Palm Court 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.

This key question was not rated at the last inspection but had a previous rating of good. At this assessment the rating is 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 colleagues from other organisations with kindness and respect.

People told us they liked the staff, one said, “Staff are very kind and pretty much all very good, they are here if you need them.” Staff were seen to respond to people with kindness, but we saw staff were rushed. Staff told us they cared about people but felt they were too busy and not able to spend the time with people that they needed.

Respect and dignity was not always considered, we saw that staff did not always identify and respond promptly when people required personal care. One person was seen to be sat in wet clothing in the communal lounge for some time, staff had not provided support in a timely manner. We observed some staff were kind and would sit with people, but several staff appeared task focused and did not always interact with people effectively. For people who were having one to one support, we saw that not all staff providing this interacted with the person unless the person became distressed. We observed limited interaction with some people who were sat in the communal lounge all day.
 

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 did not receive personalised care based on their individual needs and preferences.People told us they were asked for their meal choices each day, but these were not always provided. People’s communication needs were not updated in a timely manner to ensure staff were aware of changes. When people were sat in the communal lounge, we saw the television was on in the large open area. People’s chairs were facing side onto the television, and it was not clear who if anyone was watching it, or whether anyone had chosen the programme that was on. There was a second television where people could sit in a smaller area if they chose, and we saw this area being utilised later in the day.

There was limited evidence to show how people’s likes, dislikes or preferences were used to inform their care. The provider told us they had plans to improve this to connect people and staff who had similar hobbies, or interests to help spark meaningful conversations and forge positive relationships. This had not been introduced at the time of the inspection.
 

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.

People’s care was not always provided in line with their current needs. Documentation did not evidence how people’s choices, or independence was being maintained. Decisions appeared to be made by staff, without any clear rationale. One person was taken to their room and placed in bed in the afternoon, however, there was no clear explanation as to why this had happened.
There was limited information in care plans to demonstrate how people or their relatives were involved in how people’s care was planned.

Many people were living with dementia. There was minimal dementia friendly signage to assist people to orientate to their surroundings. There were 2 sensory rooms, but staff told us these were not used very often, there were two sensory lamps in one of the rooms, but one was not working. A sensory table was also not working. We saw during the inspection that one sensory room was used by the hairdresser when they visited the home and family members could accompany them if they wished.

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.

Care was not delivered in a way that supported peoples immediate needs. One person’s care plan included that they ‘could become agitated and distressed and make noise by screaming or shouting to catch the attention of staff.’ This person remained in bed in their room. We observed that when this person became vocal, staff had responded by closing their bedroom door. Staff did not take the opportunity to spend time with the person in response to their attempt to attract staff. This meant the person was at risk of social isolation. On another occasion we observed the bedroom door was again closed and the person was alone in their room. We requested the door be opened as the bedroom was extremely warm as it did not have a window which could be opened. However, 30 minutes later, on returning to the room, we found the bedroom door had been closed again. We raised this with the RN who reminded staff not to close the bedroom door unless care was being provided.
 

The provider did not care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

Staff had not received adequate support and supervision; the supervision matrix demonstrated that supervisions had not taken place regularly. Issues raised at staff meetings had not been responded to. Staff had raised queries about their wages and felt these had not been responded to in a timely manner. Staff told us they spoke to senior staff and the provider about staffing levels and the lack of access to equipment, but no actions were taken.

Staff told us they did not feel valued or supported. Comments included, “I have told the owners I will leave if things did not improve,” and “I am fed up, so many things are not in place and we keep asking for stuff and it's so frustrating.”

Staff told us they worked hard to make improvements, and they were passionate about trying to make sure people got the care and support they needed. Some new staff had been employed, including a training and quality assurance lead and a clinical lead however, we observed they were not able to carry out these roles effectively as they were required to take on a number of other tasks which took them away from their designated roles.
Staff were not supported by up-to-date person-centred documentation to ensure they knew people’s care and support needs and any associated risks.