Archived: Walsingham Support - 21 Budge Lane

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

People seemed relaxed in their surroundings and told us they were happy living at this home. However, our observations demonstrated that people’s dignity was not always maintained and professionals also expressed concerns about how people were being treated.

We observed staff did not always use appropriate styles of communication and interaction with people in accordance with their individual needs and that that people’s choices were not consistently met. The provider was not always ensuring people’s individual needs were met in line with their needs and preferences as the provider was unable to provide evidence that people’s individual needs were being met, for example, through seeking their feedback.

Staff demonstrated people were involved in making choices about their daily routines. Processes were in place for the provider to support people to have choice and control over their own care.

The provider confirmed they had not consistently managed staff wellbeing.

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.

People seemed relaxed in their surroundings. People were willing to engage and initiated chats with the visitors. People told us they were happy living at this home, commenting "It's not too bad" and "I like it here." Family members’ comments included, “[My relative] loves staff and food, she’s happy there. [My relative] has got to a point when she comes home to me on [day of the week], she asks what time she’s going back.”

Staff demonstrated they treated people with kindness and respect. Staff provided us with examples of how they respected people’s privacy and dignity. They said, “I have to close the door when I enter the resident's room, close the curtains and then I can support them” and “For privacy, you need to knock at the door. If [the person] says yes to coming in, they are giving their consent.” Preferences were identified and appropriate staff were available to support people. This included people being supported by a gender of staff which they felt comfortable with.

Professionals expressed concerns about how people were being treated. Professionals were concerned that people’s needs were not being met and that their needs were not being managed with compassion with regard to their dignity. These concerns were shared with the provider who had commenced work with the local authority to address these issues.

Our observations demonstrated that people’s dignity was not always maintained. Although there were no concerns shared by the family members related to the dignity and respect of people during their care we observed a staff member assisting a person to use the bathroom without the doors being closed. Staff were seen standing over a person and behind their back when supporting them with an activity which could make the person feel intimidated and uncomfortable. This meant that people’s care was not always caried out in a respectful and dignified manner.

People told us they liked staff that supported them. Family members’ feedback about the staff working at the service was mainly positive, noting they were “All very very caring” and “[Staff] that I spoke to, they seem to know [my relative’s] personality.”

Staff demonstrated people were involved in making choices about their daily routines. Staff told us and family members confirmed that people were asked by staff about their preferences and wishes. Family members’ comments included, “[My relative] definitely has choice when to go to bed. A lot [of people] go early [to sleep], but [name of the relative] waits until night staff come on and sometimes, they need to persuade her to go to bed. Choice of what to eat she gets”, “I’m sure [staff] does include [my relative] in daily routines” and “In my experience, no problems at all.”

We observed staff did not always use appropriate styles of interaction with people in accordance with their individual needs. Staff told us they mostly relied on people’s verbal communication skills because most people living at the service were able to use basic spoken language and tell staff if they wanted something. However, we found that most people required support to engage in more complex conversations and help to understand the information provided.

During our visit we did not see staff using pictures or any other communication tools to support people's communication, for example to remind people about their daily activities and choice of meals. We also found that staff interactions with people were mainly task orientated. People’s permission was not always sought before staff carried out personal care tasks.

The provider was not always ensuring people’s individual needs were met in line with their needs and preferences. People had clear individualised care plans in place, which stipulated their personal likes and dislikes in a number of areas including their choice of food and preferred activities. However, at the time of our assessment, the provider was unable to provide evidence that people’s individual needs were being met, for example, through seeking their feedback.

The provider was also unable to provide any evidence that they were supporting people with their individual communication needs. There were no communication tools in use for people using the service.

This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Family members confirmed their relative’s independence was encouraged and supported. A family member told us that staff taught their relative to use kitchen equipment so that they developed new skills and gained more independence.

Family members told us their relatives knew the permanent staff that supported them well and their choices were sought and met. Family members told us, “Yes, [my relative] gets close to them” and “New staff, I get to know them, introduce myself and have never met staff with any issues, they are there for [relative’s name]. No one difficult, [staff] on the ground do their best for their clients and care about [relative’s name], not same for management.”

Staff provided us with examples of how they encouraged people’s independence and doing things for themselves. Their comments included, “[A person] can brush his teeth himself. [Name of another person] puts tea in the cup. [Name of the third person] can chop vegetables herself or steer food when cooking” and “[Name of the person] is independent, but I have to encourage her to come for the breakfast, for example. You have to always supervise, prompt and remind [the person] what to do.”

We observed that people’s choices were not consistently met. During the day people were seen to be occupied with the indoor activities. This included people spending time using sensory toys, doing writing and watching their favourite sport programs on the TV. We saw board games, sensory toys and music instruments being available and easily accessed by people for activities. However, people were not always supported to participate in the activities outside the home when they wished to. A staff member told us, “We have 3 staff during the day but it's not enough to take people out and not for the activities they have every week. Like [name of a person requires 2 staff to support them] in the community and we don't have enough staff for that. We do more activities in the house.” This was in line with what we observed during our visit. Some family members also told us that overall people required more stimulation, commenting, “Only thing perhaps a few more activities during the day rather than watch tv” and “Environment is not ideal for [relative’s name], there is not enough interests outside his room.” This meant that people were not always supported by staff to access or take part in the activities of their choice.

Processes were in place for the provider to support people to have choice and control over their own care. People’s care plans were written following consultation with them and there was a clear record of people’s choices included in their care plans.

Systems were in place to encourage people to participate in activities. We saw people had individual activities timetables which included a range of daily of activities for them to participate in.

People’s family members told us staff were aware of their relative’s care needs when they came to live at the home. Family members also thought that people’s food choices and diets were followed as necessary at the service. Comments included, “[My relative] is not supposed to have anything large because [my relative] could choke. He uses a fork, he’s picky and [staff] accommodate that. [My relative] is happy with the food. Staff take [my relative] out for fish and chips sometimes, he enjoys that” and “[Relative’s name] eats most things. If [my relative] doesn’t like it, she’d tell them.”

Staff assisted people when they needed support to carry out activities safely. This included staff responding quickly when they saw a person requiring help to stand up from a chair.

We saw staff responded to people's immediate needs as necessary. People were well groomed and wore clean clothes because staff supported them to change when they needed to. Staff reassured a person when they noticed them feeling overwhelmed by asking questions on what could be done to make them feel better.

The provider confirmed they had not consistently managed staff wellbeing. The management team told us the the service had lacked management oversight which resulted in issues with the staff morale. The new management team were in the process of having individual meetings with staff members aimed at getting to know them and ask for their feedback. The service manager told us they felt positive about what was achieved so far because staff started coming over to ask them questions and for support when needed.

The provider was not consistently promoting the wellbeing of staff. The provider failed to show evidence that staff views were taken into account and acted upon. There was no evidence of ongoing action being taken in response to staff complaints or that staff views were actively sought in relation to their ability to support people or in relation to their wellbeing at work.