Carpathia Grange

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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 4 quality statements in the caring key question. People received exceptional care and were treated with kindness, empathy and compassion. Staff ensured people’s care, support and treatment met their individual needs and preferences and enabled them to lead fulfilling lives. People were supported in their relationships and friendships, both inside and outside the home. There was a wide-ranging programme of events and activities, including special events tailored to individual wishes and interests. People living with dementia had access to ‘Namaste care’. Relatives spoke of the impact of this approach, describing how well their loved ones had responded. One relative wrote, “We continue to be amazed as to how you and your staff continue to think up new ideas and strategies to support your residents, we are truly very grateful for everything that you do.” There was a culture of high support for staff, which enabled them to develop in their roles and deliver high quality, person-centered care to people.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Everyone spoke enthusiastically about the staff who supported them. One person told us, “Everybody is so nice and friendly. It is such a good staff team; they deserve to be recommended.” Others described staff as, “Helpful and caring”, “good and efficient and, “Lovely, really lovely.” Relatives were equally complementary. They spoke of a happy and caring atmosphere and said there was a nice ‘camaraderie’ between residents and staff. One relative told us, “They have looked after [Name] really well. They know her and know her quirks and foibles. She looks well, she is smiley and happy.” A second wrote, “The staff are all always extremely kind and helpful and treat the residents with genuine care, devotion and respect.” In a resident survey from June 2024, everyone who responded [39] said they were treated with kindness, dignity and respect and that staff provided the care they needed.

Staff spoke with kindness and passion about the people they supported. It was evident they knew people extremely well and understood their interests and preferences. One staff member told us, “I love it. I love the residents. We get amazing people come through.” Another told us they were proud of the connection they had with people and their families. Staff spoke of how they came alongside people to offer support. One staff member said, “If someone is not eating a lot, I've sat in the room with them and had my dinner, or we have a cuppa together and they eat. If they have not done much that day we might go out for a walk round the garden.” The deputy manager said, “They [staff] do care immensely for the residents, we have a very loving team.” Staff were encouraged and supported by their seniors to use their judgement and offer additional company or support to people.

Professionals spoke highly of the service and the care people received. One professional spoke of a very thorough initial assessments and a ‘holistic approach’ to care. They told us staff were friendly and approachable and knew people and their needs well. Another told us, ‘The service provided by Carpathia is very good, very good management to oversee the day to day running and good communication between healthcare professionals.’

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed staff to be responsive, kind and gentle. They showed warmth and approached people with a smile. Staff were proactive and quick to notice when people required support. We saw them pre-empt a situation that may have been uncomfortable for a person by offering a change of environment. During lunchtime, people who needed assistance were helped at a pace that appeared to suit them. Staff were proactive and facilitated people to join with others to eat, to maintain their own space or to have private time with family and friends as appropriate.

People’s individual needs and preferences were understood. In a resident survey from June 2024, everyone who responded [39] confirmed staff knew them as an individual. One relative told us, “Everything seems to suit. The care that you see when you are there, they all know the residents.” Another said, “It's such a happy, friendly care home and all the staff are very approachable and want to make sure everyone is cared for in the best way.” A third told us, “We are so grateful that despite [Name’s] needs she has not been given up on at all. The staff continue to try find ways to help and support [Name] to give her a better quality of life.” Relatives spoke of the support offered to them by the staff team, some describing the feel as of an extended family. They described practical support, such as in sorting out funding, and emotional support. One relative said, “She [registered manager] looks out for us too and has supported us as we have found [Name’s] dementia journey very distressing and emotional.” Another told us, “I like the way the staff there all interact with the residents' families. You walk in the door and you are welcomed.”

Staff spoke of the relationships they had with people, they spoke of building rapport and trust. One staff member said, “Everyone is different and has their own ways, so it’s about doing things the way they like.” Staff shared examples of how they spent time with people to understand what might be troubling them if they seemed out of sorts. They said they might try to engage them in an activity, suggest coming to the coffee shop or join them for tea and a biscuit. One staff member said the highlight of their job was “having fun and a good time with the residents.” Staff described how they engaged with people and ensured their communication and support met the person’s needs. One staff member demonstrated some of the signs they used with a person who was deaf, adding that they would also write things down for the person who could communicate back verbally. Another staff member spoke of checking hearing aids to ensure they were clean and working properly. They told us, “It will say in their care plans how to communicate with them. You will always go down to their level, make eye contact, take your time with them, don’t rush them, make sure they can hear you and your tone of voice is right.” A third staff member told us they had taken a person to the supermarket for them to see and choose their own gluten free snacks. Now they knew what was available, they preferred to give staff a list rather than shopping themselves. Staff spoke of involving people and their families in reviews of their care. The home operated a ‘resident of the day’ system whereby once a month each person’s care was reviewed by all the teams within the home.

We observed staff communicating effectively with people, according to their individual needs. One staff member used signs and gesture to communicate to a person they would look for an item that had been misplaced. The person appeared relaxed and comfortable after this conversation. Another person came into the coffee shop area apparently in distress. They were immediately supported by the receptionist and deputy manager. After some discussion, they went out happily holding the deputy manager’s hand and smiling. People’s rooms were personalised and generally people said that they liked their rooms and comforts. Outside each person’s room there was a small collage of items and pictures representing the person’s interests or background.

People living with dementia had access to ‘Namaste care’, an approach dedicated staff had been trained to deliver. Namaste Care is about creating physical, sensory and emotional activities and interactions designed to create a calm environment and provide comfort and pleasure to people living with dementia. Relatives spoke of the positive impact. One relative wrote, “Mum has severe advanced dementia and along with everything to be expected of this awful disease she is often restless, constantly moving and often comes across as being quite distressed. What has been amazing with the namaste sessions is that she seems to enter a sort of zen like demeanour. These sessions have been helpful in relaxing mum and reducing distress.’ Staff spoke of the effect on other people, including a reduction in falls and increased engagement throughout the week. They said one person who had not wished to come out of their room, now happily visited the coffee shop and had recently wanted to go out on the minibus. The home had a dementia care coach trained in delivering dementia training and completing observations. They participated in clinical meetings and provided input on distressed behaviours. The home had been accredited under the provider’s ‘Care fit for VIPS’ scheme in August 2023. The report included, “[Registered manager] and her team have achieved some truly person-centred care at Carpathia Grange, which they should celebrate.”

People were supported in their relationships and friendships, both inside and outside the home. Relatives who had two family members in the home told us they were supported to see one another for as long as they wished and when they wished. People who had moved floors when their care needs had changed, were supported to return to spend time or enjoy mealtimes with friends. People and relatives confirmed there were no restrictions imposed on visiting arrangements. People and relatives described how the activities were tailored to people’s individual needs and interests. One relative explained, “[Name] is a people person and enjoys conversations. They will make sure if awake they are with other residents. [Other name] they invite but they are OK in their room and they allow that privacy. They have a newspaper delivered and puzzles” People and relatives spoke positively about the activities and opportunities, particularly the regular visits out. One person told us, “They do some very nice things (Activities) here, it is a nice home. They have their own bus. They do look after you”. A relative spoke of a boat trip saying, “We both enjoyed it so much and it will be a lovely memory to look back on. [Name] was so happy to be out somewhere different with me.” Another relative shared, “I do see photographs of all the things she is doing, it is amazing! She has come on in leaps and bounds.” A third, “[Name] has now been afforded a new lease of live since moving to the dementia suite at Carpathia Grange.” Some relatives spoke of personalised occasions organised under the homes ‘make a wish’ scheme. They wrote, “It brings so much happiness to both the resident and the team members to make this happen.” One relative described how their loved one had always adored cats. They told us how a visit to a local cats’ café had been arranged. They said, “[Name] had a field day!”

Staff spoke with pride of the activities and support available to people, including 1:1 time with lifestyle (activity) and care staff. They told us there was a strong focus on people as individuals, describing activities that had been tailored to individual interests and needs. One staff member said, “It’s about speaking with residents and finding out what they like. It’s about making sure every resident is living their life to the full. We will make sure we’re doing activities they are interested in and enjoying.” Staff shared examples of how people had engaged positively in activities. One staff member shared how during a sensory activity smelling herbs, one lady was reminded about Sunday lunches and it started a conversation between people about what they used to put in their cooking. There was a wide range of examples of activities arranged to meet an individual interest or to make a connection with a person’s past career or hobby. One staff member said, “It touches them.” Staff spoke of offering flexibility and choice to people in how they wanted to organise their day. Speaking about preferences for baths or showering and at different times of day, one staff member said, “We try to accommodate, we try to make it happen.” The registered manager explained how one person had moved room twice recently and had now seemed comfortable with their situation. Staff shared how they promoted independence. They spoke of giving people control over what they were doing and encouraging them to do as much as they were able to themselves. One staff member shared how they supported one person to rebuild their confidence following a fall, trialling different walking aids after the person became of low mood and was staying in their room. They told us, “[Name] loves it [the frame]. They are out all the time and back to having a daily walk in garden. It has made such a difference to them.”

Our observations were positive. Throughout our visit, we observed people engaged with staff, each other and in activities. Staff created a fun and inclusive environment. Where people preferred their own space or were engaged in their own interests, this was respected and supported. We saw people going out in the home’s minibus and returning clearly having enjoyed the visit out. During the morning a large interactive activity table was used in a group activity in which people appeared engaged. Throughout the day, people were given choices, including when they wished to get up and what and where they wished to eat. To support some people to make their meal choice, plates of each choice were shown to them. The home was well presented with an accessible garden and rooftop terrace. Inside there was a choice of lounge areas and several rest areas along corridors with soft seating. We observed people making use of these areas during the day. In the home’s monthly newsletter, photos of the wide variety of activities and visits out was shared. We saw people had also been engaged in fundraising activities, birthday and anniversary celebrations and had enjoyed visits from local nursery children and students at a specialist college.

The staff team worked together to learn about people and to improve their support. Feedback was shared during handovers, daily and clinical meetings. For example, during the morning meeting it came to light a person had declined to go out on the minibus that day, a surprise as they had previously indicated they wished to. We later learnt that with some additional support and encouragement, the person had joined and enjoyed the outing. The resident of the day approach ensured each team within the home reviewed and discussed each person’s care, support and wellbeing between the different staff teams, with the person and, if appropriate, their relatives at least once a month. The home had a well-established activity and engagement programme led by a dedicated team. The programme ran throughout the week including weekends and included group and individual activities, both within and outside of the home. Staff recorded how people had chosen to spend their time and how they had engaged with activities. A new monthly update, including photographs, could be drawn from the system and shared with relatives. People’s care plans included considerable detail about their interests and life history. This supported staff to understand them and their interests. Care plans also included detail on personal preferences, such as if a person preferred support from male or female staff and how they like their light, door and windows during the night. People had been invited to discuss their future care wishes. Following a discussion about end-of-life care wishes, one relative wrote, “Thank you [staff member] for the way that you discussed this with Mum. It was clear from my chat with her today that this was handled in a very professional but also friendly and down to earth way. It's so difficult to strike the right balance when talking about what can be a very taboo subject… [we are] incredibly grateful to you for your sensitivity and kindness to Mum.”

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.

Staff felt extremely well supported. They felt they could make a positive contribution to people and to the service and were valued as part of the team. One staff member told us, “We are all respected in the team”. Another said, “I feel very supported and valued. I am very new to care, and I don’t know everything so I will always ask my team members and they take the time to support me and show me things.” Staff spoke of the support available to develop in their roles and careers, including having been approached to step up to the next level when managers had identified their potential. One said, “I doubted myself, but they supported me. They helped me a lot to come this far.” Another, “The manager and all the team encourage you to do your best and go further career wise if you want to.” Staff shared examples of positive gestures to the team. One said, “A while ago there was a discussion around staff morale being a bit low. Every Friday they will make us bacon rolls and do things like that to give something back to the staff.” Another spoke of social events for the team. Some staff told us they had been recognised in the homes GEM (Gone the Extra Mile) awards. One said, “I was nominated by the team, it is nice to feel valued by my team.”

There were clear processes in place to support staff, check how they were feeling and to seek their feedback. Staff were asked for their views in regular team meetings and an annual survey. The 2024 survey recorded the highest scores in questions related to company values, feeling they can make a positive contribution to the success of the home and being made to feel welcome and supported by colleagues. In the minutes of a meeting from July 2024, staff had been asked what things they would like to see happen, what they would like to stop happening and to input ideas on things they felt could make a positive difference to staff and the people they support. A staff recognition scheme was in place and a renewed effort to arrange social events for the team. The provider ensured staff had access to support. In addition to regular supervision, the service had trained mental health first aiders and a ‘colleagues voices champion’. An employee assistance programme was available to all staff. A relative commented, “When you go there everybody smiles, nobody grumpy as if doing a job they don't want to do. If you weren't treated well at work, you wouldn't have that cheerful demeanour.”