Cavell Court

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

Most staff were observed to be caring and the environment helped to promote people’s independence with safety in mind. People had large bedrooms and their own possessions. The environment had been carefully planned out and maintained and supported people to live in an enriching space with facilities they could use, which included individual suites which had on site kitchen areas so snacks could be prepared. Drink stations and snack stations meant people and their relatives could help themselves to drinks and an onsite café gave people an alternative place to meet their relatives. One person told us part of their daily routine was to go to the coffee shop and sit and watch the world go by. The entry of the home was welcoming, and a full-time receptionist helped ensure visitors were greeted and helped to promote the safety of those entering and leaving the building. CCTV camera covered external areas. The gardens also create extensive space for people to enjoy. A staff recognition scheme helped identify and promote good practice where staff were nominated and rewarded for good practice. Local award ceremonies were attended with a number of nominations from the home. Whilst speaking to relatives they were quick to impress upon us that some staff were exceptional and although there had been a recent movement of staff, staff still came on to the suites so say hello to people, which relatives said made their day. Information around the home was helpful and gave clear information of which staff were on duty and what was happening, or who to refer to if relatives had any concern.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most relatives and people we spoke with felt staff were kind and knew their needs well. Some staff were singled out for praise and this was recognised by the organisation who asked for feedback on individual staff members who were then subject to reward/ praise. Relatives told us their family members spoke warmly of the staff: One relative said, “They’re caring, careful, and attentive.” Another said, “The staff are very nice, thoughtful and take care of him.” Another family member said, " They are attentive and show initiative.” Relatives gave examples of proactive care and said staff noticed changes in people’s needs and responded accordingly. For example, a relative said staff noted a skin rash and referred it to the GP immediately. One relative had concerns about how staff supported their family member with their toileting needs and the timeliness of staff responses. A person using the service also raised timeliness of support as a concern in the morning.

Staff completed the care certificate when new to care and other training relevant to the needs of the people using the service which included, dementia care and person centred care. The manager was mindful of staffs behaviours and values and staff were subject to regular supervision, annual appraisal and observations of practice which included their interactions with people they were supporting. Where staff were underperforming they were supported to improve their practices. We spoke with staff who generally felt well supported and valued. Staff said they could raise issues and these were usually acted upon. The home had an open culture but several staff raised concerns about different cultural issues and there not always being sufficient understanding of each others roles and working fully as a team. There were lots of opportunity for staff to give feedback and influence service delivery. Good practices across the home were recognized and rewarded.

Partners in care had concerns over time about staffing and how that impacted on peoples care. For example people being left unsupervised or having to wait for staff to assist. Communication was also cited as an issue particularly during busy times of day and waiting for staff to assist. The manager had acknowledged these concerns and had said that team leader vacancies had been filled and this hopefully would bring more stability and management oversight to each suite. The matter of underperforming staff or staff behaving unprofessionally had been addressed.

We observed some really nice interactions across the day of our assessment and most of the feedback we received was positive. However we did note some staff interactions did not validate peoples experiences. For example, one person was brought downstairs to join in an activity. They kept asking where they were and what was happening. Staff confirmed they were living with dementia. When they asked, ‘when can I go home’ staff replied, 'In a couple of days.‘ This was not an appropriate response. Several staff also told us people from other floors were not usually supported to join in activities on the ground floor. Later in the day we observed a person banging their plate and cutlery which was a known behaviour for them . However staff just removed the plate and cutlery without engaging in a conversation with them or offering them reassurance.

People were observed as being well dressed in line with their preferences and well groomed. People confirmed they were supported to shower and or bath and there were regular visits from the hairdresser and chiropodist. People were offered appropriate choices across the day and supported to maintain connections with family and some attended community events if they wished including keeping fit and accessing church services. People were offered foods in line with their needs which included vegetarian options and 'soft diets.' People were given choices and when and what they ate. Relatives and people told us the quality of food had improved since a new chef had been recruited. Peoples needs varied across the home and this was clearly documented. One staff member referred to the home as a step ladder of support with varying degrees of needs from residential to dementia care and staff being matched to different suites in line with their interests and experiences. Wellbeing was enhanced by knowing more about the persons' back ground, life experiences and needs. Most staff were sufficiently familiar with people's needs and able to make positive, meaningful connections. A person told us how the home celebrated different cultural events and individual events like birthdays. They said there had been a recent event which acknowledged and explored people's different cultures and different sexual orientation.

Staff spoken with felt respected . Value recruitment helped ensure staff were appointed appropriately and safely and staff were enabled to do their jobs based on their individual needs. A staff member told us how their needs were supported by their shift patterns, another had moved floors in line with their needs into a less stressful environment. One staff member told us about their ill health and how they had been supported throughout. There was regular support for staff, an established human relations department and reward schemes to help recognize and reward good practice.

The home accommodated a wide range of needs and on the ground floor in particular people had access to patios and gardens which were designed to enhance people's well- being. The environment was adapted to people's needs and people could access other facilities including the café, library, cinema room etc. We noted people had aids to encourage and facilitate their independence which included walking aids, which staff encouraged people to use. At lunch time people had adapted cutlery when necessary but some people were not close enough to the table or food was too far away which did not maximise their independence.

Assessments of need took into account peoples backgrounds and involved them in their future aspirations. Many families were closely involved and were consulted at regular intervals either face to face, through surveys and, or meetings. They were supported to raise concerns should care fall short and the complaints log showed that the manager was open and accountable when dealing with their concerns.

People told us they attended meetings about their care and support and residents meetings to decide on activities, future menus and so forth. People were supported in line with their documented needs. One person told us about going out to exercise and on those days staff assisted them up earlier. Information was accessible and readily available to people such as care records, menus and schedule of activities.

Staff told us peoples needs were reviewed and staffed according to those needs. Feedback about care helped the manager decide if the service delivery was effective. Senior management teams carried out observations and spoke to staff, relatives and people using the service as part of these observations.

Our observations were mixed. Peoples ability varied and those reliant on more staff support did not always receive this in a timely way. Whilst call bells were answered in a timely way, daily routines such as personal care and meal times took some organisation and people were not always supported in line with their abilities. We did not see most people involved in day-to-day activities although we did see people accessing the café and people confirmed that staff asked if they wanted to go in the garden. Because activities were rotated on different floors it meant some people were reliant on staff to support them to attend an activity should they want to go. If staff were busy this impacted on their ability to support people. Staff on upper floors did not know what activities were being provided, we overheard people asking staff what was happening and people being directed to the lounge and being told to wait there. Staff told us some people struggled to engage or take part in organized events. There was a volunteer at the home but for such a large service they were only able to offer so much. We did see some heads of department interacting and involving people as they went round.

One page profiles gave an overview of people's needs. Communication across the home and audits of care helped to determine what was working well and what required improvement. The home was on a sharp learning curve constantly trying to improve the 'customer experience'.

Everyone we spoke with felt able to approach a team leader or manager to raise concerns and felt their concerns would be addressed. Shortfalls of care were documented and the complaints log showed how these had been responded too. People were given every opportunity to raise issues and family members we spoke with said they felt consulted and issues had usually been responded to although one felt they had to take their concerns higher as laid out in the complaints procedure. Safeguards were in place to give a voice to those receiving care to raise concerns about their health and safety and these were responded too. Call bells were accessible, in reach and usually answered in a timely manner. Response times were monitored. Access to health care was good although the service had to navigate three different GP surgeries. Although health care assessments were completed we saw from records that access to a private or domiciliary dentist was problematic.

Staff were allocated to a different suite and the manager tried to maintain consistency as far as possible to enable staff to get used to people and their needs and were able to respond quickly. Some staff told us certain parts of the day were busier and people had to wait for their care. This was dependent on other factors including staff working as a whole team and all departments working together. The manager said they had changes to their staff team in February which may have impacted on peoples experiences but felt now they had staff in the right place and working effectively.

Our observations of care was that peoples needs were responded to and no one appeared neglected. People were encouraged to get up and participate in the day. Staff responded quickly to call bells and although staff said they were busy staff appeared calm and unhurried. Break times for staff on long days were scheduled across the day.

Staff turnover was not significantly high and staff were asked regularly about their well -being and confirmed they received regular supervision. Staff reward programmes and reward ceremonies helped to ensure staff were acknowledged for their contributions to care particularly when staff did something exemplary and were nominated for their good practices and progression within the organization. Opportunities existed for staff to seek promotional opportunities and do further study. Staff told us they were generally happy with their training and induction but felt it would be helpful to see further development of staff i.e. bite size learning, different topic of the day to raise awareness, particularly for newer staff who were often on a steep learning curve. We met staff who had just been appointed and they said they were well supported and the service was inclusive of their needs.

Training records showed high levels of compliance and additional training was provided which was role specific. Champions were being promoted across the service but currently there was a low uptake and not all staff in senior positions had time aside to catch up with administrative tasks which put a strain on their roles. Well-being of staff was supported through engagement and training and individual assessments of staff circumstances in line with their job role.