Chandos Lodge Nursing Home

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 that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

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.

The provider always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We observed that staff were kind, caring and approachable. They provided reassurance, and supported people during mealtimes, including sitting with them and offering encouragement.

Relatives described staff as ‘kind, caring, patient, friendly and helpful’ and overall described the care provided as good. Several relatives expressed gratitude that their family member was supported by the service, particularly as other care providers had not been able to meet their needs, highlighting the complex needs of the people using the service.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

During the inspection we observed a notice on the notice boards which stated, “Bedrooms doors are to remain open and secured with fire door guards.” We noted that bedroom doors in that corridor were open, with staff unable to explain how this arrangement promoted choice, privacy or dignity. Bedrooms were generally sparse, lacked personalisation and limited people’s ability to make choices about their environment, which did not promote a person-centred approach to care.

The service had CCTV throughout communal areas of the service. For people who had capacity, there was no evidence that they had been informed about the CCTV or had provided consent to its use. Signage regarding the CCTV was not prominently displayed making it difficult for people to see. As a result, people’s privacy, autonomy and ability to make informed choices were not consistently supported. In response to our draft report the provider provided evidence that CCTV signage is displayed in the service and that they have commenced seeking consent from people on it's use.

A relative commented, “When I look at the interactions between the carers and the residents, I would say that it is more supervision than personal engagement on a one-to-one basis with the residents.” This meant people’s individual needs were not consistently met.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

People had a choice of food and drinks, and the cook demonstrated awareness of people’s likes and dislikes. The service offered some activities, including exercise sessions, reading the newspaper aloud, karaoke, an external singer, bingo, movies and floor games. There was no appointed in-house activity co ordinator with a staff member having oversight of activities alongside their care duties. Some activities were one to one or in the lounge where staff were supporting multiple people at the same time, limiting meaningful engagement. There was no evidence that activities were provided for people who remained in their bedrooms.

Supervised corridor walks were included on the activity programme, but these did not provide meaningful choice and presented as institutionalised practice. The physical environment, combined with the high levels of dependency and distress among people restricted opportunities for people to participate in activities of their choice. As a result, people had limited opportunities to engage in meaningful, person centred activities and experiences.

Relatives told us there was a lack of activities for people. A relative commented, “There does not seem to be much going on in terms of activities and people just seem to sit around.” They told us their family member’s individual interests had not been supported, despite requests for this to be considered and they felt more could be done in relation to activities.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Some people in the service received one to one support which enabled staff to respond to their needs promptly. However, some people were unable to use the call bell, limiting staff’s ability to respond to their needs in a timely manner. We also observed that staff did not always consistently monitor people who were unable to use a call bell in line with their assessed needs. The high levels of distress among people in the service made it challenging for staff to respond to everyone consistently, so staff were not always able to meet people’s needs promptly.

A relative told us that their family member had issues with their dentures which required staff support during meals. They told us this not was not consistently managed, despite being raised with staff. This meant the service was not always responding to the person’s immediate needs or mitigating risks.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

The provider told us that staff have access to monthly reflective sessions, a buddy system and debrief sessions following a death or critical incident. However, records did not evidence that these were taking place. Team meetings did not record reflective practice and a staff member confirmed there was no debrief following incidents. As a result, staff were regularly exposed to verbal and physical abuse that had become normalised, and they did not consistently receive the support needed to promote their well-being.