Archived: My Life Choice

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 there were breaches of dignity; staff caring attitudes had significant shortfalls.

The provider was in breach of the legal regulations relating to dignity and respect.

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.

People were not treated with kindness, compassion, dignity and respect at all times. The language staff used to describe people’s communication needs was not always respectful of their individual needs and preferences. For example, where 1 person was using Makaton to communicate, a member of staff told us they, ‘[Person] would be better with BSL [British Sign Language], but they don’t want to learn that’. This was not respectful of the person’s preferred method of communication.

Staff did always use appropriate terms to describe incidents where people were experiencing distress. For example, staff frequently described people as ‘in behaviours’ or ‘having behaviours’ during incidents of distress. This language did not demonstrate a compassionate and caring approach to understanding why the incident had taken place or what the person was communicating.

People’s relatives told us not all staff were caring in their approach. Comments included, “Staff took [person’s items] as punishments. They’re very punitive”, “[Person] has had some issues with some of them. Some don’t listen to [person]. They don’t ask [person] how they feel” and “[Person] repeats things and they ignore them. I’ve had to say can you respond to [person] please.”

The provider had not ensured people’s care plans demonstrated the importance of treating them as individuals. There was a lack of information about how to support people holistically to achieve their individual goals and aspirations.

The provider’s incident reporting processes did not demonstrate how people’s individual social and emotional needs were considered to minimise the risk of distress. People’s distress was documented as ‘behaviour’ without consideration for what people were trying to communicate or whether there was an unmet need which could be explored to minimise the risk of further distress.

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

We received poor feedback from people’s relatives about how people were offered meaningful choices about their care. Comments included, “[Person] doesn’t have choices. They wash [person] when they want; feed [person] when they want and give [person] what they have in, not what is [person’s] choice”, “They [staff] don’t really do a lot. They don’t do anything with [person]” and “[Person’s] not had any progression in their situation.”

People’s daily care records did not demonstrate how staff were promoting independence and control in people’s care. For example, entries where people requested support or communicated choices did not always demonstrate staff responding appropriately to facilitate these choices.

Staff did not always demonstrate a positive approach to involving people in their own care planning. One member of staff told us, “ We don’t talk to [person] about their care plan. [Person] knows their routines.”

The provider did not listen to or 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.

Where people could not communicate verbally, staff did not consistently demonstrate caring and compassionate interactions which enabled them to anticipate and meet people’s needs quickly. Where people were experiencing distress, staff did not always demonstrate an appropriate response to minimise this distress. One relative told us, “[Person] can be quite physically aggressive, but they [staff] reacted wrong”.

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.

We received mixed feedback from staff about morale within the organisation and about how well supported they felt. Comments included, “Morale is 100% low now, they don’t care for the staff like they used to”, “Managers haven’t always had staff’s best interests”, “We don’t see managers as much as we should” and “Managers at the top don’t really communicate with us.”

A staff survey completed from January to March 2025, evidenced staff had given similar feedback to the provider. However, the provider was not able to demonstrate what actions they had taken in response to this feedback in order to address the concerns and improve staff wellbeing.