Heathlands Care Centre

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 requires improvement. At this assessment the rating has remained requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (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 staff treated people with kindness, empathy and compassion, or respect their privacy and dignity. People and their relatives told us staff were generally kind and polite although we received some comments regarding staff appearing impatient at times. One person told us, “Some of the [staff] are very good but one or two I am afraid are pretty poor and not very dignified”. They went on to describe a small number of staff could respond abruptly to requests to be supported to the bathroom. A second person told us, “The carers are nice and look after me.”

Staff were generally polite to people in their individual interactions although on occasions did not always support people in a dignified way. We observed a staff member supporting someone with their meal at lunchtime. The person was clear they did not wish to eat anymore. The staff member did not listen to their wishes and continued to put food in the into their mouth. A second person told staff they did not want either option available to them at lunchtime. The staff member said they should try one of the options and placed the food in the person’s mouth without their agreement which caused the person to become upset. Despite similar concerns being raised at our previous inspection we found the provider had failed to ensure additional monitoring to ensure people were treated with dignity at mealtimes.

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. For example, staff were not aware of one person’s religious beliefs which were important to them. There was nothing recorded in relation to this within the person’s care plan or risk assessments regarding how this may impact on decisions about their care, and no guidance was in place for staff to follow. During our inspection we observed people watching a church service on television. This was also recorded as the activity for the morning on the activity schedule. Several people were sat watching the service although the sound was too quiet for them to hear. Staff were unable to tell us what denomination the service was and were not able to say if this was in line with people’s beliefs. In contrast, staff were aware of another person’s religious beliefs. The person told us they were pleased to have a regular visitor from their local church which brought them comfort.

Whilst there was good information written in some people’s care records relating to their life history and background; staff were not aware of this information. This meant they were unable to use this to generate conversation and build relationships with people.

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. Comments from some people and their relatives demonstrated people did not always have choice and control over the time they were supported to get up and go to bed. People told us they believed this was due to the shift patterns staff worked rather than providing personalised support in line with people’s wishes. One person told us, “I often have to go to bed at 5.30(pm). Some days I am tired by then, but others I am not. I don’t rock the boat. I haven’t said anything because we rely on them [care staff] but that means I can be in bed from 5.30pm to 9.30am. That is sixteen hours and is too long for any human being.” One relative told us, “It’s quite often the case [relative] is still in their nightclothes at nearly lunchtime which was never something they would do at home.”

In other instances, we observed people being offered choices regarding where they wished to spend their time and what they would like to do. We spoke to one person regarding the temperature of their room. They told us this was their preference and their request to be in a cool part of the home was respected. Another person told us they did not have a preference regarding the gender of staff supporting them with their personal care but were pleased to have been asked.

Activities available to people were not always person centred. The activities planner was repetitive with the majority of sessions on offer revolving around listening to music, board games and watching television. The activity staff had not received training in providing activities to support them in personalising 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. People told us they did not always receive the support they required promptly. One person told us, “On bad days I can wait half an hour for them to come after I’ve rung my bell [to support them in the bathroom]”. They told us they were not always able to wait that long, and this caused them distress. One relative told us, “I don’t think they always have the time and patience. I wouldn’t say he is unsafe, but I think they could listen more to what he says”.

Staff generally worked to a set routine throughout the day. We did not see care staff go to sit with people or speak with them outside of this routine. We observed a number of occasions where people summoned a staff member to come closer to them. The majority of occasions staff responded and asked people if they were okay. However, on other occasions we observed people shouting loudly. Whilst they did not appear to be shouting to gain staff attention, staff did not go to check how they were, if they were uncomfortable or if they needed anything. We checked one person’s care plan and found there was no guidance for staff to follow in these circumstances.

The provider did not always care about and promote the wellbeing of their staff. We received mixed responses regarding how well supported staff felt. Staff stated the manager had been supportive and they felt listened to. They gave examples of concerns they had shared regarding routines of the day which the manager had addressed. One staff member told us, “[Manager] has been very good. I can go and speak with [them] and rely on [them] to listen.” Other staff members told us their relationship with the provider could be more difficult. They relayed examples of inappropriate comments made to them which they found disrespectful.

Systems were in place to support staff such as staff meetings and supervisions. However, the manager was in the process of ensuring these were completed on a regular basis and were embedded into the practice of the service.