HF Trust Cheshire

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

The recruitment needs in the service impacted on some people not being able to have their allocated 1:1 with care staff and plans being cancelled. Care plans were not always reflecting peoples current care and support needs. People were not always participating in regular reviews of their care and support to also include family members. The feedback from staff was mixed, some staff being positive about the recent changes and the changes in management, however there was a high volume of feedback where staff were not feeling valued, supported and not listened to by the management team.

This service scored 50 (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 treated with dignity and respect by the staff who supported them. However, relatives told us due to the high turnover of staff this had a negative impact, and some staff did not know their loved ones well and this could cause some distress. One relative said ‘’It is difficult for [Name] to form long-term relationships with staff as there was so much change and moving around.” Another family member said, “Some of the staff are kind and caring, however some do as little as possible during their shift”. Another family member told us, ‘’I don’t see a care plan. If he’s stressed, they ignore [Person] and he comes around. He can be very challenging. Staff are good. I don’t know the manager.'' One family shared their loved on can often be, ''Very forthright and sometimes shows aggression, however, the staff know them very well and are skilled in handling any challenges presented, this is always done with empathy.''

Staff told us they respected people’s privacy and dignity at all times. A staff member told us, “We make sure it’s the only number of staff required, having the door shut, speaking respectfully, making sure they consent, some people have preferences and using a person centred approach and speak to them and speak through what you are doing where appropriate.''

We received mixed feedback from partners regarding staff supporting people with kindess, compassion and dignity. Partners commented there had been several safeguarding referrals and issues around neglect. A partner commented that some staff did not treat people with dignity. Where a person had specific communication needs, a staff member said, “She [person] won’t be able to understand you, she can’t tell you how she’s feeling”, despite the person having access to a communication aid. Where people had anxiety, staff had described them at times as being “stubborn or naughty”. However, one partner commented, “I feel the staff team I have met over the years do care about the individuals they support, they are open and honest with me."

People did not always get the choice or preferences they wanted. For example, one family member told us at the most recent review they agreed to work together to enable their loved one to see their family more through virtual meetings and they were excited about this. They told us this had not happened and had, "Gone by the wayside". Another family member said they had concerns around staff members understanding [Persons] communication ‘’I have concerns around this in regards to agency staff who are utilised a lot due to HFT's staff retention. Agency staff don't know [Person] well.''

Staff we spoke with confirmed they were aware of people’s preferences and people were treated as individuals. A staff member told us, "When we do the monthly evaluation with the people we support, weekly activities and this includes social and spiritual activities and gave an example of someone wishing to pray every evening and this is incorporated in their night routine."

Some staff were able to explain how they provided choice and promoted independence to people they care for, showing an understanding of person-centred working. However, this was not always the case with care plans and details of people life stories were not clear throughout. Updates were not regular undertaken and recent care plan reviews did not demonstrate enough collaboration with service users had been sought. When we asked one staff member about updates to care plan they responded by saying, “Not really no. I haven't seen anyone for a while. I don't know when updates happen or when the care plan was last updated.”

People and their relatives told us they were in control of their care and their choice was sought and valued by staff. However, due to high turnover of staff some relatives were not satisfied as activities were cancelled due to staff shortages. A family member told us that, ''[Person] is often left disappointed when their scheduled activities and 1:1 sessions are cancelled due to staff shortages and needing to provide staff cover at other locations.'' Another family member told us that they felt that ‘’[Person] social needs are not met. [Person] loves taking part in activities, but they are regularly cancelled.''

Staff we spoke with understood what was meant by person-centred care and explained how it was important people had choice and control in their lives.

Care plans did not always contain relevant or up-to-date information for staff to support them to deliver personalised care. Some staff said they did not know who had updated care plans and in two homes staff members did not know who had completed risk assessment. One staff member did not know you had to read a risk assessment for key information or any updates.

People gave positive feedback about how staff responded to their immediate needs. Where people’s needs changed staff reviewed care and support as needed to ensure people received tailored support which met their current needs.

Staff told us they had time getting to know people to understand their preferences and needs. Most staff used this information to monitor changes in people’s needs in order to provide responsive, person centred care and support.

Many staff members told us they were not happy working at HF Trust Cheshire DCA and did not feel valued. Staff told us their well-being had been impacted and they felt the provider did not take this into consideration. One staff member told us they were worried that HF Trust would not exist when they returned from holiday such was the low morale amongst staff and lack of support from the provider. Another staff member told us, “They were supposed to have supervisions, that almost never happened, I have had one in March 2024 by another manager who was not mine”. Leaders told us ‘’ Each staff member is asked to fill out a well-being plan. This highlights what well-being looks like to them and how they need to be supported. This is regularly updated yearly as a rule but where a person is having a difficult time this is update more frequently. The hub page has a range of well-being tools and advice on support where needed to help staff feel supported as much as possible to be empowered and inclusive in day to day care outcomes for people we support and them as a workforce. We can offer well-being action plans where these are requested as well as flexible working requests.'' We asked the leadership team if they analysed why many staff were leaving they responded, ‘’Yes this is completed by the recruitment team and shared in the regional managers meeting which is then shared with deputies for learning and retention measures to drive change and improve regional concerns for improvement.''

There were limited processes to enable the management team to promote and maintain the well-being of the staff team. Staff had not had frequent supervisions and staff who were off work with physical or mental illness were not supported through their time off and return to work. Staff meetings were infrequent meaning staff felt separated from the management team as well as feeling undervalued and unsupported.