St Audrey's

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

People’s individual preferences for support were not always considered and care plans lacked detail about what was important to people. Staff did not always meet people’s immediate needs. The provider had not ensured people were supported with meaningful activity. Staff interactions with people tended to be poor and mainly task-focused. There was a lack of support with communication to ensure people understood. However, most people and relatives described staff as kind and caring. Staff felt supported by the current manager.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most people and their relatives gave positive feedback about staff being kind and caring. A relative told us, “I love all the staff; they are very compassionate and caring. They know [person] and they make them feel loved and cared for. I’ve got no issues there.” A person said, AC “They all seem great. Very kind and helpful” However, 1 person said “I’m lonely. Not a little bit, a lot lonely.” And another person said, “They are really good. They are very busy and I understand they can't chat.”

Most staff we spoke with felt people received good care. We were told how they supported people to maintain their dignity. A staff member told us, “I hold the towel up for privacy. It is what I would want for my Mum.” Another member of staff said, “The staff give their best all the time and residents are well looked after.” However, some staff raised concerns and 1 told us, “The quality of care we give I guess could be better if carers concentrate mainly on care instead of cleaning taking up most of our time.”

Other professionals told us staff knew people well. A professional said, “The staff were knowledgeable about the residents.”

We observed a lack of interactions between staff and people during our visit, and the few interactions we did see were poor. During lunch, we heard someone ask what it was, and staff responded, “It’s your lunch.” Rather than explaining what they had to eat. A member of staff told an inspector, “You are lucky, [person] is not in a mood today. [They are] usually in a mood." This was disrespectful, particularly because they said it in front of the person. People were left alone in the communal lounge for lengthy periods. We observed a person sitting in the communal lounge with a blanket on their lap which they pulled up exposing their thighs. This was not dignified, and no staff were around to discourage them from doing it.

We received mixed feedback from people’s relatives about meeting social needs and supporting with communication and choice. A relative told us, “Yes, they take the time to understand [person’s] background…so I appreciate that – they do try and are attentive to it. Proper management is needed for better structure of the activities.” Another relative said, “They have sing songs in the main room. I’m not there that much but there doesn’t seem to be much else going on…I’ve been in there and the staff ask what [person] wants for lunch. I don’t think [person] understands what they are saying.”

The provider told us they felt the lack of activity we observed was inconsistent practise rather than the norm and they expected this would improve when a new manager was in post. Staff told us the lack of interaction with people was because the activities staff was on leave. However, we spoke with 1 staff member who gave examples of topics they spoke to people about and seemed to know them well.

Of the limited interactions we observed between staff and people, we found a lack of support with communication to ensure they understood. For example, a staff member asked a person what they would like for lunch and did little to help them understand, then went away having not made it clear what they were going to do. We observed 1 member of staff speaking warmly with people who clearly related to them as individuals. However, engagement from all other staff was very limited and task focused. We observed a staff member in a person’s room not speaking to them. When they finished what they were doing they left having not spoken at all. We observed 6 people sitting in the lounge for 40 minutes. During this time, staff walked in and out with no attempts to engage with people or offer any meaningful occupation other than 1 person receiving a visitor.

People’s care records lacked detail of their cultural, social and religious needs. There was little or no information about their past/background. Some people’s care plans included areas of need which were not relevant to them. For example, sections on inhaler use when the person did not use inhalers. There was a blanket approach to completion of monitoring charts where there was no identified need for this.

A person we spoke with enjoyed the activities but told us other people did not really engage with them. They said, “[Activities staff] is so good but can’t do anything when they are all asleep. They do things like crosswords.” People’s relatives told us staff supported people to be independent and confirmed they were supported to maintain contact with friends and family. A relative said, “I’m trying to go every few months…I try to [speak on the phone] every week.

Staff told us people were supported with activities. A staff member said, “[Person] has been involved with the gardening. We do work together.” However, we found activities only seemed to happen when the activity staff was working; we were given very limited examples of support from other staff. A staff member told us, “Most of the time there is a [staff member who] comes after breakfast they sit in the lounge and do activities – songs and music. Sometimes [they] read them newspapers, puzzles until lunch. After they sometimes go to bed to rest. Some of them just sit in the lounge and sleep.”

During our visit, the only interactions we observed were task-focused such as support with medicines and meals. With the exception of 1 staff, we did not see staff interact with people in a social way or support with any activities.

The provider had not ensured people were supported with meaningful activity. We reviewed the activities planner and found no evidence they were personalised to anyone’s particular interests. Activities were added to the activities planner for care staff to do with people in their absence, but these were not happening. People’s care records included details of what they were able to do for themselves to guide staff to support their independence. Morning and nighttime routine sections were detailed to give people choices and promote their dignity.

Staff did not always meet people’s needs. We saw and were told people did not always receive the support they needed to ensure they had enough to eat and drink. However, the provider had arranged for a person to move bedrooms promptly following an incident to meet their needs more effectively.

Some staff were able to describe ways they supported people to meet their needs. A staff member told us how they used different approaches to support different people. However, this seemed to be what they had worked out for themself rather than any documented guidance.

Staff interactions with people tended to be task-focused and those we observed were poor. They did not respond well to people’s needs, such as support with meals and drinks and communication. For example, at lunchtime we saw 2 people struggled to recognise and eat their meal without clear support and prompting. However, we saw staff ensure people’s call bells were in reach and responded promptly to them.

Staff felt supported by the area manager currently overseeing the service but had also felt the impact of not having a stable manager for some time. The staff team were affected by some upsetting challenges recently but told us they felt well supported with this. A member of staff said, “Personally I feel supported as much as can be expected by the area manager and people from other homes and head office considering we have had no manager in place for 4 months.” Staff also described more personal circumstances which they felt supported with. A staff member told us, “[Area manager] is very supportive. [Area manager] suggested I have a break – they recognised something was wrong, things were getting a bit much.

The provider had not ensured regular staff supervisions were completed. We requested some to review but did not receive any.