Gloucestershire Health & Care NHS Foundation Trust

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question inadequate. 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. People’s choice of activities was not always recorded in the care plans.There were missed opportunities to extend and build upon these activities to ensure people had a more enriching and meaningful day-to-day experience.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours observed on the day of the assessment showed that they were discreet, respectful, and mostly responsive when interacting with people. They provided help, emotional support, and advice at the time it was needed.

For example, staff gave one person their own clothes and shoes, as they used many. We observed warmth and kindness from staff towards the people they supported.

Staff signposted people to other services when appropriate and, when necessary, supported them to access those services. For instance, the team communicated effectively with new providers identified for individuals due to leave the service, to ensure all needs and preferences were captured and shared.

Staff reported that they felt able to raise concerns about disrespectful, discriminatory, or abusive behaviour or attitudes without fear of negative consequences.

Staff also supported people to understand and manage their care, treatment, or condition. They used pictures as a communication aid; however, this approach needed further development to ensure choices were meaningful and fully accessible to individuals.

Improvements had been made to ensure people’s dignity was respected. At the last assessment, the provider had failed to follow its own policy regarding who could access CCTV screens. CCTV had been recording people’s living areas and toilets. systems were now in place to reduce the use of CCTV and ensure privacy and dignity were maintained when its use was necessary.

CCTV monitors were placed in the observation room, with signage reminding staff about privacy protocols. Blinds were installed on observation room windows to prevent others from looking in, and privacy screens were added to the monitors. The modern matron carried out twice-daily checks to ensure that audit forms were completed, explaining the reason for CCTV use. Privacy screens were also in place when people were using the bathroom.

However, we found some conflicting accounts from staff and discrepancies in records regarding how and when CCTV monitoring was used.

Relatives told us that staff were kind.

The evidence showed some shortfalls. The service 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.

Staff reported that working at the service was very rewarding, and they valued the time they had to get to know each person’s individual needs, likes, and dislikes. For example, one person went home every other week, and a trip to the beach was planned for the following week. Another person who enjoyed cycling was supported to visit a school and a large field for bike rides.

However, there were missed opportunities to extend and build upon these activities to ensure people had a more enriching and meaningful day-to-day experience.

Staff knew the people well and responded to requests in a caring and respectful manner. Staff did not always support people to identify potential triggers for distress, nor consistently use this information to inform tailored de-escalation strategies for individuals.

Staff adapted their communication to meet the individual needs of people who used the service. For example, picture cards were used to aid understanding. However, this approach required further development.

The evidence showed some shortfalls. The service 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.

The service had several systems in place to promote people’s choices..These included daily staff safety huddles, designed to review immediate concerns and agree on short-term strategies. Weekly life meetings, chaired by a Clinical Psychologist, were also held to discuss ways to improve people’s experience of care. However, these systems were not always robust. For example, senior staff told us that people were offered choices of activities but these choices were not consistently recorded in care plans. For example, in the June/July 2025 multidisciplinary team (MDT) meeting minutes, it was documented that one person went out for ice cream and to see cows, and that they enjoyed the outing. However, there was no recorded follow-up to explore why the person enjoyed the activity to inform plans for similar events in the future.

Since our last assessment people are spending more time out of their flats and in the community. However, people’s opportunities to access the community remains limited. Some relatives expressed concerns about the limited range of activities available, and the time family members continued to spend in their flats.

The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff were not always fully aware of, or responsive to, specific risk issues. For example, there were concerns about the potential dangers of restraining a person with epilepsy which had not been explored by the staff team.

Staff did not always respond to changing risks to minimise any discomfort or distress..

However, we noted that staff often used de-escalation techniques to manage situations where people’s distress became heightened. As a result, the use of physical restraint had reduced by approximately 50% since the last assessment.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff who participated in focus groups told us they felt respected, supported, and valued. They spoke positively and with pride about working for the provider and within their team. Many expressed a desire for the provision to continue, with the ongoing Learning Disability Review being conducted by the Trust to look at and improve the service provision.

Staff had access to support for their physical and emotional health needs through the occupational health service. Staff sickness and absence rates were similar to the provider’s overall average.

Staff appraisals included discussions about career development and how it could be supported.