concerns were taken seriously or that they had much influence and control over who provided their support and when.

Whilst the provider recorded people’s preferences in line with their care needs, people’s these were not always upheld in relation to people’s gender preferences or if they were uncomfortable with a particular member of staff. People told us it was hard to get through to the office to raise concerns and concerns were not consistently managed.

Care plans documented people’s needs and what support they needed but daily notes showed care workers did not consistently meet people’s needs or facilitate their independence. For example, 1 person’s record said they could make a drink independently but consistently showed care workers made a drink for them. If care workers had sufficient time they could be prompting and enabling rather than doing for people what they could do for themselves. We found evidence of another person wanting to use the toilet, but care staff encouraged the person to not leave their bed as they were wearing continence aids and to use these instead. This was not promoting this person’s independence and control.

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 generally voiced concerns about the service and did not feel staff delivered their care and support effectively. Of the 19 people and relatives spoken with most comments were around time keeping, and the length of the call itself. 11 people thought new care workers lacked the skills to do the job and needed more training and there were concerns about language barriers where people felt they could not always make themselves understood. One person said, “There is a need for carers to go back to training. Back to basics.” Another person said, “There’s not much interaction.” And another said, “We don’t have a proper conversation.” Concerns were expressed about care tasks and the timing and thoroughness of the task.

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.

Staff spoken with during and following the assessment raised multiple concerns with us. We also received concerns prior to our assessment from staff who had already left. Staff concerns were mostly about the lack of stable, suitable management, sickness and staff vacancies which did not ensure the service was effectively planned and coordinated and staff said rostering did not consider travelling time or how far care workers were expected to travel. Gaps in supervision and formal support were identified. Lots of supervisions had been completed in the last 3 months and these were usually by videoconference or phone call. Prior to this, supervisions and staff observations of practice were inconsistent. Feedback from staff was consistently poor, 1 staff member said, “Horrendous. Calls are added without permission. Staff are given long routes which make no sense, so they are driving back and forth and always running late. The staff member went on to say, “It’s a constant guilt trip.” Another staff member said, “We get no breaks.  Sometimes I have an 18-hour day. Weekends are worst.” Staff felt their concerns were not listened to and no support was provided when they were struggling with personal issues. Despite this when we carried out our assessment the provider told us they were committed to taking on new care packages and had the staff they needed. This was at complete odds to what the staff were telling us.