Archived: Serene Residential Care Limited

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 requires improvement. 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.

This service scored 30 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

Although there were some positive, kind, and compassionate interactions between staff and people, this standard of care was not consistently maintained. Instances were noted where staff practices did not promote or uphold people’s dignity, privacy, autonomy, or choice.

For example, 1 person had not been supported appropriately with their personal care needs and was sitting in the lounge with their fingernails heavily soiled with faeces. This was attended to by a member of non-care staff, but the person had been served their breakfast with their fingernails in this dirty state. We also saw staff place screens around a person sitting in a chair in the lounge to empty their catheter bag. The screens provided minimal privacy, and it was easy to see what staff were doing.

While staff appeared well-meaning, the observed shortfalls in care delivery demonstrated a lack of understanding and awareness of fundamental care standards. Furthermore, staff sometimes used infantilising language regarding people who had dementia, learning disabilities or mental health issues. One staff told us, “[Person] wants attention. If [person] wants attention they get upset, it is like a child having a tantrum”. There was no understanding from most of the staff we spoke with of people’s diagnosed complex conditions or how these affected them in everyday life. This use of language did not promote people’s dignity and failed to show them respect.

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, unique backgrounds and protected characteristics.

Care plans lacked sufficient detail to guide staff on people’s specific needs, wishes and preferences. This limited staff’s ability to deliver person-centred care. Staff failed to show a robust understanding of people’s different assessed and diagnosed needs.

Staff did not have the required skills to differentiate between conditions and provide care and treatment in line with their needs and failed to treat people as individuals. A staff member we spoke to told us, “We need more training and information regarding people’s mental health conditions, and other more specific training.”

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.

People were not consistently offered choice in relation to their care and daily routines. Observations of mealtimes highlighted restrictive practices with a lack of choice being offered to people over the type of food, quantity and whether they required any additional condiments or second servings. This was the same for the offering of drinks; whilst a choice was offered, personalisation was not discussed or offered.

A relative told us, “[Person] loves to eat crisps, but they don’t have many now.” Feedback from most relatives was that people did not have a lot of choice over their day-to-day life, and where they did have choices, these were limited.

People were also not supported to meet their personal care needs. Two people's care plans said they liked to have their hair washed at least twice a week. However, we found no evidence of either person's hair being washed for a month. This was also apparent from their appearance. Another person's personal care records showed there were gaps of up to 7 days between support with personal care. This person was reliant on staff to meet their personal care needs.

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.

People and relatives told us they did not feel there were enough staff. Concerns were raised by people regarding staff availability. People reported a lack of visible staff presence, particularly on the ground floor. In some cases, when call bells were activated, people informed us they experienced delays of 15 minutes or more before receiving assistance. This undermined timely care delivery and compromised safety, especially for those with urgent or complex needs.

We did not observe people being offered support to use the toilet and where people were solely reliant on staff to provide this care, documentation was not always accurate or reflective of timely support being offered.

Furthermore, staff did not show the appropriate level of understanding for people who were living with dementia or who had episodes of distress caused by their mental health condition. Staff were unable to explain how they responded sensitively to people during times of crisis and emotional distress and often used unprofessional language when describing how they responded to people. Comments included, “[Person] has moments when they get angry. You’ve just got to leave [person] alone and tell them to relax.” As well as “[Person] gets angry when they don’t get things straight away. [Person] used bad language, so we just told them to calm down.” and, when referring to a serious life-threatening event 1 staff member told us “[Person] had a bad moment last year but they were checked over and were then fine. [Person] likes to have attention.”

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.

Staff told us the previous manager was supportive, and they felt valued by them. They all referred to the current manager at the time of inspection as not having enough time to reach out and implement robust communication and support networks, but they said they were hopeful the new manager would be able to do this and support staff. Supervisions were not routinely held and where they had been these had not been specific to each staff member’s need and failed to robustly capture support and development opportunities. Staff told us communication could be improved in the service between the leadership and care team and they felt this would improve staff happiness. There was no evidence of any other workforce wellbeing strategies successfully implemented in the service.