Harper house - Wolverhampton

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 is the first assessment for the service under this provider. This key question has been rated 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 treat people with kindness, empathy and compassion.

The language used by staff when they were describing people’s care needs to us was not always dignified. For example, 1 staff member used the term, “Kicking off” when describing 2 people’s needs. Another staff member told us a person, “Likes to hit other service users and staff” and another person, “Has good and bad days. It’s if he can’t get his own way.” This language showed a lack of understanding and compassion towards people’s individual needs and behaviours.

People and their relatives gave mixed feedback about how they or their loved ones were treated by the staff. For example, as described under our safeguarding quality statement, 1 person described staff as bullies and a relative described hearing staff being rude to their family member. However, some people described the staff more positively. With 1 person describing the staff as, “All nice”.

On the day of our inspection, we observed staff treating people kindly and respectfully.

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.

Some people told us their individual preferences were not consistently met. For example, 1 person told us and their care plan recorded they had a strong preference for Indian foods. However, their care records showed that over a 29 day period, Indian food was only provided on 4 occasions. A staff member told us they had raised a concern with the managers about this but had not felt listened to. They said, “I asked for Asian foods for [person], they told me to get out of the office.” This meant this person’s individual cultural food preferences were not consistently met.

Care plans mostly contained detailed information about the way people wished to receive care and support. However, the information in these care plans was not consistently followed by staff. For example, as described above the person’s care plans around their food preferences was very detailed, but this information was not consistently used to provided individualised care and support.

The provider did not always promote an environment that consistently offered people choice and control over their care and support.

People gave mixed feedback about how they were supported to have choice and control over their care and support. Most of the varied feedback people shared around choices related to food. For example, 1 person described how they did not like the food available at the service and they did not feel they had sufficient choice. This led to them purchasing their own ready meals on a regular basis. We observed this person eating a ready meal they had purchased on the day of our inspection. Another person described the food choices more positively. They said, “I like the food and I get a choice.” This meant the food choices offered to people did not always meet their preferences.

Care plans contained detailed information about how people wished to be supported and independence was promoted throughout these care plans. However, the information within care plans was not always followed to enable people’s independence to be consistently promoted. For example, 1 person’s care plan recorded how important a time specific routine was to them. This person showed us their bedroom and we saw all the clocks within the room displayed incorrect times. This meant the person did not have full control over their routine as they were unable to identify the correct time.

The provider did not always listen to and understand people’s needs. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff told us people were not always supported to access the community when they wished to do so. One staff member told us how a person’s behaviour escalated when they could not be supported to access the community. They said, “He asks to go out but there’s no staff.” Another staff member told us how people could only access the community at set times due to staffing levels. They said, “All people get to go out. They go out after 1.30pm. Two staff stay in the home, someone covers when people go out.”

Care records contained the information staff required to respond to distressed behaviours. However, we saw these plans were not always followed. On the day of our inspection, we saw staff responded inappropriately to a person’s distressed behaviour. The staff followed direction from a manager who advised them to administer a sedating medicine, rather than follow the person’s care plan in response to the behaviour. This meant the person’s distressed behaviour was not managed in an effective or caring manner.

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

Staff gave mixed feedback about the support they received from managers at the service. Some staff described feeling like they were bullied by managers. For example, 1 staff member said, “[Member of the management team] demonises me. She has bullied me lots of times” whilst others spoke more positively about the support provided. For example, another staff member said, “We’ve got a cordial relationship.” Staff told us they did not often see the provider at the service.

The provider told us staff received regular supervision and appraisal, ongoing training, occupational health support and were signposted to external support services where required. However, staff could not confirm they received regular supervision from the management team who were in place at the time of our inspection.