Archived: Bethany Lodge

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

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 inadequate. This meant people were not treated with compassion and there were instances where people’s right to privacy, dignity and compassionate care was compromised.  We found the provider was in breach of the legal regulation in relation to dignity and respect and 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.

The provider did not always ensure people were treated with kindness, compassion and dignity.

Whilst the staff we spoke with told us they were caring and compassionate in their responses to people’s needs our observations did not always demonstrate this. We observed an agency member of staff with their feet up on a person’s furniture on their phone ignoring the person they were supporting. Another person who wished to enter the main building was actively discouraged by a number of staff in an uncoordinated way which led to further distress for the person. The provider had not taken adequate steps to ensure people’s dignity was always protected. There were occasions where people were in a state of undress who were assigned members of staff to work with them and were able to enter other people’s rooms with some occasions leading to harm and distress. One person’s room did not have any facility for privacy even though concerns from the public had previously been raised. This had only been addressed by the provider after the issues were identified by the inspection team. We were not assured the provider had the approach and understanding to ensure staff were providing the level of care needed to protect people’s rights around privacy and dignity.

The provider did not always treat people as individuals, or ensure their care and support met their needs and preferences.

There was no structure or clarity for people receiving care often leading to avoidable incidents of anxiety and distress.

Aspirational goals were not set for people and a lack of structure in the opportunities offered meant people were denied the right to grow as individuals and denied life choices. One person’s daytime routine was limited to trips out in the car and to McDonalds with no other structure or opportunity. Other people’s care did not reflect a focus on growth or enrichment of experiences.

Individual aspects of people’s health were not always considered and decisions were made by the provider that did not reflect what was in people’s individual assessments and plans.

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.

The provider did not make adequate attempts to ensure the environment was conducive to peoples individual’s needs. Effort was not taken to ensure the environment was homely and well maintained. There was a lack of provision for people to have their own space or choice and control over their day.

There was a lack of structured activities for people, and where activities did take place these were not always suitably planned to maximise the outcomes for people.

There was no documented evidence to support people being involved in planning their own care or making decisions relating to their care and support. The provider did not demonstrate any mechanism or system to encourage feedback from people using the service.

The provider did not understand people’s needs and wishes. Staff did not always respond to people’s needs in a timely manner to minimise anxiety and distress.

During the inspection we observed 1 person became anxious over an activity which was due to happen later in the day. Whilst the person had been given objects relating to this activity indicating this activity was to take place, staff had not considered the impact of the lack of structure and timeliness in the activity beginning. As the person became increasingly distressed staff did not demonstrate an approach which responded effectively to the person. This led to an avoidable escalation in anxiety and did not demonstrate an approach which was responding to the person’s immediate needs.

Incident records that we reviewed during the inspection documented other incidents where it appeared staff responses were not in line with what would be considered as an appropriate response to increasing anxieties or distress. This led to instances where the use of emergency medication could have potentially been avoided with better staff responses.

When we spoke with staff they did not feel concerns raised over the safety and risks of people at Bethany Lodge were listened to. There was a disconnect between the thought and operations of the provider and manager and what in reality staff felt as concerns. This did not reflect a positive working environment that provided seamless, safe care.

Information in people’s care records which should provide staff with the information to enable them to provide the right care for individuals lacked detail. We were not assured there was adequate provision of information or guidance to staff to enable them to provide the best care and treatment to people in the service.