Joseph House

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed one quality statement from this key question and the overall score for this section has been determined using scores from the last inspection. People who used the service were able to exercise some choice and control in relation to their care. Care plans contained specific information to guide staff about people’s preferences. However, some aspects of the service showed people were not encouraged to pursue their goals and aspirations or take assessed risks towards them. People were cared for, but the service needed to be more proactive when considering people’s choice and control over their own lives.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

Relatives praised the staff and found them very kind and felt they promoted choice and independence. One person commented, ‘Recently, [my relative’s] whole room was re-decorated. [They were] asked what colour [they] would like and now everything is green. [They] also [have] a new bed and bed covers, staff helped [them] to buy one day. Everything what [they] want.’

People’s care plans documented people’s likes, dislikes and what was important to them. In spite of the individual staffing levels and access to transport, some people were not seen to be living their best lives, with a lot of time being spent in the service.

Staff told us they understood people’s rights and choices and were able to tell us about how they tried to include people in decisions. However, it was not clear how people were supported in positive risk taking. Staff did not understand this concept and instead talked solely about keeping people safe. While this is laudable and important it does not increase people’s skills and independence.

Staff were kind, caring and patient with people. Staff offered choices and some interactions showed good relationships had formed. We observed some people carrying out activities in line with their expressed wishes documented in care plans. However, some staff had limited interactions and did not always promote people’s choices. For example, at lunchtime staff asked people what they wanted to eat but no additional methods of communicating were used, such as pictures or photographs of foods. Some people appeared to make no choice, but this may have been because they didn’t fully understand what was being asked. Some staff did not have English as their first language which may have contributed to this issue. We observed one person who was alone with staff in their room in the afternoon. There was no stimulation for them. No radio, book, picture, television as these had been damaged and removed.

People directed their care and support but, given the high staffing levels with many having 1 to 1 or 2 to 1 staffing, people were not always being supported to experience new things or increase their independence skills, should this be their wish.

Care records documented people's needs and preferences clearly. Care plans were routinely reviewed to ensure the information captured was still relevant. Oversight of people’s control of their lives could have been more robust to ensure, where people wished this and were able, they had opportunities to make more decisions about their own care.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.