Archived: Durnsford Lodge Residential 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 assessment of this key question in February 2019 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.

The service was in breach of legal regulation in relation to person-centred care, staffing and good governance.

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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

People’s basic human right to privacy and dignity was not always understood by staff or respected. Throughout the assessment, we observed staff consistently left some people’s bedroom doors open even when they were in bed. This meant people living at the service, staff and visitors were able to see into some people’s rooms when they were sleeping. There was no information contained within people’s care plans to indicate this was a person’s choice. Senior staff, the registered manager, and the provider did not challenge this practice.

There was a lack of attention to people’s appearances and to maintaining their dignity. Some people’s clothes were stained or had food down them, their hair looked unbrushed and not clean. Some people were seen to have an unkempt and unclean appearance. For example, we noted one person had the remnants of their lunchtime meal on their clothing in the late afternoon. Another person, who had recently been unwell, had the contents of a cardboard sick bowl left next to them for 3 hours despite this being brought to the attention of staff by the inspection team.

One person’s personal information was not always kept secure. For example, a letter addressed to one person about their personal financial arrangements was pinned to a notice board in the registered manager’s office for all to read.

We noted some people’s bedrooms, although visually clean, contained an unpleasant odour, which impacted on people’s living environment and well-being. This contributed to a breach of regulation in relation to person-centred care.

Staff mostly knew people well [see safe section of this report] and spoke about people with kindness and compassion. It was clear from our conversations that staff had developed good working relationships with people and their families and genuinely cared about the people they were supporting. Staff spoke passionately about providing good care to people but told us they felt rushed and did not have enough time to spend quality time with people.

Relatives spoke positively about the care and support their loved ones received. Comments included. “Yes, I absolutely have confidence in what they do for dad.” “From what I have seen, they are polite and very helpful, and they take good care of him.” “The staff are very kind and caring, we are very happy with the care they give.”

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 into account people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff told us they did not have time to support people the way they wanted. One member of staff said, “We just don’t have enough time to sit with people.” Another said, “We are supposed to provide activities in the afternoon, but we just don’t have the time.”

Some care records we reviewed contained lots of information to aid staff to support people in line with their wishes and preferences, but it was not evident this information was being used to provide person-centred care and support. For example, one person’s care records stated, ‘I like to watch TV in the lounge, and I enjoy the company.’ On all 3 days of the inspection, we found this person was sitting alone in their bedroom with no stimulation. Another person’s care plan stated, ‘I enjoy all sorts of activities and really do enjoy the visiting entertainment. I would like staff to record how well I participate in the activities and if I enjoyed myself.’ Despite this statement, there was no record or evidence of this person participating in any activities for 28 days. This contributed to a breach of regulation in relation to person-centred care.

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.

As described within the safe, effective, and responsive sections of this report, some care records were very detailed and contained clear information about what each person could do for themselves and described any areas where people required some additional support or guidance; others were not. It was not always evident from the records or speaking with staff how people were being supported to understand their rights. This contributed to a breach of regulation in relation to person-centred care.

Staff described how they took a positive approach in encouraging people to be as independent as possible, whilst recognising when people needed additional assistance. Staff had developed good working relationships with people and their families. People we spoke with seemed happy with the care provided and told us they like the staff supporting them. One person said, “[staff member’s name] is lovely, she comes and sees me when she is on shift.” Another said, “They [meaning staff] have treated me very well.” Relatives were complimentary about the staff team and had confidence in their care and support they provided. Comments included. “Yes, her needs are being met, definitely.” “I would say yes, they do meet her needs, but I think homes in this country are not really fantastic.” “She loves it there; she is very happy there and says they look after her well”.

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.

Call bells were not always in reach for people in their bedrooms, which restricted their ability to summon help when needed. Staffing levels, as identified within the safe and responsive section of this report, impacted staff’s ability to meet people’s needs promptly. Staff consistently told us there were not enough staff to meet people’s needs safely and get everything done. Whilst most people we spoke with did not have a view on how their needs were being met. One person told us staff were always rushed and there was not enough staff at mealtimes because so many people were in their rooms and needed assistance. This contributed to a breach of regulation in relation to person-centred care, staffing and governance.

People’s immediate health care needs were responded to promptly. Records confirmed that staff made referrals and contacted emergency services when people needed specialist advice and support.

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

The registered manager and nominated individual told us they cared about their staff team and were committed to ensuring staff felt valued and appreciated. We saw examples where the provider and registered manager had provided positive feedback and thanked staff for their ongoing support. We saw the provider had nominated a number of staff for the ‘Plymouth Excellence in Care Awards’, in recognition of their achievements. Some staff were positive about the management changes and told us the registered manager was approachable. However, staff told us they did not feel their concerns were listened to or fully acknowledged in terms of staffing levels and workloads, as detailed within the safe and well-led sections of this report.

Staff were able to provide feedback through surveys; however, we found not all staff had regular opportunities to take part in supervision, nor were they supported to gain the skills necessary for their own personal development, as detailed in the safe section of this report. This contributed to a breach of regulation in relation to staffing and good governance.