Lilias Gillies House

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

At our last assessment we rated this key question good. At this assessment the rating has remained as good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

Staff attitudes and behaviours when interacting with residents showed that they were mostly discreet, respectful and responsive, providing residents with help, emotional support and advice at the time they needed it. However, during our visit we observed 1 resident in the garden starting to become distressed. We did not see staff responding to them or approach them to see if they were okay.

Residents said most staff treated them well and behaved appropriately towards them. Three residents told us that most staff respected their privacy and dignity and knocked on their door before entering their bedrooms. One resident said that some agency staff could be abrupt and rude. Staff mostly supported residents to understand and manage their care, treatment or condition.

Staff directed people to other services for some specific needs and, if required, supported them to access those services.

Staff understood the individual needs of residents, including their personal, cultural, social and religious needs.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards residents without fear of the consequences.

The service treated people as individuals and made sure people’s care, support and treatment took into account people’s needs and preferences. The service were aware of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for disabled residents by ensuring disabled people’s access to premises and by meeting residents’ specific communication needs. One resident was in a wheelchair and had access to the communal areas in addition to an accessible bathroom and bedroom.

Staff communicated with residents, finding effective ways to communicate with residents with communication difficulties. Staff used alternative methods to communicate with a resident who was non-verbal.

The service did not have access to a translation service; managers told us that they would use translation services from the local authority to ensure that support was in place for a potential resident who required translation support or use staff within the organisation that can speak the same language.

Residents had a choice of food to meet the dietary requirements of religious and ethnic groups. Residents were responsible for cooking for the other residents in the service and planned a menu for each week.

Staff supported residents to access their chosen place of worship within the community. One resident told us they were supported to visit their local church.

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

The service followed the ethos that this was therapeutic community, therefore residents were promoted to have independence, choice and control over their decisions, including their care and treatment. One resident described the service as more of a supported living rather than a therapeutic community.

Residents had access to the community to promote and support their independence, health and wellbeing.

Staff did not always respond to people’s needs in the moment or act to minimize any discomfort, concern or distress on the resident or wider group.

We were not assured that staff always managed changing risks to, or posed by, residents well. One resident was under the care of their local mental health team with a plan to discharge them back to their care of their GP. We raised concerns about the acuity of their illness as the resident was not compliant in taking their medicines and had not received a recent review from a psychiatrist to review their mental presentation.

Staff told us that they used de-escalation techniques to reduce the need for physical interventions when residents’ behaviours became heightened. Staff told us they were trained in MAYBO to equip them with the skills to prevent, manage and de-escalate a resident that may become distressed. We reviewed 5 incidents in detail and saw that staff had attempted to deescalate the resident at the time, however in 2 records we could not see any evidence that staff had attempted to de-escalate the situation. For some incidents, the police had been called to manage a situation when it could not be de-escalated by staff. Residents described negative impacts on their own wellbeing and feeling of safety as a result.

Residents could access a sensory room in the service for those who would find this helpful at certain times.

Residents had an opportunity to express their views, wishes and needs in the weekly community meeting. Staff asked residents to think about developing coping strategies to remove themselves from a challenging situation.

The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

The service cared about the wellbeing of their staff and supported them to deliver person centred care. The service provided paid time off for staff to attend personal psychodynamic therapy if they wished to do so.

Staff had their own staff room and separate kitchen when they wished to take a break. Staff had opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. Staff attended weekly business meetings and a reflective space to reflect on their recent experiences at work.

Staff said they felt respected, supported and valued by managers. Senior managers had a 24/7 on call rota so staff could access them for support when required.

Although staff did not have access to an occupational health service, managers told us that senior managers would assess individual needs and put appropriate emotional and physical health support in place when required.

There were 2 students on placement within the service. One was an art therapist trainee, who supported facilitating the weekly art therapy group.