Hawthorn Lodge Care 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 50 (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 ensure people were treated with kindness, empathy and compassion by respecting their privacy and dignity. Staff treated colleagues from other organisations with respect.

People we spoke with were not all enthusiastic about the whole staff team being kind and respectful. We received concerns from people about the approach of the night staff in particular, which we raised with the management team to review. One person said, “The night staff aren’t kind. I don’t feel happy here, it’s the staff and the noise.” Another person said, “It’s so noisy everywhere downstairs and there’s no quiet lounge to sit in. I can’t see well now so need some peace.”

Some people told us they found some of the staff disrespectful and they felt ignored at times, with their presence not being acknowledged. Although we observed some kindly interactions between staff and people, the staff did appear task-led and at times preoccupied. For example, we observed at lunchtime that there wasn’t a real warmth between staff and people, with few spending time to stop at tables for a chat or to encourage people with eating well. However, one person was more positive and said, “They’re kind and will listen if I’m worried about something and make sure you’re ok.”

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.

Care plans lacked personalised details on people’s goals and aspirations. Staff explained they were frequently finding they were task-oriented, leaving little time for them to personalise care for people. Although people had easy access to accessible public transport, people were not being regularly supported to engage with their local community. People we spoke with felt the garden was not an area which was comfortable to spend time in and was primarily used by people who smoked. The maintenance person explained they were working to ensure the garden space was pleasant and inclusive for all people living at Hawthorn Lodge. We saw this plan was incorporated into the overall service improvement plan.

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.

Some people told us their choices and preferences were not fully respected. People we spoke with described feeling no control over their medicine times, which could disrupt their sleep patterns. Some people told us about delayed evening rounds or early waking for pre-food medicines. Similarly, people needing support for mobility and personal care did not appear to be given much choice of their bedtime, they described feeling this was for the convenience of staff. One person said, “They get me in bed soon after tea but I’d rather have company in the lounge. You just lie in the dark. And one morning they nearly forgot me and it was 10am before anyone came.” Another person said, “Bedtime is quite up to me, but I have to wait for my tablets about 9pm, then I turn out my light. Then I get woken up about 5.30am with my medication to be given before I eat, then I try and go back to sleep.”

We raised people’s concerns around choice and independence with planning their day and night routines with the management team to investigate and review. The management team were responsive to the concerns raised.

We were told that a local church visits once a month for a small service in the lounge and was popular. Visiting entertainers also featured regularly. One person said, “Today we did a bit of yoga then exercise to music. I join in most things. A lady comes in once a month for a singsong. We do a quiz and beanbag throwing but I like bingo best. A church comes in once a month for hymns, a prayer and a little sermon. It’s quite popular.” A relative told us, “My family come and take me out at times. I join in most things as it keeps us active. We’ve not done any gardening before, it’d be nice to do some pots.” The management team explained they were in the process of recruiting a full time activity coordinator, as the previous staff member had recently left. The management team were receptive to the feedback given by people and their relatives in regards to improving the availability of activity provision.

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.

We reviewed the care plan and risk assessments for a person living with skin management needs. The information in these records was contradictory and confusing. The details on how this person should be safely moved by staff, and which equipment should be used was unclear throughout the care plans. This left the person exposed to the risk of further harm, from staff not having clear guidance to follow.

We received mixed feedback on the call bell response from staff. Several people were unaware of having a call bell or the location of this within their room. One person said, “Mostly it’s 5-10 minutes before anyone comes, but it can be a lot longer if they’re dealing with an emergency. That’s what they tell me.” Another person said, “I try not to ring much, but it can be instant or half an hour to wait. No rhyme or reason.” We observed another person had a call bell in their bedroom which was not placed in their reach. This person said, “Mine is out of reach from where I sit or lie so it’s useless. I can’t get hold of anyone at night.”

We raised people’s concerns around call bell responses, for the management team to review and address.

Where people required support for transferring, we saw staff were calm, patient and spoke kindly with people. One person spoke about this, saying, “They use the rotunda to get me from bed into my chair and I feel safe enough.”

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.

Some staff we spoke with expressed concerns over their workloads. For example, one staff member told us, “There should be 4 cleaning and laundry staff each day but there are regularly 3. There are 3 today and there were 3 yesterday.” We checked the staffing rotas, which confirmed this to be the case. The staff we spoke with explained they had raised their concerns with the previous management but had not felt listened to. We discussed staffing pressures with the management team, who were in the process of reviewing staffing levels and recruiting where required.

The majority of the staff we spoke with spoke positively of the recent management changes within the service and explained they now felt more supported and involved. Addressing the previous poor culture had been a priority for the management team, and the changes made had led to an improvement in the culture of the service. We saw from staff meeting minutes, these were now being held frequently. Giving staff the opportunity to share their views and feel listened to.