East Dean Grange Care Home

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

Some staff did not feel supported in their role and the systems in place did not enable the provider or registered manager to recognise the diversity of the staff team and provide the personalised support that they needed. Workforce well-being was not a priority at the home. This feedback was raised with the provider following the site visit and action was taken to improve this quickly. People were treated with kindness and respect by a staff team who knew them well. Relatives also spoke positively about the approach of staff and how they were caring towards their loved ones. People were supported where possible to be as independent as possible. Individual needs were assessed and documented; however daily notes needed improvement to ensure they fully reflected what a person had done each day.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives were treated with kindness and respect. Comments included, “Staff are kind and patient. I've never heard anything other than kindness and patience and they are always smiling;” “Staff are to be commended, first class team;” “Seen nothing but patience and kindness;” “I am sort of happy here, staff are very kind;” “Majority of the staff are very good, kind and caring, do treat me with dignity and respect.”

Staff spoke about people with kindness and compassion. They demonstrated a compassionate attitude towards people when supporting them and engaging with them throughout the day. They understood how to provide care in a dignified way.

Healthcare professionals told us staff treated people with kindness. One healthcare professional said, “Staff are kind and know people’s needs well.”

We saw that people looked comfortable in the presence of staff. They approached staff freely and engaged with them throughout the day. Staff treated people in a respectful, friendly and positive manner. We observed one staff member sitting with a person who was distressed, identifying the reason they were upset and providing gentle and kind reassurance. They stayed with the person until they were feeling better.

People and relatives told us staff knew them and their loved one’s well. They told us people were treated as individuals and staff took time to get to know their wishes and preferences.

Staff knew people really well. Most staff were able to tell us about people’s individual care and support needs. They spoke about people as individuals and were able to tell us about their interests and families.

Staff addressed people by their chosen name. They supported people in line with their individual care plans, choices and wishes at the time of receiving care. For example, one person said they did not like the meal they had been offered and an alternative was provided which they ate.

Care plans contained some information about how people liked their care provided, how they preferred staff to meet their care needs and wishes. However, there was a lack of information about people’s interests and hobbies. Daily notes did not fully reflect what people did each day.

People and their relatives were able to make choices each day. Comments included, “I can have a shower or a bath;” “I prefer to stay in my room or the garden, none of the activities appeal to me really;” and, “Food is excellent, limited choices, chef is very good at offering an alternative, I do make an effort to go to the dining room as I enjoy the banter and conversation, plenty of good snacks and drinks.” Visitors told us they were able to visit the home whenever they wanted to.

Staff knew people well. They were generally able to tell us what people were able to do for themselves and where they needed support, for example with mobility or assisting to make choices.

There was information on some people’s doors, yet to be rolled out to the rest of the home, showing information about people, their interests and what was needed to keep them safe. This helped staff understand about the support people needed to remain independent. People who were able had call bells that they could use to call staff if they needed support. Other people had sensor beams in place. These alerted staff if someone, who was at risk of falls, was walking and staff were able to support. This enabled people to spend their time independently and know staff would be with them when needed.

Care plans contained information about how staff should promote people’s independence. For example, describing what aspects of personal care people were able to do for themselves and where they needed support, such as leaving the bathroom light on at night to enable a person to use the bathroom independently and safely. These were reviewed regularly. However, people’s daily notes did not always fully reflect what they had done each day and needed improvement to be more personalised.

People and relatives told us that staff responded promptly to any immediate concern. One relative said, “When there is an emergency staff respond like a well-oiled machine. They make sure they contact the appropriate professionals as well.”

Staff understood people and how to respond to their immediate needs. This included knowledge of how people’s health or well-being may change throughout the day, and how support required adaptation to ensure people are kept safe and well.

We saw staff react promptly when people needed immediate support. This included when people were unwell and in response to call bells. However, 2 people requested to go out and were offered to go out to the local coffee shop at 11am, both people agreed for this but were not supported until much later, meaning they were sat around waiting for a long period. At lunch time, people were brought into the dining room early and waited a while for lunch to be served. Staff interaction with residents during lunch was minimal. We saw only those people who required 1:1 support with their meals had any engagement from staff.

A number of staff told us they did not feel supported at the home. They described how they had experienced bullying, discrimination and humiliation. Staff told us how they were expected to undertake multiple roles including housekeeper, carer, kitchen and activity staff. They told us at times management were over critical of their practice. Staff told us they would always raise any concerns that were related to people and the care they received. However, they would not raise other concerns to the management team for fear of reprisals. Staff described division within the staff team and how certain colleagues were not supportive of each other. There was a disparity in work task division at times. Staff told us they received regular supervision and feedback, however, the effectiveness of this was mixed. Following the inspection, this was discussed with the provider and action was taken to address the concerns raised by staff.

The systems in place did not enable the provider or registered manager to recognise the diversity of the staff team and provide the personalised support that they needed. There was no separate staff room, this meant staff had breaks in a quiet area of the dining room. However, this did not give them any privacy or time away from the workplace. We saw staff were approached by people during their breaks and they responded appropriately. Although there were regular meetings and staff supervisions, the service did not provide a comfortable environment where staff felt able to contribute to decision making. Staff were covering multiple roles and there was an expectation of staff covering multiple roles each day. This meant staff felt unfulfilled as they did not have time or support to complete any role to their full potential. Following the inspection, we discussed these concerns with the provider. They told us they have a zero-tolerance policy in relation to bullying and discrimination. They introduced an anonymous feedback form for staff to identify any concerns. They had individual discussions with staff and demonstrated a willingness to work towards improving staff well-being to help improve the culture of the home.