Lavender Fields

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 inadequate. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.

The service was in breach of legal regulation in relation to providing dignified care to people.

This service scored 30 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not treat colleagues from other organisations with kindness and respect.

Staff did not always describe people in a respectful way. For example, staff described people living on the 3 floors as, “have capacity; “sometimes have capacity” and “no capacity”. People were not considered in a kind and respectful way.

A person admitted to hospital had been refused entry back to their home and was returned to hospital. There appeared to be flawed communication between the service and the hospital. The provider had not considered the impact on the person and their loved ones. The person was not treated with dignity and respect by the provider.

On the first floor most people had their beds positioned as low as possible to the floor. Staff told us this was to keep people safe, however, a blanket approach to safety had been used, without consideration for everyone’s individual circumstances. Although the mitigation measures may be appropriate and safe for some people, others could find it undignified and people living with dementia could find this disorientating.

Feedback we received from relatives was not always positive, “In January I visited and noticed long hairs on (loved one) chin like a beard. I felt it wasn’t dignified, and I emailed asking them if they could deal with it. I received a very stroppy letter back from (a member of the provider’s team), it was very rude saying (loved one) can make their own decisions, they can’t they have severe dementia and last time I went they didn’t even recognise their room".

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.

The provider did not always take account of people’s strengths and abilities. We found leaders and staff lacked an understanding of how people should always be treated as individuals. Many people’s care plans and risk assessments were system generated, with standard statements that were not individual, so did not describe the person and their unique circumstances. New staff and agency staff may not have the information required to enable individual and respectful care and support.

We received feedback, which was not positive including, “The activities are very geared to the females knit and chat, painting nails, bingo. They used to go to the pub – just the men and male carers and they really enjoyed that but not anymore.” And “(People) used to have outings but not anymore, none for over a year.”

A person told us, “They’re too busy to help me out of bed. If I’m awake early they might help me. They have a routine to get people up, washed and go to breakfast”.

We did observe staff treating people with kindness and permanent staff, and agency staff who attended the service regularly, knew people well. One person’s relative told us, “The quality of care from the staff is excellent, from the cleaners to the district nurses coming in, our problem is an administrative issue”.

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.

People’s care plans had not been completed with them to make sure staff knew how to support them in the way they preferred such as to promote their independence and choices.

Following a serious allegation made by a person, staff had recorded in the incident record their care plans would be updated to ensure only female staff should attend to their personal care to ensure the person felt safe. Care records did not demonstrate or highlight this important update. Their nighttime care plan continued to state, ‘happy to have male or female staff’. There was a risk all staff may not be aware of this change, particularly agency staff, creating a risk to the person’s safety, health and well-being.

People were not always supported to remain as independent as possible, A culture had developed where staff were making crucial decisions about people’s care that they were not trained to do, placing people’s independence and safety at risk. Actions taken by staff did not always promote people’s independence, such as, people at risk and not at risk of falling had the same interventions applied to them. This did not promote individual choice and control.

The provider had not provided consistent observation and support to staff to ensure their practice was safe whilst treating people as individuals, which had affected the quality of care provided.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

For example, relatives told us people’s needs were not always attended to in a timely manner. A relative said, “He’s had no breakfast, and they haven’t got him up” (after 11am).

Some people required time critical medicines to control the symptoms of Parkinson’s disease. There were times where people had waited for their medicines outside the recommended allowances. This placed people at risk of increased symptoms such as tremors and delayed reactions which could lead to falls or delayed speech.

The service used a nurse call bell system where people could push a button to alert staff if they required support and assistance. The provider’s own audits found that call bells were not being answered within the expected time frames. No action was recorded as being taken to improve this.

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

Many staff told us they had not been supported by the provider during long periods without a manager. A stable manager had not been in post for nearly 2 years. Staff felt they were “left to get on with things” and this had contributed to staff making decisions about people’s care in isolation.

Staff had been given limited opportunity by the provider for a 1:1 supervision with a manager which meant they did not have access to a route to raise concerns and receive formal support and direction.

Staff told us they had been informed during the inspection there would be an extra member of staff deployed. We were told staff were emotional as they were relieved, they would have more staff.

A relative told us, “I have met the manager; (they) put themself forward. Morale amongst staff is low because there is no continuity and no leadership but there are some very able people working there”.