Archived: Tulipa 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

We assessed 2 quality statements in the caring key question and identified areas of concern. The scores for these areas have been combined with scores based on the rating from the last inspection. Staff did not always treat people in a kind and compassionate way or used undignified language when they referred to people. Staff did not always have the skills to communicate and engage with people to ensure they were supported effectively. There was a lack of information for staff about people’s preferences and life history to ensure staff could speak with people about things that were important to them.

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 were not always treated with kindness, compassion and dignity in their day-to-day care and support. Relatives told us, “Sometimes [our relative] is wearing trousers that are far too short, dirty or ill fitting. Sometimes they do not even have socks on, even when it is cold. I wouldn’t want to walk around looking like that” and, “[My relative] did not look clean which was surprising as they normally look better. They needed their hair washed.” Other relatives commented, “Privacy is interesting. It is difficult to have private conversations, but this is due to space. Otherwise, they do the best they can” and, “They are very caring and treat the residents with respect. They give them time and we can’t fault the staff at all.” People told us, “We have a chat and a bit of a laugh” and, “They [staff] know I like having my hair done. They helped me wash and did my hair this morning.” Another person felt that some of the staff were not very respectful.

Feedback from staff was not entirely positive and views were mixed. One staff member said, “Some staff are not hitting the mark. Some people are left with dirty food on their tops, it’s not acceptable.” Another staff said, “Last week we went up for respect training, but they [staff] came back and sat on their phones. It had no impact.” A third member of staff said, “I think staff here do a good job.” The registered manager said, “We promote privacy and dignity by being discreet with personal care, thinking about the person, not the task.” The registered manager commented, in relation to a kind and caring culture within the staff team, “It is a work in progress. It could be improved. Sometimes they work well together and other days are not so good. I try and change the pairing up [of staff].”

A health care professional told us they had no specific concerns to raise. They said they felt the area manager and new deputy manager were making a positive impact at Tulipa House. We approached other health care professionals for feedback and did not receive a response.

Some care we observed was not compassionate nor did it support people’s dignity. For example, one person was being supported to eat their breakfast in the lounge by staff. The staff member did not engage with the person and was using their work mobile phone whilst supporting the person to eat. Staff were not always respectful and spoke of supporting people with washing and dressing in the morning as ‘get-ups’. During lunch, a staff member was heard to say, “Quit the attitude. I have brought you lunch”. People were not supported to keep their glasses clean. The management team told us this was because people did not want them cleaned when they were asked. There were other times where staff were kind and caring. For example, one member of staff woke someone up for lunch in a very gentle and caring manner.

People’s religious and cultural needs were not consistently considered. People’s religion was noted in their care plan, however there was no information about how often this option was offered. One person told us they would like to go to church but that it was not talked about. One person’s care plan noted, ‘[Person] does not follow her religion, but they will need to be made aware that if she changes their mind then this will be supported.” There was no information to note this had been revisited and discussed with the person. Three relatives told us they had not been involved with the planning of care and support.

The registered manager told us they regularly talked to staff in meetings and supervisions about treating people how they want to be treated. They told us it was important people were called by names and not room numbers. We observed this was the case. However, feedback from staff was not always positive. One staff said, “I don’t think there is enough staff here some days, today is a good day but sometimes there is not enough time to spend with people. It’s task, document, task, document, task document. I would rather spend time talking to people.”

We observed a lack of engagement with people. For example, there were several occasions when people were anxious and walking with purpose, however staff did not engage to distract or divert them. Several members of staff told us they did not have time to spend with people. We observed some positive interactions. For example, one member of staff spent time with a person who did not want their lunch and gently encouraged them to eat. The same member of staff was then observed speaking with people in a respectful and gentle manner, making sure people were given time to eat their meal at their leisure.

Some care plans lacked information about people’s likes and dislikes and life history, this did not always support staff to treat people as individuals and get to know people well. For example, one person’s personal history only noted they did not wish to discuss anything at present. However, there was information available from when the person first moved to the service which included detail about their family, previous work and what they enjoyed doing in their free time. This had not been recorded in the person’s care plan to guide staff on how to engage the person and talk about topics which may be of interest to the person.

People were not consistently supported to have choice and control over their day to day lives. People told us they were not offered a choice of what clothes to wear each day. This was confirmed by the records. Relatives told us they were only able to meet in the dining room, or the garden. They said, “‘In the last home they were in, I could go to their room, support them with their meals. I would not come here at mealtimes as I would feel like I was in the way. It would be too crowded in here” and, “We only ever visit in the dining room, there’s not a lot to talk about or do. In their room we could look at her things, watch TV. A bit more privacy would be nice.” People were supported to maintain relationships that were important to them.

Feedback from staff was not always positive about supporting people to be independent. Some staff told us they did not always have the time to support people to do things for themselves. One staff said, ““Some staff do [promote independence], if it’s taking too long some staff will do it themselves. Staff will feed people if they are taking too long.” Some staff told us they did not always have the time to deliver person centred care and offer people choices. One staff said, “When it comes to the get up’s [to support people to get out of bed in the morning] it’s treated like it’s a job. Things are done for people; people get a quick scrub. Some staff need to go a bit slower; you would not treat your mum like that. We start at 5am getting people up, if they decline it is documented and we will try back later. People can stay in bed all day if they want to. It can be rushed because of staffing levels.”

People were not always offered choices when they should have been. Staff were throwing a ball to people. They included a new person in the game without asking them if they wanted to play. They told the person to catch the ball and threw it to them. They then said, “now legs” and kicked it to them. The person looked uncomfortable with the exchange. After a while staff stopped playing with the person, again without speaking to them about what they wanted. The person told us they did not want to play with the ball, and they had not been asked. People were offered choices of meals and drinks. They were able to help themselves, if able, from a drinking station which offered different flavoured fruit squashes.

Care plans did not provide staff with guidance about how much people could do for themselves. There was little information about how to encourage people and promote their independence.

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.