Four Acres

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 remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 75 (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 treated people with kindness, empathy and compassion.

People were comfortable in the company of staff. We saw staff smiled at people, called them by their preferred names and helped put them at their ease. Staff reassured people, especially when they were anxious or becoming anxious. For example, we saw staff sat with 1 person who was becoming distressed about when their visitors would arrive. The staff member held the person’s hand and chatted to them, so they recovered quickly and became settled. One relative we spoke with said, “The staff I have been exposed to, I think they just go above and beyond. I think the staff they’ve got are wonderful and from what I can see [Person] is taken well care of. They bend over backwards to make sure [Person] is comfortable.

New staff to the home were keen to develop understanding of the people they cared for. One new staff member said, “I am getting to know them, and they are getting to know me.” We saw people were comfortable with the staff caring for them and often showed affection to staff. Staff took time to check on people and offered to get them items to increase their comfort such as cardigans when people may be cold. Staff were discreet when taking and supporting people for personal care. Staff took time to involve people in day-to-day life at the home, so people would know they were valued.

During our visit, we saw 3 boxes of people’s shoes in a communal lounge area. Staff said they needed to be collected by people or family members. We discussed a more dignified way of arranging this with the manager, especially if some owners of those items had passed away. The manager agreed to find a more considered solution.

The provider treated people as individuals and made sure people’s care, support and treatment met their needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff had a good understanding of people’s individual needs and preferences but carefully checked in with them in case they wanted something else, at that moment, when supporting them. Staff offered day to day choices and options to people, for example, when supporting them to eat and drink. However, on the first day of our visit we saw some people were not offered a second choice of meal which presented a missed opportunity. Where people were given choices, staff respected their responses.

We saw staff were respectful of how people presented in the moment. When staff were in the lounge areas, they gave people time to vocalise. We saw 1 person was becoming anxious because they thought there was an activity they had to be involved in. A staff member explained calmly to the person, the activity was in the afternoon, and it was still morning. The staff member asked the person if they would like a drink and the person followed them happily.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Where people were independent, they were comfortable to make themselves and their visitors drinks. Staff understood some people liked to maintain as much independence as possible by completing elements of their own personal care. In 1 example, staff told us how 1 person liked to shave themselves. Staff showed us how they supported people who may struggle with areas such as remembering to put their shoes on. A staff member told us how they encouraged people to make their own decisions about what they would like to eat, by showing them the menu a couple of hours before mealtimes and showing plated food at the time of choosing. This helped people to maintain control and encouraged them to make their own decisions.

Staff recognised how aids and equipment promoted independence. One staff member said, “There are loads of different aids to help people move around safely. We have a lift, different hoists, assisted baths. People are referred to occupational therapists if they need anything special.” Another staff member said, “Sensor alarms give people independence to stand and sit more safely. Wheelchairs and handrails also help people to be independent safely around the home.”

People were offered opportunities for meaningful occupation. Some people enjoyed spending time chatting to staff, watching the television or completing puzzle books. There had been recent trips out of the home for people to enjoy. A pet therapy dog was visiting the home on the second day of our inspection, with games in the garden planned for the afternoon. We saw some relatives feedback surveys that asked for more activities. The manager told us activities was an area that was planned for continued improvement.

Staff did respond to people’s needs in the moment or acted to minimise any discomfort, concern or distress.

People and relatives said staff responded when they needed help and support. One relative said, “Oh they (staff) really put themselves out, to come in and have a chat and sit with [Person] for a few minutes and talk about anything, they’re a really good bunch (staff) and [Person] is always pleased to see them which I think says a lot.”

Staff understood when people wanted support, such as giving people something to lean on when they completed word search puzzles. Staff also responded quickly to people when they were becoming anxious. Staff were mindful of the deployment of other staff and worked together to achieve this, so people were quickly reassured. Call bells were answered promptly. Staff described the level of support from senior staff as good, although they acknowledged there had been changes. Staff said they would not have any hesitation in raising any concerns. Staff told us of 1 example for a person who at times, showed escalations in their anxiety. Staff said they had raised their concerns with a GP and since a recent medicine review, episodes of escalating anxiety had reduced. Staff also said they had made a referral to a mental health team to seek further support.

The provider did care about and promote the wellbeing of their staff. They did support or enable staff to deliver person-centred care.

No staff members raised any concerns about their individual treatment by senior staff. A staff member told us they felt supported through their first 1 to 1 meeting with their manager and said, “It has given me ideas about areas to develop further.” Staff told us they felt valued because of recent changes and if they needed any support or adjustments, they felt confident to bring this to the manager’s attention. If staff were concerned with any practices in the home, the provider had information for staff to ‘whistle blow’ to help protect their identities.