Harborne Lane 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.



People did not always receive support in line with their needs, this was a breach of regulation 9-person centred care.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People who could speak to us spoke positively about the staff team. One told us, “I think that the staff are caring.” Another said, “The staff are very nice.” Relatives we spoke with also described the staff team as ‘kind’. One relative told us, “I have asked [name of relative] if they are happy here and they have said they are. [Name of care worker] is very kind”.

Staff told us about ways in which they supported people with kindness and they spoke fondly of the people they supported. They described ways in which they preserved people’s dignity and privacy. Staff also spoke positively about each other as a team. One staff member said, “During personal care, I close doors, and I cover people up. If someone refused care, I would leave it for a while and then try again”.

Not all people living at the service were able to speak to us about their experiences of care. For these people we used a structured observational tool to assess whether they received kind and compassionate care and were treated with dignity. We saw some examples of people being treated in a caring and dignified way.

We received mixed feedback from people and their relatives about being treated as individuals. Some people and their relatives told us people were not always able to do the things they wanted to do. One person told us, “Staff don’t have time to sit and talk, but they would come if I needed them”. Another person told us, “The staff don’t always make conversation when caring for me. Need more staff in the lounge to look after our needs.” Another person told us, “They are not very caring in the night, take long to come or not at all.”

We saw a mixed picture regarding the treatment of people as individuals. There was little evidence of how people’s individual interests and wishes had been considered in the provision of activities in some cases. For example, one person had a diagnosis of depression and due to their health condition was mostly care for in their room. Their care plan did not include information specific to their needs in relation to depression, strategies for staff to follow or activities staff could offer. There was no information relating to signs or symptoms of low mood or triggers to enable staff to monitor depression effectively. We saw many people being cared for in their rooms, either exclusively or for most of the time. Records showed these people were left without activities and engagement for many hours each day.

However, some people and relatives told us staff treated them as individuals and were familiar with their needs, preferences and daily routines One relative told us, “It was [name of relative] birthday and the home arranged for their hair and make up to be done which made our relative feel very special and it was lovely to see their pleasure”. Staff demonstrated they understood people’s needs and wishes and treated them as individuals.

We found improvements were required to ensure people’s independence, rights and choice were promoted. One person had a restriction in their care plan. No documentation was in place to evidence the restriction was put in place in their best interests.

People and their relatives spoke positively about the care they received and the positive caring relationships they experienced. One person told us, “[Staff] do ask my permission to administer personal care, they speak to me.”

Staff showed an understanding and commitment in providing person centred care and helping people to identify their goals. Staff told us how they supported people in line with their individual preferences. Staff said they were committed to ensuring that people received person-centred care, and they enabled people to have choice and control of their lives.

The service provided people with personalised care according to their specific needs and wishes. Information available to staff included how people communicated and how others should communicate with them. Information was available in a pictorial format for people who required this. The service used different forms of communication to ensure people could express themselves and makes choices regarding their care.

We received mixed feedback from people and their relatives in relation to staff responding to their needs. One person told us, ““When I press my buzzer, they come in and switch it off.” Another person told us, “Sometimes you can’t find anyone in the lounge to assist us.” Another person told us “Staff do go missing for a while.” A relative told us, “There was one incident when a young man came into my relative’s room with a female carer to wash my relative and my relative made it clear that they were not happy and so the young man left. I was pleased that the carers accepted my relative’s decision but maybe they should have checked first.” Staff told us how they took time to get to know people which helped them build positive relationships. Staff said they knew people well enough to recognise when there was a change in their physical or mental health. They were aware of the need to contact various professionals so additional support could be sought. People were supported to stay healthy and well. Records showed staff ensured people routinely attended scheduled health care appointments and had regular check-ups with a range of health professionals.

Most of the staff told us they felt supported by the current management team. Staff told us they were not supported by the previous management team. One staff member told us, “The previous management team [have now left the home] were not very supportive and the atmosphere at the home was not very good”. Another staff member told us, “The previous management created a toxic culture, there were cliques and distrust. They have all left now, and the new management team have created a better working environment”.

Some staff told us they had been supported by the acting manager with personal matters which had enabled them to work flexibly at times of difficulty. This meant they were able to provide a better standard of care to people as they were not working when they felt less able to support people well.

Staff told us they had plenty of opportunities to give feedback and were confident their views and opinions were valued. Regular meetings and supervisions took place, which enabled positive conversations. The management team were aware of workforce diversity and gave examples of where adjustments had been made to support staff with their personal circumstances, health conditions or cultural needs.

We saw policies and procedures in place to ensure equality, diversity and inclusion was upheld. The provider told us they were fully committed to these principles and values and were a responsive service and were able to meet diverse needs.