Burger Court

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

At our last inspection this key question was rated requires improvement. At this assessment, the provider had improved, and this key question is now rated good. People were treated with kindness and compassion, by caring staff who knew them well. People were supported to have independence and had choice and control over their daily lives. Staff responded to people’s needs in a timely way. People’s care records were not entirely personalised, as they did not always include information about people’s communication needs, or their individual needs and preferences.

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 felt they were treated with kindness by caring staff. Comments from people and their relatives included, “I feel that I am treated with care and dignity from the staff, they are very good” and “I think my relative is treated with respect and dignity. [Staff] respect their personal needs and have a good relationship with my relative.” However, concerns had been raised with the Care Quality Commission prior to the assessment that some people did not feel staff had been responsive in relation to the management of the behaviours of other people living at the service.

Staff told us told us people’s care plans and risk assessments helped them understand people, and that working with them closely meant they knew how to provide support in the most appropriate way. However, we found people's care records were not always accurate and therefore did not fully reflect people's needs. The manager said they would be auditing care files and staff performance to make sure records reflected that staff were taking a kind, compassionate and dignified approach to people, although this had not started at the time of the inspection.

We did not receive any negative feedback from partners in relation to people being treated with kindness, compassion and dignity.

During our visit to the service, we saw an interaction between a person who was displaying some confusion and a staff member who took the time to talk with the person and provide reassurance. The conversation was not rushed, and the staff member displayed empathy and understanding in the situation. On another occasion, we saw a staff member needed to speak with a person on a delicate subject and asked them to accompany them to a more private space, displaying dignity and respect towards this person.

During our visit to the service, we observed conversations between people and staff that demonstrated staff knew people well and knew of their preferences and likes or dislikes. We saw people made choices about how they spent their day and people’s care plans also evidenced their likes, dislikes and preferences. However, we found documentation was not always up to date.

Staff told us that working closely with people and taking the time to get to know them meant they were able to support people to take up activities of personal interest. They gave examples of people completing sports, spiritual activities and activities to build and maintain their independence. The manager said they knew they had work to do to promote an individualised approach to care. We saw an example of how the manager was doing this with the introduction of much more person-centred care records.

We saw people made choices about what they wanted to do each day. For example, people chose to go out shopping, go for a walk or spend time in their room. We also observed conversations between service users and staff that demonstrated that staff knew the individuals who they were working alongside and knew of their preferences and likes or dislikes.

We found people’s care records were not entirely personalised, as they did not always include information about people’s communication needs, or their individual needs and preferences and their life stories had not always been completed. We also found that activity recording sheets were not routinely completed and where they were, it showed limited access to people’s recorded interests. For example, 1 person had listed boxing, rugby, music and ten pin bowling as their interests. However, only 2 weeks of activity recording sheets were included in their care records and there was no indication of the person being involved in activities relating to any of their listed interests. We raised this with the manager, who told us they had started working on ensuring people’s care records were more person-centred. For example, 1 person’s care file was decorated with things appropriate to them such as their favourite bands, drinks and pastimes and included photographs relevant to their life. To help staff understand the person, their communication care plan also included words and phrases the person used to describe their feelings.

We received mixed feedback about people's experience. Some people felt supported by staff to maintain their independence. For example comments included, “I am given a choice to attend any activities in the home, but my decision is respected”, “I feel that I have my own independence and can choose the things I wish to daily” and “I do feel my independence is totally supported. It is maintained by all the staff at the home. I have been asked to take part in activities, but it is my choice to be involved or not.” However, other people told us they had not been included in planning their care.

We received mixed feedback from staff and leaders about how they supported people to maintain their independence. For example, staff had informed people in a meeting that no one was allowed to have alcohol in the home. We shared our concerns with leaders about a restriction being placed upon people. The Nominated Individual told us this was not the case, and the manager assured us they would address this misunderstanding with staff. We saw positive examples of how staff responded to people’s individual requests in meetings and in their key worker discussions. For example, a pool table had been ordered, trips had been organised and gardening had been arranged for people who had shown an interest in this. Staff were also supporting a person to maintain contact with their family.

People had regular meetings with their key worker to discuss their wishes, raise concerns or queries and request support. However, we found that at times some of the communication from staff did not support people's independence, choice and control.

We found communication with people did not always demonstrate an ethos of promoting independence, choice and control within the service. For example, people had been told in a meeting that staff would be inspecting their bedrooms, and a prize would be awarded for the cleanest room. Staff had also informed people of a blanket restriction on the use of alcohol in the home. People’s care records provided some evidence to show people were involved in discussions about their care and what activities they would like to engage in. For example, 1 person was being supported to look into volunteering roles after being supported to complete a college course and another person was being supported to learn more about a religion, they had expressed an interest in following.

Most people told us staff supported them as they needed. For example, 1 person said, “I feel I get the support when needed.” However, 1 person told us that they did not always feel listened to by all staff, including senior managers, and that on occasions their care plan or positive behaviour plan was not always followed.

There were enough staff on duty to make sure people’s needs could be responded to in a timely way. Staff told us they understood people and their needs and so were able to provide support as soon as it was needed. We saw examples of staff immediately offering reassurance when people became visibly upset.

During our visit to the service, we saw staff responded to people as they needed. We found staff prioritised the needs of people, above other things going on at the service. For example, the manager responded immediately to people coming to speak to them during our discussions.

Staff were appreciative of the new manager and told us they found them to be supportive and approachable. They felt comfortable to raise things with the new manager, as well as senior managers, and believed they would be listened to. Comments from staff included, “We can go to the manager with any complaints and she’ll sort them promptly. We can bring up recommendations for the benefit of the residents, or the service, or us and they’ll be listened to“ and “I feel confident in [manager], she knows what needs to improve and she knows how she’s going to do it.” The manager told us they were available to staff whenever they needed support. For example, 1 staff member had recently changed their role within the home. They told us they had been supported and trained to do that.

Processes were in place to support staff. This included the provision of a counselling line, occupational health department and the manager making themselves available for staff to speak with.