Archived: Harmony House

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 this newly registered-service where a rating has been awarded. This key question has been rated requires improvement.

Requires improvement: This meant people did not always feel well-supported, cared for ortreated with dignity and respect.

This service scored 40 (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 treat people with kindness, empathy and compassion, or respect theirprivacy and dignity. Staff did not treat colleagues from other organisations with kindness andrespect.

People and relatives were complimentary of the staff. Comments included, “The staff are fabulous. They talk to me nicely” and “They are nice to me here. The staff are nice and caring I like them all.” Most people in the home were cared for in bed which limited their opportunities for social interaction. Some people told us they didn’t always feel cared for. One person said, “I was left in bed until 9.30am and they had left my breakfast next to me. It was cold. When I don’t want to be woken up they do, and when I do want to be woken up, they don’t. I would’ve preferred to be woken up to have my breakfast hot.” During our visit we heard 1 person in bed was calling out multiple times to gain staff attention and was ignored by a member of staff in the corridor, as well as other staff who walked past their bedroom. This increased the persons anxiety levels. We asked a staff member about this person calling for help. The staff member said, “That’s [Person name] that is what they do.” We discussed our concern with the area manager who told us they went into to see the person. The area manager said the person was fine, only needed to see someone and they were okay. We felt it was not kind and unnecessary for the person’s calls for help to go unheard. People’s comments showed they felt staff were kind and caring but at times, people felt they were left without prompt assistance. This was more related to staff being busy than staff’s lack of focus and attention. One person said they were in bed most of the time and on occasions, they were not covered up by blankets, but they said they did not mind. Following our attendance at the morning handover meeting, we saw some people were in the dining room. One person said, “I have not had breakfast yet, I don’t know what I am supposed to be doing.” Staff did not respond to the person. Some people’s comments about staff were that staff were kind and caring, but at times, people felt ignored. Comments were, “A [Person] around the corner shouts a lot… some of them (staff) just walk past and ignore them. They do nothing. They don’t ask us anything about the running of the home.” One person said staff didn’t always knock the door, they just entered the person’s room. When a member of the inspection team was talking to 1 person, a staff member walked in without knocking or asking if they could come in. The person said to us, “That’s what they do. You could’ve been my relative and we could have been having a private conversation."

The provider did not always treat people as individuals and made sure people’s care, support and treatment met people’s needs and preferences.

People had personalised care plans which detailed their needs and their preferences to support staff in meeting their needs. This included dietary preferences. Staff spoken with understood people’s needs and how best to support them, although time constraints meant it was not always possible. During our first visit, almost everyone remained in bed. On the second visit we saw staff supported people to mobilise and use communal areas. Staff supported people at their pace. Where people took time to walk down corridors, we saw staff were patient and staff encouraged people to take their time. One person liked to spend time in the garden and a staff member told us they were supported to grow beans in the garden. However, we have reported other people felt staff supported them with their care needs, but more effort was required to support them with activities, social interactions and in line with their preferences.

The provider didn’t promote people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

A high proportion of people living at the home required hoisting and access to slings. A staff member told us each person had a single sling allocated to them. If this required laundering the staff member advised us, “There’s no guarantee we will get it back the same day.” Failure to have access to adequate number of individual slings increases the risk people will not be able to move around the home as they wish, safely. Two staff members told us there were no separate toileting slings in place, as these were not required. The absence of systems to promote toileting slings means people’s independence may unnecessarily be reduced. We asked a staff member why there was no toilet slings, and they said, “There used to be.” People and relative feedback showed their individual choices, such as having a bath or shower, or leaving their room when they wanted, was dependant on staff’s availability rather than their choices being front and centre of their care. One person said, “My day for a shower is a Friday. However, last Friday it was 3.30pm before they came to give me a shower, I didn’t want one then. Everyone has a day allocated and on other days you just get a wash. It’s 11.25am now and I haven’t been offered a wash yet today.” One person told us staff supported them to be independent. This person said, “They (staff) got me a grab stick so I can pick things up myself, that helps my independence."

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

People said because staff were so busy, this meant staff were not always responsive to them. One person said, “They need to be available at the right time. If I don’t tell them in the morning, I want to go to the bingo so they can book a wheelchair for me, then I can’t go. It’s all too much hassle.” Another person explained if they need to go to the toilet, delays caused them problems. One person told us, “I’ve been out of bed this week once. I would like to get out of bed every day. I would like a shower every day, they can’t as there’s not enough staff.” Where people were in communal areas, which was the case on our second visit, we saw staff responding to peoples’ needs. For example, staff helped people walk slowly down corridors, reassuring them not to rush. Some people’s feedback showed they preferred to stay in the bed or room and that was their choice. We discussed our feedback with the manager so they could make sure people’s needs could be responded to.

The provider cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care. However, staff did not always feel listened to.

We saw staff were designated care champions for specific aspects of care such as nutrition, safeguarding, end of life and oral care. Staff took a professional interest in their topic and shared learning and information about their topics to the staff team. Staff gave examples showing how they had been supported to change their roles as their own individual needs changed. The staff member said, “I like my job. They [senior staff] were flexible regarding the change.” One staff member said the provider had made reasonable adjustments for them, such as where they worked to reduce fatigue or when personal circumstances meant time off was required, this was supported. However, some staff told us where they had raised issues with the management team, limited actions were taken to make improvements. One staff member said they had previously raised issues but now they did not. Another staff member felt their concerns were not always taken seriously. So, they told us they did not feedback any longer.