Delrose

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• 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 1 quality statements in the caring key question as part of this assessment. This quality statement score has been combined with scores based on the rating from our last inspection, where the service was rated requires improvement. Relatives raised concerns about some staff’s knowledge, motivation and skills in meeting their family members communication needs. They told us this had a detrimental effect on how people were supported to participate in activities at the service and in the wider community. We observed mixed quality support and staff interactions with people. Some staff had developed a positive working relationship with people as they understood their communication and behavioural needs. However, other staff were less confident or appeared less motivated and did not demonstrate all the skills needed to keep people calm and engaged throughout the day.

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.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People were unable to give us verbal feedback about their care. Therefore, where appropriate, we spoke to 5 relatives about their family member’s experiences of receiving support and care. We also spoke to an advocate, who had recent experience working with 2 people living at the service. Relatives raised concerns around staff’s skills in meeting people’s communication needs. Comments included, “[Staff] did not use Makaton with [person]. They know that [person] can do a few signs, but they need to use Makaton all the time to help [person] communicate better.” Relatives raised consistent concerns about people needing more structure, and variety within their weekly activities. Relatives were disappointed that staff did not seem to have a knowledge or interest in what planned activities were in place for people. Comments included, “I asked staff what [person] does all day and they do not know.” Relatives felt that lack of staff confidence was a barrier to planning and supporting people to participate in meaningful activities. They felt this was impacting people’s ability to maintain and develop independent skills. Comments included, “Staff will not promote independence and [person] likes others to do things for them now. Staff need to offer activities and keep with it.” Relatives felt that the lack of consistent management at the service had a negative impact on how care was planned, delivered and improved. Comments included, “In the past has been on holiday with two workers but there are no managers around long enough to organise this."

Staff told us they gave people choice where people had the capacity to choose. This included drinks, snacks and what clothes to wear. Staff said they help people to make decisions and refer to the care plans for decisions they would like to take. This included using communication aids to help promote people’s choice and independence. However, they told us that some staff were not motivated in their role and this made it harder to promote a consistent approach across the staff team.

We made assessment site visits to the service on 4 separate occasions, during different times of the day. We observed a range of staff providing support to people in communal areas of the home. We observed mixed levels of staff interaction and support for people. In one positive example, we observed staff members using communication strategies identified in people’s care plan to help them to make choices around their daily routine. We also observed positive interactions between staff and a person when they were being supported to make a pizza. The staff member was fully engaged with the person and supported them to carry out aspects as independently as possible. However, we observed some staff who were not engaging with people and staff who were not focused on supporting people during mealtimes. This resulted in people not always having a sense of purpose as they were allowed to passively engage in tasks.

Care and support plans contained guidance about people’s communication needs, likes and dislikes. There was information around choices and maintaining independence. However, the system to ensure care plans were regularly updated to reflect people’s current needs was not effective. Some people’s care plans did not contain up to date or accurate information. This had been identified by commissioners during reviews of people’s care. For example, one care plan had conflicting information around a person’s sensory loss and how to communicate with them. We brought this to the attention of the area manager who agreed to review the person’s care plan.

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.