Astley Hall Care Home

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.

This service scored 55 (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 always treated people with kindness, empathy and compassion. People’s privacy and dignity was not always respected. Staff knew people well and understood individual routines, preferences and things that mattered to them such as their appearance or people who were important to them. People’s dignity was not always maintained consistently. For instance, people’s dignity had been compromised at busy times of the day because there were not enough staff to support them when they needed it. At other times we also observed staff were responsive and assisted people to their bedrooms when they needed to use the toilet or freshen up.

Some people told us they felt they had some control over their own privacy and enjoyed the company of staff with similar interests. A person told us, “Staff are respectful; they know what I can do for myself and what I need help with; there’s no complaints from me.” Relatives comments included “The staff are mostly lovely; now there are two staff particularly nice [Staff name] and one of the Nurses; they are lovely and compassionate. One guy [Staff name] is an absolute legend too” and “Care is very good and staff are great; all very caring and they know [Person] and the other residents here.”

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

People were encouraged to have items of personal importance within their bedrooms, to personalise and create a homely place.They told us staff met their needs and understood their individual preferences and routines. A relative told us, “They are really good with [Person] with entertainment; they always try to include them, and they put [cultural appropriate] things on their screen too” and “I think the carers are able to communicate with [Person]; overall I think things have gone smoothly.” We observed staff were patient, kind and communicated with people in a respectful way.

Staff told us at times; their approach can be task-oriented in order to meet people’s needs and manage risks. Staff told us an additional staff member would give them time to provide personalised care to people. People’s care records were not always person centred to guide staff on how to provide person centred care. The regional manager had identified this through their own audits and assured us they had begun to address these issues.

Care plans included people’s interests, diverse backgrounds and abilities, and had information about any protected characteristics. Staff told us any changes to people’s care was shared with them at the daily handovers meetings.

People and relatives were encouraged to attend residents and relatives meetings. A relative said, I have been to two ‘relatives’ meetings and I found them useful. I go along to listen and hear; there was a question and answer session with the manager.”

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 experience of staff promoting their independence and control of their care and wellbeing was mixed. A person told us, “In the past some of the carers (then) were often impatient and talked over him and [Person] found that wrong but now things like that are much better.” Another person told us, “I'd like to be around people of my age and my interests. There's not enough social things for me to do; the manager is aware of this.” Where people relied on support from staff they sometimes experienced delay and this was supported by the feedback from relatives, staff, and our own observations. The regional manager was aware of this and assured us action was being taken to improve staffing numbers and staff deployment.

People told us they made day to day decisions about their care and how they wished to spend their time. People’s visitors were made to feel welcome and could visit anytime. Activities were adapted for each person’s needs, for instance, one person was helping to pot some plants for the hanging baskets. Where people could use assistive technology this helped them to increase levels of independence and control over their own environment.

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

People reported staff did not always respond quickly to their requests for support and described numerous occasions when staff responses had been delayed. People told us the response times from when they rang their call bells varied but were always answered. Relatives shared both positive and negative experiences which affected their family member’s wellbeing. One relative described their family member being showered, dressed and seated when they visit, but today staff were 2 hours late in supporting their family member and they were eventually ready just in time for lunch. Another relative told us, “There is no stimulation for [Person], they get frustrated that they have to wait sometimes, as they need 2 staff to help them.” We observed staff were responsive but at times they had to prioritise people, which meant some people had to wait, and this supported the feedback received. These concerns were raised with the regional manager. They told us there was no systems in place to monitor call bell response time; but they had begun the process to have access to call bell reports to improve oversight of call bell response times. They also assured us staffing levels and deployment would be reviewed. When we returned the following day the staffing numbers had increased on one floor only and a further review was being completed.

We observed staff were responsive and took prompt action when a person had slipped off the chair and lay on the floor; they checked the person was in a comfortable position, carried out further checks and contacted the GP for advice. When a person showed signed of distress, we saw a staff member reassured them and treated them with compassion.

The provider did care about staff but did not always promote their wellbeing. They did not always support or enable staff to deliver person-centred care.

Systems were in place to support staff, and most staff felt supported by their peers, senior care staff and nurses. Feedback from staff about support to promote their staff wellbeing was mixed. A staff member said, “I'm happy in my job, love our residents and we have a great staff and team work.” Staff told us there had been occasions when the service was not safe so they did not take breaks, but this was not always recognised. Other comments included, “I have not had any individual supervision since I joined. We have group supervisions when some mistakes happen,” and “I am not happy with my work because they won't let me grow and I am losing my skills.” Staff told us there was a chest freezer stored in the limiting space for staff to have their breaks and have something to food and drink. We shared the feedback with the regional manager and they assured us work was underway to improve the culture, support and to develop staff. There was a range of services and support available to staff, which included access to confidential support and advice, including as bereavement support.