Archived: Asquith Hall

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

Caring - This means we looked for evidence the service involved people and treated them with compassion, kindness, dignity and respect. At our last inspection we rated this key question as good. At this assessment the rating is now inadequate. People were not well cared for, and their dignity was not always maintained. Staff and leaders did not know people well. People’s individual needs and choices were not considered. We identified 1 breach in relation to person-centred care.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s dignity was not always maintained, and people were not always treated with care, kindness, compassion and empathy. One person told us, “This is a horrible place. I think it's called a care home but there's no caring. I have to look after myself, no support with a wash or shower. I would love to live anywhere else, anywhere at all."

Leaders and staff failed to take action to ensure people’s dignity was maintained and their basic care needs met both prior to and during inspection. For example, during an information sharing meeting between leaders and staff it was noted that oral care for people was missing from the day’s records. Leaders did not investigate this any further to ensure people had received oral care. No further discussion or action was taken.

Partners shared significant concerns regarding the care people were receiving.

We observed people did not have their dignity maintained or their basic needs met. There were several examples of this observed during the inspection. For example, 1 person looked dishevelled and unkempt, with a strong body odour and they were wearing urine saturated clothing. In addition, we observed a person in their room with the curtains closed, sitting on the bed looking unkempt, with messy hair, an unshaven face and wearing only pants and vest. There was no sheet on the bed and the duvet had no cover. There was no call bell for them to gain staff attention. We observed a person sitting up in bed, in the dark, staring ahead. Their bed sheet was scrunched up beneath them and they were holding their duvet scrunched up over them. The room was stark and bare and there was faeces on door handles. Two people were observed to have long brown fingernails. In addition, a person was observed to have unbrushed and unwashed hair and their trousers were on back to front. One person did not have any clothing on their bottom half and there was no duvet or sheets on their bed to protect their dignity. People were often laid in beds without appropriate bedding or with dirty and stained bedding and equipment. One person was standing in the corridor with a large amount of nasal mucus on her face and dripping from her chin. Staff members walked past the person without offering any assistance for over 15 minutes.

People were not treated as individuals and their needs and preferences were not considered. There was no consideration given to people’s strengths, abilities, aspirations, culture, unique backgrounds or protected characteristics.

Leaders and staff did not know people well and often did not know basic information about people’s needs or their preferences. Care was task orientated and did not reflect an individualised approach. One staff member told us, "We've been given nothing. We don't know anything about these people, and we are working the floor."

We observed people being cared for by staff and leaders that did not know people or their individual needs. For example, whilst in a communal area one senior leader said, “The gentleman in the orange he doesn’t seem to have moved.” A staff member responded, “He can move himself.” Another then stated, “No he can’t he’s a full hoist.” The senior leader did not know his name, he was not being looked after in an individualised way and he was being spoken about across a room full of other people and staff.

Systems and processes had failed to ensure people were treated as individuals and cared for in a way that met their needs. There was no evidence of people’s preferences being included in care records and care records were often inaccurate and inconsistent. People’s care plans did not reflect individual life histories or future aspirations.

People’s independence was not promoted, and they had little to no choice and control over their care, treatment and well-being. People were not supported to make choices about their lives, improve their independence and have control over their routines.

Leaders and staff did not advocate for people and did not support them to have control over their lives. They did not support people to follow their interests or participate in activities.

We observed relatives visiting people at the service. However, there was no meaningful engagement between staff and people and there were no activities on offer. The atmosphere was often sombre. We observed people in their rooms continually with no 1:1 activity or meaningful engagement. People in the communal areas were sat around the edge of the room, facing the TV, for long periods of time with no other form of entertainment. On one occasion we saw an error message in the middle of the TV screen for a long period of time, this was not removed or noticed by staff. There was an activities board in situ in the corridor outlining available activities. We saw no evidence of any of those activities being facilitated for people.

Systems and processes were ineffective in ensuring that people’s independence, rights, choice and control were supported. They did not ensure that people’s well-being was suitably considered or that people were meaningfully engaged. Care records contained no evidence of people or relative involvement in making choices and decisions about their care and support.

People did not always have their immediate needs responded to. People were often left unsupported for long periods of time. People unable to move from their beds were not able to alert staff if they needed assistance as calls bells had been placed out of reach.

Leaders and staff did not respond to people’s immediate needs. They did not effectively engage people and listen to their views and wishes. One staff member told us “No [people are not being cared for]. It is impossible. There is no time."

Staff did not respond quickly and act to minimise any discomfort, concern or distress to people. For example, 1 person had fallen and was on the floor for 40 minutes with staff present, during this time they received almost no comfort from staff. It was over 10 minutes before anyone spoke to them, then a staff member said, “Don’t worry we will get you up.” Following this there were significant periods of time where there was silence and nobody was talking to the person, explaining what was happening, or offering reassurance. In addition, we observed a staff member entering a person’s room after the call bell had been sounding for over 11 minutes. The staff member entered the room turned the alarm off and left.

Wellbeing of staff was not promoted, and they were not supported to deliver person-centred care to people. Feedback included, “[Two members of provider level management] are not supporting us. They are here now but it’s obvious why they are here it is because CQC are” and “We [staff] come second."

Systems and processes were not effective in supporting staff in their role or supporting their wellbeing. Staff supervision was not consistently taking place. For example, 1 staff member employed for over a year, had not had any documented supervision or appraisal completed.