Hazelbrook Christian 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 45 (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 did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat each other with kindness and respect.

Some people told us they were not always treated with dignity and respect. One person said, “I haven’t got any dignity anymore”, while another said, “Sometimes there can be two carers in my room and they speak in a different language in front of me.” Not all staff had completed training to help them understand, respect, and actively promote the dignity of the people they supported.

Staff shared examples of times when staff were unwilling to help each other when needed or spoke to each other in a rude or dismissive way. Staff reported this made it difficult to work together, which affected the quality of care provided to people in the service.

However, we observed some staff treating people with kindness and respect. The staff we spoke with demonstrated a caring attitude when sharing concerns about shortfalls in the service and how this impacted on people. The people we spoke to told us, “[Staff] are kind and helpful andtry their best at all times.” A relative said, “Ican’tfault thestaff;they are so pleasant and friendly.”

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 obtain and record information about people’s strengths, aspirations, life histories, culture and unique backgrounds.

Care plans included basic information about people’s medical history and care needs. Not all care plans included information about people’s life histories, likes and dislikes, and what was important to people. Some information had not been updated since the person’s admission despite regular care plan reviews. When information had been recorded, we did not find evidence to show this was used to provide person centred care in line with people’s needs.

People’s bedrooms were not always personalised or tailored to the individual. People’s full names were displayed in small writing on their doors. One person’s name was spelled incorrectly, and some did not show the preferred name of the person. Bedrooms were generally sparse, lacked personalisation and limited people’s ability to make choices about their environment.

We did not observe any meaningful activities happen during the inspection. An activities schedule was on display in the service. Planned activities included manicures, one to onechat, songs of praise, quiz time, breaking news, and local news.

There was no evidence in care plans to show activities were planned in line with people’s hobbies and interests. When asked about activities a staff member said, “It’s the least thing we do here, we don’t have the time”.

However, people and relatives told us how staff tried their best to treat people as individuals, such as knowing their likes and dislikes, understanding people’s health needs, and helping people to access religious services.

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

People told us they had not been involved in their initial assessment of needs or their care planning, and some were unaware they had a care plan or risk assessments in place. This is important as being aware of these can give people a sense of ownership and control over their life. They can make informed decisions about their care, ask questions and help shape the support they receive.

Staff told us they felt unable to promote people’s independence due to staffing pressures. A staff member said, “During care tasks we try and explain to people they can do it for themselves, but they have become fully dependent on us.”

We observed some people being offered choice around meals and snacks, however other people were not offered the same choice. One person told us, “There isn’t a choice of hot meals. If you don’t want the hot meal, you just get a snack.”

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

Staffing levels did not effectively enable staff to adapt care in response to individual and immediate needs. The staff we spoke to recognised they were not always able to respond to people’s needs due to staffing pressures. Staff told us how personal care tasks such as showering and toileting were not being completed. A staff member said, “Iftheydon’thave capacityto askthen theydon’tget toileted, they’re just left to sit in their pad.”This can have a serious impact on people’s physical health as well as their sense of self-worth.

People did not always get help quickly when they were distressed or uncomfortable. We found delays in how staff noticed problems and reacted. One person told us, “I do get concerned when I am in the lounge andIsee people calling out for thetoilet,but they do nothing for a long time.” Sometimes, people had to wait to be supported out of bed or with their meals due to lack of staff availability.

A call bell system was in place, however people raised concerns about the time they had to wait to be supported by a staff member. One person told us, “If I use my bell,it can take a while for them to arrive.” Another said, “Sometimes they come quickly and other times I have waited over an hourfor them to answer my bell.” This meant people could not reliably call for support when they needed it, which placed them at risk of unmet care needs, delayed assistance, and distress.

The provider did not care about or promote the wellbeing of their staff. They did not support or demonstrate an understanding of the importance of staff wellbeing in delivering person centred and compassionate care.

Staff reported reduced staffing levels had a direct impact on people’s care needs not being met, which negatively affected their own wellbeing. Staff described feeling under pressure and distressed at not being able to meet people’s needs in a timely way, if at all.

Staff told us they felt scrutinised by the provider’s use of CCTV. They described feeling anxious and concerned that the constant monitoring of CCTV footage was used to punish staff, ratherthan for safety, learning or improvement. A staff member said “[The provider] rings the home and knows exactly where staff are at certain times, things are taken out of context to target us.”

Another said “There’s even a camera outside the staff room and where we sit outside for lunch, so you just feel like you’re being constantly watched. Everyone’s scared they’re going to be targeted.” This contributed to a lack of safety and openness.

The provider did not create opportunities for staff to reflect on their practice or discuss the emotional impact of their work. Staff said they did not feel supported and their wellbeing was not prioritised by the provider. Some staff reported not having timely breaks due to insufficient staffing levels.

Concerns raised by staff were not consistently addressed by the provider, and this further contributed to feelings of mistrust and dissatisfaction. Staff spoke positively of the registered manager in listening to and responding to their concerns, but believed the registered manager was unable to make any positive change due to the provider’s oversight and control.