Hatfield Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last assessment we rated this key question good. At this assessment the rating has changed to inadequate. This meant people’s needs were not always met.The service was in breach of legal regulation in relation to providing person centred care.

This service scored 36 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs. People’s care plans were not person centred, they did not have detailed information about people’s choices and preferences. There were limited details about people’s health conditions and how these affect people. The management team reviewed people’s care plans, but they had not identified the care plans did not contain person centred information.

People had limited interactions with staff, and these were often task orientated. We observed people sitting in the communal lounge with no stimulation and no staff present for long periods. When staff were present it was to perform tasks such as giving out meals. Staff did not spend enough time with people to support them in a person centred way.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. There were systems in place to provide staff training, however, staff understanding had not always been assessed. For example, the menu did not always support people requiring a diabetic diet or understanding how to evacuate people safely.

People received support from a core team of staff, the service did not use agency staff and there was a low staff turnover. Senior care staff had been trained to administer insulin ensuring people received their medicine at the appropriate time.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The service did not have comprehensive pictorial signage to support people to find their way around the building and to their room. People living with dementia often become confused by lots of information being given to them at once. The provider had not produced simple pictorial documents to explain people’s rights. The easy read service user guide was complex, the words had a symbol above them meaning there was twice as much information as provided and it was 32 pages long.

The processes in place to provide people or their representatives with information were not effective. There had been an occasion where a representative had not been given information about the fees and contract conditions before these came into force. People’s representatives had complained they had received documents which contained other people’s names, which was a breach of confidentiality. There had been occasions where legal representatives had not been kept informed of changes to people’s condition when they were unwell, even though the service had been informed of this.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The service gathered feedback using their digital reception system. The analysis showed there were negative responses, the response recorded was from a person who did not understand how to use the system, and they had been contacted by phone. However, there were no notes about the conversation with the person to assess if the response recorded was accurate. All feedback obtained relied on numbers and there were no additional comments to explain the rating given, without comments and suggestions improvements to the service could not be actioned.

Relatives told us they knew how to raise concerns, they told us they would talk to staff about ‘niggles’, and these had been sorted. The provider had a complaints process in place, we reviewed the complaints received. The provider had responded to the complaint but had not to all areas of the complaint or apologised for the areas not covered in the response.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Staff were not always available to support people when they needed it, people had to wait for support when 2 staff were needed. Relatives told us they had to raise concerns about their family member not having a regular shower, there was no evidence people had regular baths or showers.

People had access to out of hours healthcare, staff contacted health professionals when people were unwell.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this. The management team had not recognised when people were being discriminated against, they had not advocated for people. For example, when people had been inappropriately placed and the service could not meet their social or cultural needs, this had not been followed up with the funding authority as a matter of urgency, so the person could be moved.

The management team had not reviewed people’s experience of living at the service. They had not identified that people were not receiving person centred care which enhanced their wellbeing.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. People’s care plans contained a section for end of life planning but there were not always details about people’s wishes. Some people had anticipatory care plans which had been completed with the GP, other people’s care plans stated they did not have capacity to express their wishes. Staff had not acted to find out if people had expressed their thoughts and wishes previously.