Archived: Bowland Lodge

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 the last inspection we rated this key question requires improvement. At this inspection the rating has remained requires improvement. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.

We found the provider was in breach of the legal regulation relating to person centred care, promoting independence, staffing and good governance.

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.

Staff treated people with kindness, empathy and compassion and respected their privacy and dignity. People praised staff for how well they worked with them. Staff interacted with people in a respectful and caring way and took time to reassure them. One person told us, “The staff have always been really kind.” Staff treated colleagues from other organisations with kindness and respect. A staff member said, “Despite all the difficulties and not being paid properly we come to work because we feel the people are our family and want the best for them.”

The service did not treat people as individuals. The environment was not designed to encourage people to develop or maintain their independent living skills, yet the aim for some people was to support them to move to more independent living settings. The activities co-ordinator had been made redundant, and staff were expected to provide all the activities. We observed none occurred throughout the 3 days we visited. Care was not planned or delivered in a personcentred way, and staff did not demonstrate a consistent understanding of people’s individual needs, preferences or life histories. Information about what mattered to people was either missing, inaccurate or not used in practice. As a result, care was taskfocused and routineled rather than tailored to individuals. This placed people at risk of receiving inappropriate care. A staff member said, “We want to help residents get the best out of life but [partner’s son] always argues about the cost and won’t let us do things. For example, 1 of these residents likes to go to the bingo at a local social club on a Sunday evening and to watch the football. They usually see some of their family members and old friends at this club too. We haven’t be able to take them for months and [partner’s son] won’t pay the staff wage.”

The service did not support people to have independence, choice and control over their care. People were not consistently involved in decisions about their day‑to‑day lives, and staff did not actively promote independence. Opportunities for choice were limited, and decisions were often made for people rather than with them. Care delivery followed set routines instead of personal preferences, which restricted autonomy and reduced people’s control over how they lived their lives. This had a negative impact on people’s experiences and outcomes and increased the risk of institutionalised care.

Staff listened to and understood people’s needs, views and wishes. They responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. However, the continuing poor oversight and management meant there was not always the staff available to do this. A staff member said, “We want to provide a good service. I like feeling like you’re making a difference. However, we can’t do this as there is not enough of us now there is no activities coordinator.” Another staff member said, “Often we can’t make sure everyone is okay because a few people need far more support than we can offer. Staff descriptions of incidents highlighted ineffective staffing arrangements and poor leadership oversight. Staff reported being left to manage situations of heightened risk without appropriate management presence or support, which placed them and others at risk of harm.

The service did not promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care. Staff were not consistently supported through supervision, training or leadership oversight. This reduced staff confidence and competence and contributed to inconsistent care delivery. People told us the [partner’s son] often shouted at the staff and refused to pay for things. A staff member said, “[Partner’s son] keeps threatening to take the staff room off of the staff so they can make money from it.” Most of the staff team were not receiving their pay properly and some had to wait for months to get paid in full. This uncertainty around their own financial stability compounded the low morale of the staff team. The lack of effective workforce support increased the risk of poor outcomes for people, as staff were not adequately equipped or empowered to meet needs in line with expected standards.

Staff were committed to providing support for the people and felt they worked well together as a team. A staff member said, “All money for the activities for residents is fundraised by the staff already. At Christmas, staff took it upon themselves to make sure that every resident got at least a few gifts to open on Christmas Day and a Christmas Eve box. We sorted and wrapped all of the gifts but simply asked if management could provide things such as tablecloths and a few extra tables for Christmas lunch but these were not provided.”