Tuscany 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 Outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 95 (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 was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

We observed extremely kind and compassionate interactions between staff and people. Staff were clearly passionate about supporting people and creating a good quality of life for them. One staff member told us, “You feel connected to the residents. It’s all about teamwork here. You could get assigned to anyone on shift and you have to do the best for them.” Another staff member said, “[Person] is excellent. I like working with him.” The manager told us, “If you sit and listen to [staff member] and [person] talking, it’s the most beautiful interaction and I’m so proud of it.”

We observed staff supporting people to increase their confidence through positive relationships, based on their understanding of their individual needs. For example, a staff member explained to us how building a trusting relationship with the person he was supporting had led to exceptionally positive outcomes for them. They told us, “We have a lovely relationship. For [person], it is not always easy. I read his support file. He used to only have a shower once a week and now he looks forward to it daily. First of all, you have to speak to him calmly and reassure him. No loud voice and be patient with him. One day a professional came to take a blood sample. He would normally have refused, but by talking gently and saying things like ‘you are the best man ever’, he agreed. It melts my heart every time I see him.” This demonstrated how staff’s outstanding kindness and compassion towards people had improved their lives, self-esteem, and physical and mental wellbeing.

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

Staff had taken the time to get to know people very well. This meant they were able to meet people’s needs and preferences and ensure their care and support was individualised to them, resulting in a reduction of people’s anxieties. Following the implementation of a weekly activity board, a staff member noticed that one person had become increasingly anxious about ‘how many sleeps’ there were until their planned activities. The staff member considered how to support the person to reduce anxieties such as, recording on the board each day how many nights there were until that person’s activities. This resulted in improved outcomes for the person and was implemented by the rest of the staff team. The deputy manager told us, “[Person] is so much happier now. And it’s made him so much less anxious as he had his plan documented for him. You can tell there’s such a bond between them (the staff member and person).”

We observed staff supporting people with kindness and respect to increase their confidence and independence through positive relationships, based on their understanding of their individual needs. For example, a staff member explained to us how building a trusting relationship with the person he was supporting had led to positive outcomes for them. They told us, “We have a lovely relationship. First of all, you have to speak to him calmly and reassure him. No loud voice and be patient with him. One day a professional came to take a blood sample. He would normally have refused, but by talking gently and saying things like ‘you are the best man ever’, he agreed. It melts my heart every time I see him.”

Another staff member had been working closely with a person who found it difficult to socialise in group activities. The staff member spent time with them teaching them how to play chess and draughts, meaning they could enjoy a calming and quiet activity together. The person now enjoys playing these games regularly with the staff member and their confidence has improved.

People were supported and encouraged to live a regular life for people of their age. The demographic of the service was young to middle-aged males. The management team acknowledged that people of their age typically enjoy socialising at night time, usually in nightclubs or similar settings. The provider was exploring how they could support people to do this, such joining a national campaign which organises club nights for people with a learning disability.

Staff demonstrated a strong commitment to people’s individual's routines and preferences, rather than adhering to standardised care schedules.For example, two people preferred to sleep until lunchtime, with one choosing to stay up late and have their evening meal in the early hours of the morning. Staff fully supported these choices by preparing meals late at night and ensuring they could rest undisturbed during the day. This approach considered choice and dignity, and promoted a personalised, respectful culture that met people’s individual needs.

The provider was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff went above and beyond to support people with skills that enabled them to have more independence and choice in their lives. One person had been supported how to recognise and write numbers from 1-10. Staff had achieved this by playing regular number games with the person.

Another person was being supported in learning how to cross the road safely. Previously, staff would have to navigate beside the person and pre-empt their moves as the person would walk extremely fast and had no understanding of road safety awareness. With the support of staff, they were now able to press the button at traffic lights and were aware of the need to wait for the green man before crossing. Although staff still supported them when out in the community, it had improved the person’s safety and risk awareness.

The culture in the service enabled people to make choices for themselves and increase their independence, whilst feeling safe and supported. One person had previously been too anxious to visit a barber with staff. However, through staff working closely with people and building up trust with them, the person now felt comfortable for staff to support them to visit the barbers for a haircut. People were able to choose which colour file they wanted for their care plan, what they wanted to wear, and how they wanted to spend their day. The deputy manager told us, “Staff ask people what they want for dinner. They always knock on their door. We ask them what they want to do, and we can change if their choice changes. I’ve always told the staff they don’t wait for us; we wait for them. They get to choose what they want to do, not us tell them.”

People were encouraged to be independent in their home and be fully involved in daily activities. Staff supported one person to learn how to close the boot of their car. We observed another person helping staff to prepare dinner by peeling potatoes. People were also supported to clean their own flats and wash their laundry where they were able to do so. This meant people received exceptional support and were encouraged and engaged to be active participants in their own life.

The provider was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

One person had a routine which was very important to them, of accessing the community each day to visit the local shop and pub. Staff were aware that this routine would be disrupted over the Easter weekend and the significant impact this could have on the person’s wellbeing. They spent time supporting the person to understand about the change in order to minimise any distress. Staff members then purchased the person’s usual drink order from a shop in advance, meaning the impact to the person’s wellbeing and routine was reduced and they could enjoy this at home rather than at the pub. This demonstrated staff knew the person well and worked with them to reduce as much anxiety and disruption, as possible.

People were supported by staff who truly understood their different communication methods and took action to meet their needs. This meant people’s goals and wishes were consistently met. During a menu planning session with people living at the service, one person communicated through picture cards that they wanted to bake a cake. Staff supported the person to go and buy ingredients and to be able to follow a recipe and bake. This had a really positive impact on the person and turned into a regular activity. The manager told us, “His newfound love of baking has enriched his life by promoting his independence skills. [Person] is also a sensory seeker who enjoys safe touch. By meeting his sensory needs and exploring alternative sensory seeking ways, this has [had] the potential to decrease events associated with his [medical diagnosis]. Baking gives him the opportunity to use his sense of smell and touch also. This enables him to make his own snack for his day centre visit whilst educating him around healthy choices.”

Interactions between staff and people demonstrated relationships were extremely caring and compassionate. This enabled staff to anticipate and meet people’s needs quickly and in ways that reduced and mitigated people’s discomfort and distress. One person had previously experienced high levels of anxiety when travelling to visit family members. This had led to a prescription of an anti-anxiety medicine to be used during the car journey. Staff understood the potential side effects of this medicine and proactively assessed the person's needs and anxieties, so that it was no longer required. This resulted in the person being able to enjoy more frequent visits to family and being less distressed whilst travelling. The manager told us, “This has opened up [person’s] world.”

Staff reacted to issues with people’s usual care provision in a timely manner. One person’s wheelchair had broken, and staff informed the management team immediately which led to a fast repair and the least amount of disruption to the person. The deputy manager told us, “Staff are proactive in telling me if anything needs fixing.”

The provider cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff were supported to manage their work-life balance. The manager had informed staff they were able to submit formal flexible working requests to fit in with the needs of their home life such as childcare. These applications were all being considered and where possible were going to be implemented.