The Hall

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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 had not been treated with kindness, compassion and dignity. People’s human rights were not upheld, because people were unlawfully restrained. People were not supported to be as independent or have choice and control of their lives. The principles of RCRSRC were not met; people did not have goals or aspirations they were working towards. People were not supported to be involved in their care; people had not been involved in creating or reviewing their care plans. We found one breaches of the legal regulations in relation to person centred care.

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.

People were not always treated with kindness, compassion and dignity in their day-to-day care and support. People were restrained multiple times, often in an undignified, and unlawful manner. We observed incidents where people had become distressed, and not been treated with kindness, or dignity. During one incident, staff are seen to be teasing a person, when the incident escalates the person hits their head, but this is not checked by staff until later. Relatives told us their loved one's were not always treated with kindness, and that staff had shouted at their loved ones.

Staff told us they knew people well, including their preferences, wishes, personal histories, backgrounds and potential. However, we found that staff did not always respond to people in a dignified way, and that staff often escalated incidents of distress. People were not always well matched with their designated support worker and as a result, people were not at ease, happy, or engaged and stimulated. We observed one person with little engagement throughout our assessment.

People had not been treated with kindness, compassion and dignity. Following incidents of restraint or distress, there were no observations or health checks carried out on people. People's care plans had not been regularly reviewed, and contained incorrect information. For example, one person's care plan had another person's name within risk assessments. Language used within care plans was not always positive or dignified when referring to autistic people, or people with a learning disability. For example, one person's care plan stated that they 'liked to be the centre of everyone’s attention or their behaviour will begin to decline'.

People did not receive kind and compassionate care from staff who used positive, respectful language which people understood and responded well to them. Some language used by staff to describe people was not positive or dignified. For example, when describing one person staff said they were 'attention seeking' and if they were not 'the centre of attention' they would 'kick off'. Records of people were also not always positive, for example one incident form stated a person had 'exhibited unruly behaviour.' This had not been identified and addressed by the manager. During incidents of distress, staff looked scared of people. During one incident of distress a staff member stood behind a sofa, leaving the other staff member without their support. During another incident an agency staff member poured water on a person's head in order to 'calm the person'. The manager took appropriate action and stopped them from returning to the service.

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 were not supported in line with the principles of RCRSRC. People did not always have the opportunity to try new experiences, or develop new skills and gain independence. Staff told us that with some people they only took on walks to the woods, or drives in the car because they were concerned about people having incidents in public.

Staff told us that one person could become distressed if they were not engaged in meaningful activities. The staff member told us that they would "Find ways to kick off." They also told us that when engaged in activities the person felt 'empowered' however, incidents we reviewed with this person demonstrated that they were not always involved in meaningful activities. This had not been identified and acted on by the manager and provider.

People living at the service had a variety of needs, and required differing levels of support. Some people were supported to be independent; we observed one person making their own food and drinks. However, social workers told us people lacked activities and inspiration to work towards goals. Some people observed lacked any meaningful engagement and encouragement to become more independent.

There were not effective processes in place to ensure people were supported to have control and choice over their own care, and to make decisions about their care, treatment and wellbeing. Each person did not have a care plan which identified target goals and aspirations and supported them to achieve greater confidence and independence. There were not processes in place to ensure that surveillance was used positively to promote the independence of people using the service. Records showed that surveillance had been used by the provider to monitor how much cleaning was being completed by night staff.

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.