Support for Living Limited - 246 Haymill Close

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

We identified breaches of Regulation in relation to person-centred care and dignity and respect. People were not always treated as individuals or given opportunities to make informed choices and gain new skills. People were not always treated with dignity and respect. However, most staff were kind and people had good relationships with them. We did not assess all the quality statements within this key question. We used the ratings awarded at the last inspection to calculate the overall rating.

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.

Relatives told us they felt staff were caring. Their comments included, ''[Person] is well cared for and loved by staff'' and ''Staff are kind and caring, they come across as nice people.'' Relatives also told us gender preferences for staff and privacy were respected.

Staff told us they had undertaken training about privacy and dignity.

Feedback from 1 external stakeholder was that there had been improvements in the culture of the service, but they felt staff could do more to positively interact with people.

Staff did not always engage with people in a person-centred way. We witnessed a small number of interactions where staff spoke with people as if they were giving them a series of instructions, for example telling a person to ''stand up'' repeatedly without showing understanding of how the person was processing this information. We also found staff did not always initiate interactions with people and tended only to respond when people approached them. However, we observed staff were generally polite and kind.

Relatives told us they felt people received good care. However, we found people did not always experience personalised care and support which met their individual needs and preferences.

Staff did not demonstrate a good understanding of best practice for supporting people as individuals. They referred to people being 'stubborn' and wanting to spend their time asleep or watching television. They were not able to demonstrate how they provided people with choices for meaningful activities, to pursue goals or to learn new skills. The management team told us they recognised care was task based and there was limited variation in people's daily lives. They told us they were working with staff to try to address this.

Staff did not always initiate engagement or provide choices, stimulating or different experiences. The staff were calm and there were some gentle interactions, such as holding people's hands. People were not distressed and staff responded when people initiated contact with them.

Staff practices at the service were not always person-centred and did not treat people as individuals. For example, logs of care showed that people were routinely woken in the early hours for support to change their continence aids. This practice did not show respect or treat people as individuals. We discussed this with the management team who agreed the practice was likely to be staff following set routines without questioning whether this met individual needs. Care plans did not always reflect people's individual needs. Where personalised needs and preferences had been identified these were not being met. For example, where people had expressed specific interests or preferences there was limited evidence that they were supported with these. Care records showed people did not live varied or active lives and there was no emphasis of providing quality of live experiences in line with best practice for caring for people with a learning disability. Some of the language in people's care records did not follow best practice or show respect for people they were written about.

Relatives told us people had good relationships with staff. However, 1 relative explained that they did not feel people were given meaningful choices unless they were with staff who were familiar and understood their way of communicating.

Staff explained they offered people choices, but they did not always demonstrate an understanding of how to engage people with meaningful choices. For example, they did not offer alternatives or encourage people to try new things.

People's individual needs and preferences were not always understood by staff. Three of the 4 people spent the day of our visit either sleeping or sitting in front of the television. They were not given a choice of television programmes and were not interested in the programmes being shown. Staff did not engage with people to offer them other choices or activities.

The provider employed outreach staff who visited the service to provide some social activities both at the home and in the community. On the day of our visit, 1 person was supported to go shopping. Records confirmed this person had regular support in this way. Other people were sometimes supported by the outreach staff and 1 person undertook some voluntary work for the organisation. However, there was limited evidence of meaningful activities outside of these arrangements. Staff did not provide a range of different experiences for people to choose from or engage with. Care records showed there was limited variety in people's daily routines which did not reflect best practice for enhancing quality of experience. Reviews of care did not include evidence of consultation with the person or their families. They did not give detailed reflection on what had gone well and what needed improvement. When staff had identified areas for improvement, these had not been made. For example, one person's review in October 2023 identified a person needed to have more positive interactions from staff. There were no records to show how this would happen and whether this was monitored. Our observations were that there was still a lack of positive interactions and this need remained unmet. Another person's care review in January 2024 identified their religious and cultural needs were not being met. This was still the case at the time of our inspection and there were no records to show action had been taken to address this.

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.

The staff told us they felt supported by the management team and the provider. They had opportunities to undertake training and seek promotion.

There were systems designed to help staff with any concerns they had relating to work or in their personal lives. Staff told us they knew how to access these and felt they would receive the support and assistance they needed.