Hatfield Lodge

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 assessment 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 supporting people as individuals.

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 always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Relatives told us they thought staff were kind and treated people well. However, staff did not always recognise when they were not treating people with dignity. For example, some staff had nick names for people and used these when they spoke to people. There was no evidence people, or their relatives had requested the names to be used. The management team were aware of this practice and had not addressed the issue with the staff involved. The provider had not recognised the use of a plastic cover over the dining room seats was not dignified for people to use.

During our onsite inspection, a screen had been used to protect a person's privacy, when the district nurse had visited them while they were in the lounge.

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. People’s care plans contained limited information about their choices and preferences, there was little detail about their lives before they moved into the service. There was very little information about people’s previous hobbies and interests. It is recommended by the Alzheimer’s Society people, or their family complete a ‘This is me’ (or similar) document as it “helps health and social care professionals better understand who the person really is, which can help them deliver care that is tailored to the person's needs.”

There was no evidence activities had been planned with people’s choices in mind. There were weekly activities plans which included ball games, musical bingo and limited 1-1 time. These activities were generic and did follow guidance about which activities benefit people such as being involved in household tasks. There were very limited activities in the communal lounges during our inspection, people were not offered the opportunity to help staff with household activities such as laying tables.

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing. The structure of the routine within the service was task orientated. People were not given choices about how they spent their time, there were very few activities for people to take part in. We observed people spending time sitting in the lounge with nothing to do.

People had no control over their own care or support, people had limited choice over when they got up or had a shower. Staff allocation sheets showed the same people were supported by the night and day staff, there was no evidence this was people’s choice or how this had been decided. The allocation sheets included who was to have a shower, there was no evidence about how this was decided.

The environment did not support people to be independent and had not been decorated following best practice to help people to identify rooms and areas, such different door colours. There were limited pictorial signs around the service, only the communal areas such as the bathroom had clear signage. The corridors had been recently decorated the same colour as the doors to people’s rooms, which all looked the same. People’s doors had their name written on them, there was no photos or memory boxes to help people identify their room.

The provider had requested visitors not to visit during mealtimes, which was 2 hours at lunchtime and an hour at teatime. The provider told us they liked visitors to ring before they visited to enable staff to enhance the visit such as ensuring people are ready or back in their room before the visitor arrived.

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. During our onsite inspection, we observed people becoming anxious and agitated while sitting in the lounge. Staff offered to take the person to the toilet, however, this took nearly half an hour as there were not 2 staff available to support the person. The person was becoming more agitated while waiting for staff.

Staff took appropriate action when people were unwell. On the day of our onsite inspection, a person had been unwell in the early morning, emergency services had been called. Staff had worked with various health care professionals including the frailty team to make sure the person received the support they needed.

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. During meetings care staff had expressed concerns about their workload and they did not have time to spend with people. Staff surveys result also showed staff did not feel they were being supported to provide person centred care. The registered manager had not acted to review staffing levels or the way support was being provided to see where changes could be made.

We observed staff having their breaks during their shifts. Staff received regular supervisions to discuss their training and work practice, some supervisions were observations of their work.