Bethrey House

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

The service was not caring. We identified 1 breach of the legal regulations. People were not always treated in a kind and caring way as staff did not always fully understand their needs or have access to information about people. The systems in place needed improvements to ensure people could be supported with their individual needs, be offered choices and be treated in a kind and compassionate way.

This service scored 40 (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 not always supported in a kind and caring way. One person said, “If they’re busy it’s often a ‘tell-me-later’ attitude if they’ve got no time,” Another person said they felt staff meant to respect them but not always, although the person did describe them as 'wonderful'. They explained they were trying to retain as much independence as they could but felt there was a lack of autonomy. The person said, "It annoys me if I stand up and they say, 'Where are you going?'. They know where you are every minute of the day.”

The nominated individual told us it was important to treat people in a kind and caring way and explained to us this was important to them as one of the providers of the home. They said, “We want to create a nice family atmosphere”. Staff felt they were kind and caring towards people and felt this was important. They told us they would support people when asked and do things for people in line with their individual preferences. However when asked, the examples they gave to show this were limited. We asked staff why they hadn’t supported a person with their health condition, and they could not provide an explanation.

As part of this assessment, we asked for feedback from the local authority They told us they had recently attended Bethrey House and found concerns. They had worked with the provider to put in place an action plan which they shared with us. The local authority found concerns around people’s mealtime experiences and the choices they were offered; they asked the provider to ensure people were consulted on the activities they were involved with and review the access issues in the home that people faced.

Although we saw some positive interactions between staff and people, we saw people were not always supported in a kind and caring way. A person was telling us about their health condition and concerns they were currently experiencing. A staff member intervened and explained how this was treated, despite this the staff member never offered to support the person with this or delegate this to another staff member, they left the person as they were.

People felt they were not always treated as individuals. One person said, “They don't ask, they tell. Being ordered to do things. When you've reached a certain age, it makes you feel like a child. Can I have a shower when I want one? No, I cannot." Another person said: "I wouldn't mind having help with a shower. I've never had to beg, but they don't ask how you like things to be. It's personal and private."

Staff and leaders told us how they treated people as individuals. Staff told us how they considered people’s individual choices. However, they could not always tell us how people preferred their care or what was important to them.

People did not always receive individual care. At mealtimes everyone remained in the same chair and a table was put in front of them, they were not offered a choice about this or asked if they wished to sit at the small dining room table. Although people were dressed individually, everyone had the same routine. For example, people were taken for personal care before mealtimes. When people arose, they were bought into the lounge and were not asked where they would like to sit but sat in their ‘usual chairs’. Activities also took place in the same area where people sat and ate meals, offering people no change in environment.

The systems in place to ensure people’s individuals needs and preferences were considered were not effective. People did not always have care plans in place when needed and care plans that were in place were not always reflective of people’s current needs and not always followed by staff. There was some reference in people’s care plans to likes and dislikes however this was limited and not consistently completed.

People told us they were not always encouraged to be independent or make choices. One person explained how important keeping independent was to them, “I want to be independent and not a burden, I sometimes need nudging, staff don’t know me, so I don’t really get that here.” Another person commented on being active they said, “They’ll let you just sit for ever. I look after being independent for myself. Something should be done about people just being left to sit all day. I’m aware of the moving and do it myself, but others are not up to it without being encouraged by staff which they never are”. Another person said, “I pay for the room so should be able to go where I want and what for. I know it's for safety, but it's still very hard. I don't have any individual choices, it's what makes it so hard.”

Staff and leaders told us they offered choice’s to people and they were encouraged to remain independent. We asked staff about people’s evening meal choices and they told us people were being offered the same options as lunchtime. Staff confirmed to us they had not recognised this lack of choice.

We saw the environment restricted people being able to make choices, for example due to the ramp being mobile people could not always access the garden or other areas of the home without support. We saw some people were seated away from the television and could not see or hear it and commented on this. At lunchtime we saw people were offered a choice of meals. This included a jacket potato with a filling. Later we saw staff were preparing an evening meal and they were using the same filling as at lunch time as a sandwich or on toast. The provider had not considered people were only offered limited choices.

There was no effective system in place to enable people to consistently have adequate choice and control relating to their care, and independence was not always promoted by staff or the environment. Records and people confirmed they were not involved with planning or reviewing their care and therefore it was unclear how people made choices about their care. There were some references to people’s preferences in care plans when they were in place however this was not always completed and staff did not always follow people’s care plans.

We received mixed feedback from people about how their needs were responded to. One person said, “I am itching around my waist. I need a bath and they don’t always get you a bath. It makes a difference to my skin. I’m always asking for a bath.” Other people we spoke with raised no concerns..

The nominated individual told us there was a handover process in place which they were updating to ensure changes in people’s needs were responded to. Staff were not always able to tell us what people’s current needs were for example, health conditions and mobility needs. They were not always aware of what was in peoples’ care records when asked.

People’s needs were not always responded to. For example, when a person requested support with their health needs, we saw a staff member acknowledged this and then did not take any action.

The nominated individual discussed the importance of the workforce and how they considered their wellbeing. When asked they were unable to provide information about how this was managed and recorded. Staff we spoke with felt supported by the home and felt it was a good place to work.

There were no systems in place and the provider was unable to demonstrate how they promoted the wellbeing of staff. The provider was working on adding a staff room, so staff would have access to a designated area in the home.