Blossom HCG Ltd

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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

Staff showed they had the right values when supporting people and were able to give examples where they have listened and adapted they way of supported to ensure they provided supported that was person centred.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We observed staff interacting in a kind way when supporting people. We spoke to staff who were able to describe how people like to be supported, and were passionate when talking about the people they support. Staff and people they supported had established a rapport between them. The relationships between staff and people receiving support demonstrated a warm and person centred approach had been established. One staff member said, “I do my job because I am passionate about giving care to people. I have a strong desire to make a positive impact on people’s lives and I believe I can make a difference in their lives by helping them live a fulfilling and happy life. I find fulfilment in helping others as it gives me joy to see smiles on people’s faces.” A second relative said, "I feel the staff treat [person] with respect and encourage them to do things when sometimes they can be reluctant to do so. [Person] has been much happier here in the short while since they moved than during the 14 years at the previous place." Relatives felt staff were kind and compassionate. One relative said, “Honestly, I am so thankful we found Blossom. It was not easy making the decision for our [relative] to go into supported living and we know we made the right decision. The staffing has been consistent which helps [relative] to handle his behaviour as he trusts the staff.

Staff knew people well which meant that if there was any change in their support needs relating to their health care and wellbeing they could support them as people wished. Every staff member we spoke to was enthusiastic and positive about the differences they could make in people's lives with a warm and caring approach. Staff frequently used words such as, "Like a family," "Passion," and "Loving to care for others," when describing why they work in the role they do. Staff gave examples of how they had achieved good outcomes for people. One staff member said, "Personally I have family members with similar support needs. I love to do the job and I have a lot of love to give. It helps me understand and react in a way that is positive for the person. A good day for me and [person] is waking up and supporting them with a bath or shower, helping them prepare breakfast and all meals, plan our activities for the day. It what [person] wants, so could be things like clubs, walks, shopping, meeting friends, Zumba, visiting family, going to feed horses and ducks, car boot sales, swimming . There are many times when our service users and staff get together and it's wonderful to see how happy everyone is."  

A visiting professional reported that, "People say that they like their staff and staff treat them nicely. I have observed staff supporting people to maintain their dignity and support them appropriately. I see that people are supported as an individual and they are treated with kindness. People are supported to make choices and staff respect their preferences. Staff have a good knowledge of the person they support and they place the person at the centre of that support."

People and their relatives told us that they received the care that they wanted and were happy with the care received. A relative told us, “This weekend we experienced just how phenomenal the staff are who work with [Person]. They were out enjoying an evening in town having dinner with the carers after a trip around the town centre which was thoroughly enjoyed. This is a huge step forward as [Person] has not wanted to sit at an establishment and eat, choosing to always get a take away. The staff have been patient and followed [person's] lead allowing to get to this stage in their own time. A second relative echoed the views of others telling us, "We are absolutely thrilled with [persons] placement. We have no concerns. Staff offer choices of what to do constantly throughout the day. [Person] is kept safe and well looked after, even at night time. Staff ask what to wear, eat and do frequently and give personal space to chill in when needed. Doctors, dentist and all clinic appointments are sorted out regularly and we are kept up to date by the staff. We are very confident in their ability to look after [person]." Where people were not able to communicate verbally staff were able to share how they understood different methods of communication. Easy read information relating to people's support needs were mostly in place to help make decisions. Although we did find some examples where appropriate and adequate information was not available to make informed decisions about the support or decisions people made.

Staff knew what people could do for themselves and areas where support was needed. Staff treated people as individuals, considering any relevant protected equality characteristics. Staff told us they were aware of people's communication needs and adapted their approach to meet those. One staff member said, "Due to my client being non-vocal, they cannot vocally express his emotions however, I know by the body movement and vocal noises how they are feeling." Staff gathered as much information about a person as possible to ensure they were treated as an individual. This started as part of the initial assessment process and was continually reviewed. Staff focused on achieving positive outcomes for people using the service ensuring people’s individual needs were documented and upheld through daily care.

Relatives felt people had choice and control of their own care and staff respected this. One relative said, "[Person]has a deprivation of liberty order. But this has not restricted their needs and activities. It is in place to ensure they are kept safe at all times, that the finance and medical side is managed well, and that recreational activities are safe." Overall, although relatives felt people had choice and control we identified where there needed to be additional consideration around ensuring that where restrictive practice was used, that this was in peoples best interest. We found examples were people did not have control of their day to day decisions and they lacked the appropriate decision making to identify it was in the individual best interest. This was driven through a lack of staff awareness around what constituted restrictive practise. The provider took immediate action in reviewing their approach to independence and choice.

Staff and leaders supported people to maintain relationships with people that were important to them. Staff gave examples where they supported people with in their local community and doing things that was of interest to them. Staff awareness of what constitutes restrictions or restraint, therefore removing choice was variable. One staff member described how they manage one persons behaviour at times. They said, "The doors on the bed, we do not want them to come outside and fall down, so we usually try and wait for them to sleep and then we put the bar behind and we will remove it around the 5am." This staff member and another in this service were unaware this was a form of restraint. Documentation was not in place to evidence where this had been considered the least restrictive and most appropriate options. Overall, staff promoted choice through daily activities such as care and activity choice, but did not consistently do so with decisions around keeping people safe. The provider took immediate action in reviewing their approach to independence and choice. The bar was removed, consent records were reviewed and the provider reviewed their approach to restrictive practise.

Peoples relative and friends were actively encouraged to visit and spend time with people unrestricted. We found through discussion and feedback that although we found some improvements needed around independence and choice, the provider had a strong ethos regarding promoting independence. They unfortunately however had been on long term leave from the service, and had employed an operations manager to oversee the service in their absence. Having recently returned to work, the provider had identified instances where this interim manager had advocated the use of restrictive practise at times. The provider was in the process of reviewing all people's needs and choices. The provider acknowledged they did not have a formal system in place to monitor the effectiveness of people’s care and treatment. During this assessment they took action to seek support to develop a system that would monitor key areas and outcomes for people.

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.

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.