Shirelodge Nursing 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 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.

This service scored 45 (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. Staff did not always treat colleagues from other organisations with kindness and respect.

The feedback we received during the assessment was mixed. People and relatives we spoke with expressed that staff treated people with kindness, compassion and dignity. For example, a person told us, “Staff care.” Relatives also told us, “Staff are lovely, kind,” and, “I think they [staff] are lovely.” A final relative told us, “It’s a happy place, staff are lovely.”

However, some relatives told us improvement was needed. For example, a relative told us, “I think they could be better. I see them put food in front of residents who clearly need assistance, as they don’t touch the food, and then after 30 minutes or so a carer comes along just picks up the uneaten food and throws it away.” Another relative told us, “Carers day to day, needs a big improvement.”

During the assessment, we found staff to be kind, caring, and committed to providing positive support. However, improvements were needed to ensure people’s dignity and privacy were consistently respected. For example, we observed a staff member discussing a person’s personal care needs loudly in a manner that could be overheard by others, compromising the person’s dignity.

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.

Staff demonstrated an understanding of the people living in the home, including their preferences, likes, and dislikes. However, we identified concerns regarding how individual choices and needs were assessed and documented. Several people were being cared for in bed, but care plans did not provide sufficient guidance or evidence to explain the reasons for this arrangement or how it reflected the person's wishes and needs.

Feedback from relatives also indicated concerns about whether people were being meaningfully engaged. One relative told us, “They tell me [relative] wants to stay in bed, but [relative] is bored in there on [their] own. When I visit, [relative] doesn’t want me to leave.”

While we observed that people were well presented wearing clean clothing, we were not assured that people who were being cared for in bed were consistently supported to maintain their personal hygiene regularly beyond a bed bath. For example, one person received regular personal care in bed, but records showed they had not been supported to have a bath or shower for 6 days, with no reason for the decline recorded.

This meant we could not be assured that the person's individual needs and preferences regarding personal care were being fully considered and met.

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.

We received mixed feedback from people and relatives in relation to choice and control. For example, a person told us, “I tell them what I want to wear, I can have a shower, I just have to ask, I can choose”. Another person told us, “Staff are ok, they are patient there’s no rushing. I can’t be rushed”.

However, a relative told us, “The only time restrictions is that you must leave by 1800 each day.”Although leaders told us relatives were free to visit their loved one, they confirmed relatives were asked to visit between certain times of the day. We found this this did not promote the choice and control of people living at the home.

We received mixed feedback in relation to activities. While there were opportunities for some people to have social engagement on a one-to-one basis, a daily activities timetable and regular external entertainment, our observations found there was generally a lack of stimulation for people living at the home.

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.

It was evidenced from talking to people, relatives and staff that staff knew the people well and they were knowledgeable about people’s needs.

However, we found there was insufficient guidance available to support staff in responding consistently and effectively when people became anxious or distressed. For example, one person’s positive behaviour support plan did not contain clear information about how staff should respond to the person's anxieties, despite these being recognised as a risk to both them and others. This meant staff may not have had the information required to provide safe, person-centred support during periods of distress.

During our visits, we observed that call bells were answered promptly. However, there was limited oversight and assurance regarding call bell response times across the service. In addition, staff told us that one lounge area did not have a call bell system in place, meaning neither people using the service nor staff could readily summon assistance in an emergency. This could result in delays in obtaining support when required and reduced assurance that people could access help in a timely manner.

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

The provider carried out staff supervision and appraisals, and there was evidence that team meetings took place. However, records showed significant gaps between meetings, which limited opportunities for staff to share feedback, raise concerns, and feel their views were listened to and valued.

The provider had access to an external Employee Assistance Programme (EAP), which offered a range of wellbeing resources, including physical and emotional health support, wellbeing information videos, and health check facilities.

Feedback regarding the provider's approach to staff wellbeing was mixed. While some staff spoke positively about the support available, others described examples where they felt the provider and registered manager had shown insufficient consideration for their personal wellbeing and individual circumstances. This meant we could not be assured that staff consistently felt supported, valued, and empowered in their roles.

We also found that the staff room had recently been relocated. The new arrangement did not appear to have fully considered staff wellbeing and welfare needs. In addition, the available space was insufficient for the number of staff using it at one time, creating challenges in relation to infection prevention and control measures. This reduced staff access to a suitable area for breaks and rest during their shifts and increased the risk of cross contamination.