Fosse Healthcare - Nottinghamshire

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

We assessed 3 quality statements in the safe key question and found areas of good practice and concerns. The scores for these areas have been combined with scores based on the rating from the last inspection. 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. Some people were concerned that their request not to have male care staff was often ignored. Staff did not feel valued or listened to. Staff morale and satisfaction levels with their role were low. Some felt this could impact on the care provided to people.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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 care staff supported them to have choice and control over their own care. People said staff understood what level of support they needed with their personal care and always encouraged their independence. One person said, “The regular carers all know exactly how to support me and give me time to try things or find ways to help me get what I need done without making me feel small. We have an excellent rapport and I look forward to spending time with them.” Some did express concerns about male staff being provided for their care calls when they had asked for female staff only. Some felt their choices were not being respected. A relative said, “I had requested a female carer for the morning call if [family member’s] regular (male) carer cannot come as they get stressed when these random male carers turn up.” Some felt late calls were impacting on their ability to be in control of their lives such as making them late for social calls. One person said, “I have told both the carers and the office about the (social arrangement) and needing the care call done by (set time), but just recently, it (the call) has been getting later and later and I have missed a couple of sessions. I need interaction with mates for my well-being.”

Staff understood people’s ability to make choices and told us they would always encourage people to make their own choices. One staff member said, “I have helped people achieve things by helping them to remain independent in their own home. I help them with going out, getting them to shower and wash independently by themselves when they couldn't do before. I am helping them to achieve things they thought they couldn't do, and it makes them happy. That makes me happy too. “ Staff told us they had completed training in dignity and respect. Staff told us how they had applied this training to improve people’s experiences. The registered manager told us they felt they had the appropriate policies and procedures, staff, and training in place to ensure that people received care that was person-centred and supported their independence. They told us that wherever possible they tried to ensure that people received the care staff they wanted; however, due to staff numbers, holidays, and sickness this was not always possible. They acknowledged that communication about this needed to improve.

Staff had clear guidance on how to support people to be as independent as possible. People were supported to understand their rights by using different ways to communicate. There were regular meetings for people and staff to feedback. However, people and staff did not always feel appropriate action would be taken.

Most people and relatives felt their or their family member’s immediate care needs were met by staff. Most felt staff understood how to provide the care required and that most calls were completed in accordance with their wishes. Some did raise concerns that the punctuality of staff could have a negative impact on occasions. For example, if a person needed to go out to attend an appointment or to visit friends or family.

Staff felt able to provide the essential care that people required. They told us if people’s needs changed during their call, they were able to adapt. This included if people changed their minds over what meal they wanted or whether they required changes to their personal care routine. The registered manager felt staff were flexible in their approach and people received the care they needed.

The majority of the 47 staff who responded to our questionnaire raised concerns that their well-being was affected by the way they were expected to carry out their role. Almost all care staff used words such as, ‘overworked,’ ‘undervalued,’ ‘stressed,’ ‘worried’ and ‘unsupported’. Staff felt they were expected to complete too many calls each day, with little or no break. Some staff felt pressured to take extra calls, and when they raised concerns with office-based staff, they felt ignored. A staff member said, “I don’t feel very supported by the office staff, they ignore my messages and emails and when I ring the office to talk to any management, I get told they are either on the phone or they will ring me back, which they never do.” Another staff member said, “At Fosse they don't listen to you in what you need, and I get abuse from [office based staff member] and they don't listen. They say they will sort things, but they don't this has caused me to have mental health issues.” A third staff member said, “It’s not a nice place to work anymore as I feel just like a number and not an employee. Any concerns that I raise just get brushed under the carpet and not followed up correctly, we put concerns in but never hear back from them. I wouldn’t recommend working for Fosse Healthcare at all.” We received many similar comments from other staff to those stated above. Then nominated individual told us they were disappointed to hear the themes raised from feedback provided by staff. They told us they had a number of schemes and initiatives in place to support staff and this would be a key focus moving to improve staff morale and experiences.

The provider had a series of programmes, processes and schemes in place designed to support staff well-being. An employee assist programme was in place which offered staff access to free counselling and advise services. Rewards schemes were also in place which rewarded high quality staff performance. An end of year awards programme, presented by the chair of the provider group recognised exceptional staff performance. A centralised ‘Care Hub’ was currently in place to be available to staff should they require assistance or advice outside of office hours. This was available until 11pm every day of the week. A change to the hour’s office-based staff worked was imminent. The office would now be open at weekends and in the evenings. This will give staff access to management and other relevant staff who can offer more focused advice and support should this be needed outside of normal 9am-5pm working hours. A ‘Listening Lunch’ was provided for staff to come and meet with members of the senior management team to discuss any concerns they had or to discuss anything else that was important to them. The nominated individual told us no staff decided to attend the most event.