Fosse Healthcare - Nottingham

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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

People were supported to have choice and control and make decisions about how their support was provided. They were encouraged and helped by staff to do as much as they could for themselves, to maintain their independence. People were supported to understand their rights and how the service would make sure these were respected. People’s needs, views, wishes and comfort were a priority and staff quickly anticipated these to avoid any preventable discomfort, concern or distress. Staff were alert to people’s needs and took time to observe, communicate and engage people in discussions about their immediate needs. Staff recognised when people needed urgent help or support and used appropriate tools and technology to assist.

This service scored 45 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were treated with kindness compassion and dignity. People told us their privacy was respected and that staff approached them in a way that made them feel comfortable. People gave us several examples of how staff treated them with kindness and compassion. One person told us about a recent period of ill health and the way the care staff had supported them, “The carers have been really good and don't make me feel embarrassed.” Another person told us, “They [staff] are all very pleasant and we are getting to know each other, for example they ask who people are in my photos and show an interest.”

Staff treated people with kindness, compassion and dignity and were able to give the inspection team a lot of examples of how they did this. Staff described supporting people with personal care tasks and protecting their privacy to maintain their dignity, for example: ensuring curtains were closed and doors shut to protect people’s privacy. One staff member told us, “I show a lot of kindness and empathy and I always come in with a big smile, people say I bring the sunshine with me. I ask people how they are feeling, if there is anything they would like me to do, and I listen.”

Professionals working with the service told us about their experiences regarding people being treated with kindness, compassion and dignity using this service and reported no concerns.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People told us that they were supported to maintain their independence and were given choice and control over their care and support. One person told us, “Staff get me water and they wash my back for me, but then they go off and make the bed whilst letting me get on with what I can do myself but they're always nearby if I need them.” Another person told us about the care their relative received, “They [staff] are very good, and they do give [relative] time to do what they can for themselves, and they never feel rushed.”

Staff understood how to provide care for people in a way that promoted their independence and gave them maximum choice and control over their care. One staff member told us, “I respect people’s choices and I listen to them. I make sure I’m not overriding people’s choice and taking away their independence.” Staff were able to explain how their practice supported people’s choice and control and maximise their independence and autonomy.

People were supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. We reviewed care plan documents which told staff how to support people’s independence and considered peoples capacity in relation to choice and control. The assessment, care planning and risk assessment process identified what people could do for themselves and areas in which they required staff assistance. This strength-based approach supported people to remain as independent as possible. We found that the service was working in line with the Mental Capacity Act (MCA). The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make particular decisions, any made on their behalf must be in their best interests and the least restrictive as possible. Where people had a person legally acting on their behalf, for example someone with Lasting Power of Attorney, this was evidenced in the person’s care plan. Staff had received training on the Mental Capacity Act.

People said that the provider and the care team responded effectively to their immediate needs. People told us that the provider would change the time of calls to accommodate other appointments or changes in need. One person told us, “I've even phoned after 9:00 PM and the call goes through to a hub and they said that they'd get someone to help me as soon as possible and someone came out.” A relative told us, “They [staff] seem to notice changes in [relative] monitoring them and adapting the length of the call times as their needs have changed.”

Staff and leaders understood the importance of providing care and support that was flexible and responded to people’s immediate needs. The registered manager told us what would happen if a person was found to be on the floor and the action they would take. “Staff will phone me at the office, if the person is injured or distressed the staff will call an ambulance and stay with the person. I will reallocate the staff members calls so that they can stay with the person and look after them.” The innovations officer told us about some additional staff training that they had implemented to support staff to respond to people’s immediate needs. “We trained all staff in early signs of deterioration, including soft signs, which has upskilled carers to spot signs.”

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.