Gillingham Road

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

At our last inspection we rated this key question good. At this assessment the rating has changed to inadequate. This meant people were not treated with compassion and there were breaches of dignity. The service was in breach of legal regulations in relation to people not having choices and control of their care. This seemed particularly poor for people with a learning disability. This meant the service was not meeting the principles of RSRCRC as the model of care did not maximise people's choice, control and independence and the care was not person-centred. People were not always being treated in a caring, respectful and dignified way.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a mixed response from people and relative’s on whether staff were always kind and attentive. One person told us they felt staff were caring and felt they could laugh and joke with them and another said, “[The] carers are great”. However, 1 person and their relative felt staff were not very communicative and did not engage in conversations with them. People were not always treated in a respectful way. We noted the provider/registered manager had placed a large filing cabinet in the lounge in 1 person’s home without asking them if they were happy with this. They also had a pull-out bed in their lounge that staff used at night. The person told us how this impacted on their privacy. They said, “I can’t go in there [at night] as staff are in there. I wasn’t happy not having access to the lounge and not being able to use a kettle [to get a drink at night].” In another person’s home, the provider/registered manager had converted one of bedrooms into an office and there were health and safety notices on the walls around the home for staff. We saw examples of staff recording in care notes that they cleaned the ‘care home’ for the person who lived in their own home. These examples showed a lack of respect that these were people’s homes.

Whilst we saw 1 person’s religious preferences were respected by staff, we found staff and the provider/registered manager lacked an understanding of how people should always be treated as individuals. There were multiple references by staff to people’s ‘challenging behaviour’ or staff describing people’s behaviour to define them. The language used by staff and the provider/registered manager included, “[Person] is always demanding and wants [their] needs at that moment”, “[Person] has a history of allegations, not sure if [they are] telling the truth or not, [they] will say [they are] so sorry for lying against the staff.” We also saw a care note made by a member of staff referring to a person not liking being told what to do by staff. This was recorded in an inappropriate way including the use of an expletive.

Staff did not always consider people’s choices around the care they received. One member of staff told us the person they supported was not given a choice of when they wanted their meals. They said, “We have arranged them [times of meals], and we prompt [person] with fluids in between.” The provider/registered manager also restricted the times people could have visitors. They told us of this, “I did it with my own sense that someone [the person] needs dinner and to get to bed.” This was a total disregard for people to make their own choices of when they wanted visitors and when they wanted to have their dinner and go to bed. One person told us about evening visitors, “I can’t have friends round.” People’s care records did not demonstrate how they were involved in their care planning. People and the families were not told they were able to make choices about which care company provided care and support. They assumed that as the provider/registered manager assisted people to find their rented accommodation, they would have to use their company for care.

Staff were not always responding to people’s need for emotional support or comfort. We saw from care records and the provider told us that 1 person had a recent bereavement. There was no information in the care plan on how the person needed to be supported with this. The care notes made reference to the person speaking about the bereavement but no records of how the person was emotionally supported. One person discussed a previous trauma they had, and staff talked to us about people’s trauma from their past. This was not shared with us in an empathetic way, but just to describe why the person presented in the way did now. There was no guidance in the people’s care plans for staff on how best to support them with this trauma.

Leaders did not consider staff wellbeing enabling them to focus on providing good quality care and support to people. There were staff that were working on their own in a person’s home. There had been no lone working risk assessments undertaken by the provider/registered manager. Leaders expected staff to work 12-hour shifts with no arrangements put in place to ensure they were able to take a break. This was despite the provider/registered manager telling us they were required to have an hour break when working a 12-hour shift. The provider/registered manager told us if staff took a break whilst with the person they needed to stay in the person’s home. They confirmed this would not be a protected break as staff would still need to respond to the person if needed. The provider/registered manager also told us staff were required to go to the office once a month for their one-to-one supervision but stated staff would have to do this in their own time. They said, “Staff do not get paid [for this time], because we do it when they’re available to come to the office, usually we ask when they are happy to come into the office.”