Glebe House

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 requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The provider was in breach of legal regulation in relation to dignity.

This service scored 45 (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 respect people’s privacy and dignity. Although staff told us they were mindful of people's privacy and dignity and described how they made sure doors and curtains were closed when providing people personal care, we found during our observations that there was an overall lack of person-centred care and an understanding on how to support people with their privacy and dignity. For example, we saw that 1 person was receiving personal care with their bedroom door open while they were fully naked. Another person was seen exposing themselves in their bedroom with the door open, which staff did not acknowledge until we pointed this out to them.

After our inspection, the provider sent us people’s updated care plans and risk assessment that reflected the concerns around people’s privacy and dignity that was identified during our visits. Due to this information not being assessable to staff during our inspection, this placed people at risk of not receiving their privacy and dignity as required.

We received mixed feedback from people about staff approach to providing care. A person told us, “Staff are nice, they listen to me when I asked them to help me with something.” Another person said, “Staff are fine I have no issues”. A third person mentioned, “Some staff go out their way to help me. However, there are some staff that really don’t care they don’t listen to what I’m saying, and I don’t feel they respect my views and how I’m feeling.” This meant people were at risk of not being protected with their privacy and dignity, which could potentially put them at risk of abuse.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

Staff did not always ensure people’s strengths, abilities, aspirations, and future planning was clearly reflected in their care records. For example, we reviewed a number of care plans and noted that there was a lack of detailed information regarding what people were good at and their strengths and abilities. Care plans did not always reflect people’s history and background and were not person centred. We discussed the concerns with the provider and the registered manager confirmed that they would review each person’s care plan to reflect this information. We saw evidence that this had been completed.

After our inspection, the provider sent us updated records that was not available during our visit.

During our visit, we saw that a person was becoming agitated, and staff tried to engage with them to help calm the situation down. However, we saw in the person’s care plan that there was a lack of information on what strategies worked for this person to support them when they were anxious.We discussed this with the registered manager who informed us that they would work with their internal positive behaviour support team to develop guidelines for staff to follow.

We observed staff interacting well with people. Some staff were clear that everyone should be treated as an individual; for example, a staff member said, “I’ve worked here for a long time and have got to know people well. It’s about building up a positive relationship as this helps you to understand people’s likes and dislikes and how the person likes to be supported with their routines.” A person told us that they had lived at the home for many years and they felt that staff knew them well. The person told us, “It’s fine here. I’ve lived here for some time and the staff know what I like”.

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

We received mixed feedback from staff on independence. A staff member told us, “I encourage [people] to maintain their independence as much as possible”. Another staff said, “I help the [person] to be as independent as they can, by only supporting people with the areas that are needed in." However, a third staff commented, “No, people are not supported to do things themselves or to teach new skills.”

A person told us, “I feel that some staff rush, to get the task done”.

Care plans did not always contain specific detailed information about people's levels of independence, their daily living skills, and the areas that they required support from the staff team. For example, if the person had the ability to make a meal themselves or if they were able to dress themselves. Care plans were not always personalised, and the level of people’s independence was not assessed robustly.

Care plans also lacked details of skill teaching and what people’s future plans were. For example, the care plans did not describe people’s wishes in regard to future plans such as, if they wanted to be supported to move into a smaller accommodation or into their own home.

Following our inspection, the provider has submitted their revised care plans, which detail the ways in which the service encourages and supports individuals to maintain their independence and skills.

Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We noted that people did not always receive immediate response when people needed support. As mentioned previously, there had been a delay in seeking advice regarding a person’s wound care and when another person’s mobility had declined.

During our visits, we also observed staff did not respond to a person who was exposing themselves with their bedroom door open. This meant staff failed to provide timely assistance to a person who requested support.

We also found people’s ‘missing persons’ information did not contain vital information regarding the timeline and when people should be reported missing by staff. This meant there may be a delay in finding a person if they went missing placing them at risk of harm.

After our inspection, the provider submitted evidence that demonstrated that records were in place. However, these records were not accessible during our inspection, as we were unable to access the computer. Therefore, there was a potential risk that staff did not have access to up-to-date information for people using the service, which meant that staff may not respond as stated within line of the updated information.

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.

Some staff shared that they enjoyed aspects of their work and had positive relationships with colleagues. However, others reported feeling unsupported and highlighted a lack of opportunities to raise concerns with management.

A staff member told us, “The manager is not in the service regular, and they show favouritism to certain staff.” Another staff member said, “Management is not [very] supportive to staff.” However, another staff commented, “Manager is good they know there role well.”

During our discussion with staff, we saw that morale was low and that there was a divide within the team, which meant that the team did not always communicate with each other proactively. For an example a staff member told us, “some staff are so negative and don’t want to move forward in making changes within the team.”

At the time of our inspection, we informed the registered manager of the feedback that we had received, they said that they would discuss this with the staff team.

After the inspection the provider sent us information that they had systems in place to support their staff team. For example, it was evident that regular supervision sessions were being held, and management confirmed they operate an open-door policy, enabling staff to discuss any matters directly with the manager. In addition, a staff wellbeing hotline is available, which staff can call for advice and support.

Following our inspection, the provider also supplied evidence that two team building days had been organised to address the concerns identified and to help boost staff morale.