Archived: Bloomsbury 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

Our rating for this key question remains unchanged at requires improvement. We were not assured people were consistently supported with their independence, choice or control over their care. People were not actively involved in reviewing their care needs or their relatives involved in reviewing them. We were not always assured people’s needs were responded to appropriately.

People were mostly treated with kindness and compassion.

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.

People told us they were happy at the service and had no complaints about the staff or how they were treated. One person told us, “It’s absolutely brilliant (here). I wouldn’t give it 100/100 I’d give it 120/100. The staff are absolutely excellent.”

Relatives shared with us how satisfied with the service they were in caring for their loved ones. A relative told us, “I think it’s wonderful (at the service). I have no problems at all."

Staff told us how much they enjoyed working with the people who lived at the service. One staff member said, “I do like working here. I love the environment and talking to the residents." Staff we spoke with gave examples of how they would make sure people's privacy and dignity was respected at all times.

Visiting professionals to the service told us they always found the staff to be considerate towards the people living at the service and raised no concerns with us.

We saw that people were not always treated in a dignified manner. For example, we saw a person being supported to move by staff in an undignified manner. We also saw that undignified language was used by staff. For example, we heard staff refer to ‘toileting’ people after lunch.

We found the lunchtime experience was quick, and appeared rushed, with staff coming into the dining room and placing plates in front of people. No pleasantries were exchanged and lunch was completed within 25 minutes. We saw some people were drinking out of plastic beakers with lids on them. Other more dignified options were not made available to these people.

However, we also observed some kind and compassionate interactions between people and staff. For example, we observed engagement between staff that supported people's wellbeing, such as sitting and talking, laughing, singing and meaningful touch and people looked happy and cared for.

People gave us positive feedback about whether their individual preferences were consistently met. For example, 1 person told us the staff were ‘excellent’ and would give them a ‘strip wash’ in their own room because they could not have a bath as they could not get out of it and the shower room was too cold for them.



Another person told us how staff supported them in line with their individual preferences. They told us, “They (staff) make me my favourite for breakfast, that’s porridge with honey, fruit and cinnamon. I choose when I want to go to bed. I have a vegetarian lunch and I have 2 jam sandwiches with the crusts cut off for tea."

The registered manager and NI agreed care plans needed to be written in a more person centred way to reflect people as individuals and the new care plan software would support them to do this. Staff explained to us how they supported people in a way that was individual to the person. For example, a staff member said, “[Person] is very independent and will do a lot for themselves. I try to encourage that."

Our observations showed people sat in one lounge area, in close proximity to each other, with a television and radio, on at the same time. The radio was loud and the television volume was off, displaying the subtitles. We asked about the 2 pieces of equipment being on and were told by a staff member and registered manager, it was what people wanted. We were told by staff people needed the volume loud on the radio because they were hard of hearing and people wanted the television on to watch in the background. Improvements were needed to ensure people’s preferences were recorded in their care plans, so everyone had equal enjoyment when in shared spaces within the home and entertainment was accessible to everyone.

Care plans we looked at contained some information that was individual to the person although information contained within, for example, mental capacity assessments and risk assessments were generic and not identifying people with individual needs.

People told us they had a choice about how they spent their time and had opportunities to participate in activities that promoted their independence or wellbeing. One person told us, “I choose to stay in my own room and the staff respect that. They (staff) will come to see me and check on me. If I want to sit downstairs, I can but I’d rather stay here (in their room).” A relative told us, “[Person] is happy to stay in their room. The noise downstairs is too much. They have lived on their own for a long time and like their own company."

Staff spoken with gave examples of how they encouraged people’s independence, such as encouraging people to try and wash themselves, and brush their hair or teeth. A staff member said, “People get up when they want to. [Person] had a lie in today because they were tired. This is their home and we are there to support people when they need us."

We saw that people were not always offered choices relating to their care. At lunch time, on day 2 of the site assessment, in the dining room, everyone had been given juice in plastic beakers and were not offered any alternative, such as tea or coffee. There were no menus on the tables in the dining room to show people what was for lunch or what choices were available for them to choose from. We saw people’s yoghurt desserts were brought in at the same time as their dinner, with the silver foils removed from the cartons. No choice was offered in flavour of the yoghurt. We heard 1 person ask another person what flavour they had. The response was, “I don’t know, it’s white the same as yours.”

We saw there were fixed times for lunch and dinner set at 12pm and 4pm. The tea was set as sandwiches, usually jam. One relative told us, “[Person] isn’t a child and I have said (to staff) I want [person] to have a proper tea other than sandwiches.” In response to our assessment, the provider has since taken some action to improve the meal experience and have completed feedback surveys with people about their mealtime experiences and individual choices.

We saw there were activities for people to participate in. However, these were not always in consultation with people. For example, 2 people had gloves and eye masks put on them while they were sleeping so were unable to be fully consulted on whether they wanted to wear them or not. The choice had been made for them.

Care plans did not always reflect people’s individual preferences or outline to staff how they should encourage independence and promote choices. For example, care plans did not guide staff to offer drinks choices to people at lunch time meal, we observed. Care plans did not always reflect how the service made sure people had an understanding about their care. For example, regularly reviewing if there was a need for using different ways of communicating with people, such as easy read documents or large print which would enable people to read their care plans if they wished to. Audits had not identified that people were not always being offered choices about their day to care.

People and their family members told us they felt the service took prompt action to support people when their needs had changed. This included contacting health care professionals when needed.

Staff told us they would ensure the appropriate action would be taken when a person’s needs had changed. The staff gave us examples of when they had contacted the GP to request a visit when people had become unwell. Staff also told us regular referrals were made to health care professionals for their input, for example, the dietician and occupational health therapist and explained how they would make sure they followed the advice and guidance provided by the visiting health professional. However, staff had not followed the advice of a professional when supporting one person with a piece of pressure relieving equipment to mitigate the risk of future deterioration of their skin.

We found the service did not always listen to and understand people’s needs and did not always respond to people’s needs in the moment to minimise any discomfort, concern or distress. This included when 2 staff were observed to try and support a person to stand when the person clearly could not weight bear. There was no equipment available to support the person and there had not been a review of their ability to stand unaided to monitor if their care needs had changed.

We saw where people had activated their call bell for assistance, staff had attended promptly.

The management team told us they ensured staff had received the training they needed to deliver safe care to the people living at the service. The registered manager told us they held regular meetings with their staff. Staff told us they felt supported by the management team and enjoyed working at the service. One staff member said, “I wouldn’t work anywhere else, I love it here (at the service)."

We found that out of the 19 care and administrative staff, 17 had completed training around person centred care. Staff had received regular supervision from the registered manager and where appropriate, had their competencies assessed for administering medication. However, while staff may have completed their training, the support people received from staff was not always person centred and reflective of people’s care plans and risk assessments.