Hayes Park 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 rated inspection (published 8 March 2022) we rated this key question Good. At this inspection 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 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Some improvements were required in how the provider and staff treated people with kindness, empathy and compassion and respect for their privacy and dignity.

Staff treated colleagues from other organisations with kindness and respect.

Our observations found people did not always consistently receive care that was respectful, compassionate, dignified and met people’s privacy. For example, we found 3 communal toilets did not have privacy locks. The physical environment compromised people’s dignity and respect due to needing redecoration and refurbishment.

We observed a person who was cared for in bed who was totally reliant on staff for all their needs in a dark bedroom with no stimulation. When we spoke to staff about this person being cared for in their bedroom, they advised the person had an electronic device (an Alexa) to play the radio or music. However, this was switched off and a staff member did not know how to use the device. This showed a lack of care and compassion.

We observed a person sitting at the dining table with others waiting for their lunch to be served. Two staff took the person’s blood glucose levels in view of everyone, instead of doing this in private. This showed a lack of dignity and respect.

Staff had received training in dementia awareness, but our observations found staff required additional training and upskilling. For example, a person living with dementia liked to walk with purpose, but at times forgot to use their walking frame. We observed them walking around in the lounge with a staff member constantly saying, “[Name] use your frame.” This was continuous with no other distraction techniques used or words of reassurance and comfort. When the person sat down the staff member sat near them but engaged in no conversation. An inspector introduced themselves and sat with the person, who responded positively to their presence and conversation.

We also observed another person living with dementia who was communicating in their own way and was largely ignored by staff. This showed a lack of empathy and respect by staff.

People and relatives were overall positive about the staff’s caring approach. A person said, “I’m being well looked after. The manager treats me with respect. All the girls [care staff], the kitchen staff, cleaners, they are all nice.” A relative told us how they were happy with the standard of care. They said, “There is a positive atmosphere. Staff are engaging.”

However, a relative raised concerns about their family member’s care, which they felt showed a lack of care and attention by staff and agreed for us to share this with the registered manager. We did this and the registered manager agreed to follow these concerns up.

Feedback from external healthcare professionals were positive about how well staff worked with them, describing them as, “professional, polite, respectful,” and having, “good communication."

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.

People’s care records showed improvements were required in care plan guidance for staff, to ensure people received consistent personalised care based on their individual needs. For example, a review of people’s care records found important information was not consistently recorded. We found examples of records titled ‘all about me’ and ‘biography’ that were blank. This is important information to support staff to understand people’s backgrounds, routines and what was important to them. A lack of detailed personalised information meant people may not consistently receive care and treatment based on their individual needs and preferences.

People’s daily notes completed by care staff to record all staff interactions and used to share important information, including people’s comfort and welfare needs, lacked personalised information.

Overall, feedback from relatives were positive about how their loved one was treated as individuals. However, some relatives felt improvements were needed. For example, a relative said, “[Relation] is not looked after properly, they need to be treated as a person, they had a life.” Our observations of the environment, including people’s bedrooms, found there was a lack of personalisation that reflected people’s interests, hobbies, and pastimes important to them.

Some people’s cultural and religious needs and preferences had been met with an area dedicated to enable people to practice their faith. External religious groups had not returned to visiting the service following the Covid-19 pandemic. However, the registered manager recognised the importance of meeting people’s religious and spiritual needs and gave examples of how individual needs had been met. Staff gave examples of religious festivals and celebrations they had supported people to participate in.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Assistive technology was used to support people’s independence. For example, sensor mats were used to support people assessed as being a high falls risk. Sensor mats alerted staff when people were walking independently.

We observed people were supported as fully as possible in choosing what to eat and drink. We saw how a person’s independence was supported by the position of their wheelchair at the dining table and provision of adapted cutlery and crockery. This enabled maximum independence for the person.

People had access to friends and relatives at all times as there were no visiting restrictions in place. An activity coordinator worked Monday – Friday and supported people to participate in group activities and provided one to one time for people who were either cared for in bed or chose to remain in their bedroom.

We received a mixed response from people about how they were supported with choices. People told us they received a choice of where and how they spent their time. One person told us how they preferred to remain in their bedroom and choose not to join in with activities on offer and that this was accepted. Whilst some people confirmed they had a choice of meals, others told us they did not. Our observations confirmed people were offered a choice of meals and drinks.

The provider listened to and understood people’s needs, views and wishes. However, staff did not consistently respond to people’s needs in the moment and did not always act to minimise any discomfort, concern or distress.

Our observations as described in Kindness, compassion and dignity in this report, showed a lack of consistent care in responding to people’s immediate needs. We discussed this with the management team who agreed to arrange further staff training, and to complete additional observations of people’s experience of receiving care and treatment.

The registered manager completed daily walk arounds, and this included observing staff practice and speaking with people who used the service. The registered manager was very knowledgeable about people’s individual needs.

The provider had introduced recognised assessment tools in the care and treatment of people. This included how staff were able to understand people who may not be able to communicate verbally, particularly if in pain or distress.

The provider had policies and procedures to support staff in responding to people’s immediate needs such as falls, incidents and accidents. Staff had recorded they had read and understood these procedures.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The provider regularly reviewed people’s dependency needs to ensure there were always sufficient numbers of staff on duty to meet people’s individual needs. The staff allocation and staff rotas confirmed staff were supported to have regular breaks. Overtime was monitored to ensure staff did not work excessive hours that may impact their wellbeing.

The registered manager attended daily staff handover meetings Monday – Friday and arranged regular staff meetings. This supported and enabled the staff team to have regular contact with the registered manager. Meeting records confirmed staff received regular opportunities to provide feedback, and to raise any concerns or suggestions.

The management team were working towards improving the staff culture by reviewing and addressing the staff’s team working practice. This was important to ensure people received consistent care and treatment.

Overall, staff told us they were happy working at the service and felt well supported. The majority of staff were long serving, having worked at the service for many years. A staff member said, “The manager is good, supportive, listens and is always available.”

Some staff told us they did not always feel valued and appreciated and there was a lack of positive feedback and recognition for their work. Staff meeting records confirmed staff had raised this directly with the management team. We saw recent meeting records where staff had been thanked for their work and contribution. This showed the management team were responsive to feedback and wanted to make improvements.