The Cotswolds

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

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 65 (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.

During our assessment, we used our Short Observational Framework for Inspection (SOFI) to gauge the feelings of people receiving care who could not directly share their feedback with us. The observations made were mixed. We observed mainly neutral and negative interactions. For example, some people who used a wheelchair, were moved on several occasions around the room by staff, without any greeting, announcement or consent. We also observed positive interactions between staff of various levels, people and relatives as well.

People and relatives also told us that they were generally treated well by staff and leaders. One person told us “I get on with the staff very well” and a relative told us “My interaction with staff has been good all the way through.” Staff also felt there was a culture of kindness within the home, as one told us “You treat visitors as if it is a family home.”

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

People’s rooms were personalised, including some people’s signs on the outside of their doors, where they had chosen an image that reflects their interests or hobbies.

A group of people using the service had set up a Formula 1 Club, and other clubs such as this were encouraged and facilitated by the staff. There was room for improvement to ensure that all people were supported to engage in meaningful activities based around their hobbies and interest, particularly where people had more complex needs, this wasn’t always being done.

The provider completed personalisation audits, which included looking into people’s environment to ensure it was personalised. People were provided with contrast toilet seats, floors or doorframes where needed, and given choice of furniture within their bedroom when it needed to be replaced.

Relatives told us they feel the staff know people very well and treat them as individuals. One person using the service told us that sometimes their family will bring in specific foods from their cultural background and the kitchen staff are always happy to prepare it for them.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing, however there was room for improvement to ensure this was consistent for everyone using the service.

We found during our assessment, examples of the provider promoting independence. For example, some people who often could get lost and not locate their bedroom, had been provided personalised signs around the home, pointing them in the right direction.

The provider displayed information in multiple formats for people to access advocacy services, and where people were unable to do this independently, the provider supported them to access this.

Some people told us there was a not enough choice around food on the menu, which we also found. However, staff told us they would prepare other meals for people if they do not want anything from the menu.

During our SOFI, we observed some people were not always given choice and control. For example, there was no evidence that the staff member had not worked with people to give them choice over what to watch, and some people appeared disinterested in the programme selected.

One relative told us, when asked whether they felt their relative using the service had choice and control over their day-to-day care, “Yes, they always ask [relative] and tell them what they are going to do.”

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 had made available to staff, relevant information about people’s needs and how to meet them in line with people’s preferences, where they could establish them. This included information within care plans, assessments, and information displayed around the home. There was room for improvement to ensure this was always a clear and accurate reflection. For example, we found there was sometimes vague language used when referring to a specific health task that should be carried out by a qualified member of staff.

The provider had information in relation to allergens, modified diets any dietary needs displayed within kitchens and kitchenettes in addition to the information within their files, to ensure staff could meet people’s dietary needs at all times.

The provider used a Maybo technique, which is a model of support that enables staff to respond safely and, in a person-centred way to people in distress. We found that whilst all staff were trained in the theory of this, not all staff were trained in the practical elements, meaning there could be a delay to responding to someone in distress. The provider had already identified this and were working to get everyone booked on a training session before the end of the year.

Amongst reviews of people’s needs, and regularly updating people’s information should their needs change, the provider also undertook audits, such as call bell audits. A member of the maintenance team would spot check response times to call bells. Their most recent audit reflected quick response times, with their longest response time being just above 3 minutes.

Where people cannot use calls bells, the provider utilised other methods to enable people to access staff to meet their needs. This at times meant staff were checking on people as regularly as every 15 minutes, during waking hours.

Staff told us they were unable to respond to people’s immediate needs promptly all the time, as they felt there was not enough staff. One relative told us that staff always meet the basic personal care needs of their relative using the service, however they often had to point out and request additional tasks, such as nailcare, as this was often not done.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to develop.

Staff overall, felt their wellbeing was important to the provider, and that, even given the nature of their role and its unpredictability, they felt safe at work.

There were reward systems in place, including the opportunity for people to nominate a staff member to receive a thank you card and voucher. In addition, the provider participated in wider health and social care awards schemes where they could nominate their colleagues or submit nominations from people and relatives.

During our assessment, there was a lot of praise shared with us towards the nursing staff and how they continuously express their gratitude towards care staff and make them feel valued.

The provider was able to evidence that according to their statistics, they were one hundred percent up to date with supervisions, however some staff told us they couldn’t recall their last supervision and didn’t think they had one for years. There was room for improvement to ensure that all supervisions were meaningful and productive.

Staff felt the training provided equipped them for their role, and they were given opportunities to develop. For example, the provider operated champion schemes, where people would take the lead in a certain aspect of care. This enabled staff to develop their knowledge in a specific area and lead their colleagues in this aspect.