Gogomadu Cares Nottingham Office

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. This is the first assessment for this service. This key question has been rated requires improvement. This meant people did not always feel well-supported, cared for, or treated with dignity and respect.

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 treat colleagues from other organisations with kindness and respect.

We received mixed feedback regarding how caring staff were towards people. We collected feedback from a person and a relative and were told that 1 member of staff had a good relationship with the person. This included joking and talking about things they liked such as football but some of the staff would ‘argue’ with the person or ‘blank’ or ignore them. However, dignity and privacy were seen as a positive from feedback received. The person told us staff took their time to provide care and support, so the person did not feel rushed.

Feedback from a professional who worked with the service indicated they found it challenging to work with the provider, in part due to how they were treated, and described interactions with senior leaders as ‘aggressive’ at times and did not respond in a positive way. This approach did not reflect expected standards of kindness, compassion, and respect, and created an environment that could undermine collaborative working and, ultimately, people’s dignity and experience of care.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Care plans did not consistently contain details relating to their life histories, interests, support networks, and things which were important to them. For example, interests were listed with 1 word, such as ‘music’ with no extra detail. The lack of personal details in care records meant staff did not have access to information which may have helped them to establish relationships, build trust, and develop an understanding of people’s needs and wishes.

Feedback from the person, their relative and a professional was that staff would mainly support the person with online video’s, movies, and TV at home and that more could be done to support the person with other things they enjoyed. The person had a keen music interest and was supported a couple of times a month to leave their house to pursue their interest, but feedback indicated activities like this more frequently would be positive for the person’s wellbeing. The management team described how staff supported the person to access activities outside the home, including visits to pubs and cafés. These activities were not reflected in the person’s care plan, and there was no evidence that the potential health risks associated with these activities had been assessed or monitored.

However, despite limited written records, the management team were able to provide us with examples of conversations they had with the person. These were very specific to the person’s home living situation and individual to them and their family situation, including selection of activities and outings they used to do with the person which treated them as an individual.

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

People’s care records did not always contain information to support them to maintain and promote their independence despite limitations due to health and mobility. Information regarding what people were able and wished to do for themselves, how they communicated choices or how staff should respond if people refused their care was not always held within people’s care plans. Where care was refused, the reason for this was not recorded in detail and there was no record of a later follow up. However, the person felt they had control over their care and were able to have choice on day-to-day decisions.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Daily notes lacked sufficient detail and did not consistently record key aspects of care, such as oxygen levels or the outcomes of as required (PRN) medications, particularly in relation to pain management where further medication or referrals may have been necessary. This shortfall increased the risk that the person’s immediate needs were not recognised or responded to promptly, which may have led to unmanaged pain, deterioration in health, or delayed clinical intervention.

Feedback from a relative was that the person had to ask for things rather than things being offered. However, due to the person’s needs, having to ask for something such as drinks could lead to the risk of dehydration. The care model relied on two staff members being available at all times. However, feedback from the person and a relative was that staff were not continuously based in the same room, and it could take from 2 to 40 minutes for the person to have support if they needed something, but staff were usually within speaking range. This meant the person did not always have their needs responded to in line with what was expected and created a risk that the person’s urgent health, safety or wellbeing needs may not be met promptly, potentially resulting in avoidable harm and a failure to deliver care in line with agreed support arrangements.

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.

Despite seemingly positive relationships within the team, a lack of formal wellbeing systems and processes limited the provider’s ability to ensure consistent support for all staff. Without established policies, regular wellbeing monitoring or accessible support pathways, the provider could not demonstrate it reliably promoted staff wellbeing in a way that aligned with regulatory expectations or ensured staff always had what they needed to sustain safe, person-centred care.

However, the management team were able to give examples of how they supported the staff team across both services operated by the provider, which included offering support where staff were struggling financially or with family related issues. The management team also understood the importance of staff having time to ‘bond’ across the two services and were planning staff events, such as a Christmas party. The registered manager told us, “This year in July we are going to celebrate 10 years of operation of Gogomadu which will involve Nottingham”. This showed the management team had some effective approaches to supporting staff, despite wider concerns identified within the service.