Harrier Lodge

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.The service was in breach of legal regulation in relation to dignity and respect.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service 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. People were positive about permanent long-term staff who knew them well. However, people told us they were not always treated well by some of the agency staff. One person told us, “There used to be some lovely agency staff here, with the new agency you always get someone different. They treat you as if you’re senile. The new agency staff seem to have a bit of an attitude, and they don’t know you well enough to give you the same care as the permanent staff.” People gave us examples of the way they had observed others being treated poorly by agency staff, which they had reported. They explained, a person was slow finishing their pudding and an agency staff told them they were finished, taking the bowl, spoon and drink away from them. Following the incident there was a poster saying there would be no agency on the unit, but the person did not get a response to their concern.

Some people had not been supported to maintain their dignity. A person told us, “Sometimes I must wait to get to the toilet because I need a 2 to 1 transfer with a hoist, and sometimes there’s not enough staff, so I must hold on. Now they use a bed pan if I’m in bed to save using the hoist. It took a bit of getting used to.”

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. People told us permanent staff knew them well including their choices and preferences. However, people and relatives told us staff were very busy, and this impacted on how much time they could spend with them. A person told us, “I get on well with the staff. We have a laugh and a joke. Overall, the staff are terrific, but the agency staff not so much.” Another person told us, “They’re very good. Anything you want and they’re here for you. The nurses are lovely. I can’t fault them. Some staff are chatty and very nice, but others you can tell they don’t want to talk to you, so you don’t try.”

People described how staff knew their preferences for baths or showers, and they were supported to do this. Relatives told us, permanent staff had built a relationship with their family members and understood their routines to help reduce their anxiety.

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. People were supported by lifestyle staff who organised activities and trips for people.However, staff told us, there had recently been a reduction in trips as only lifestyle staff could accompany people, care staff had not supported on trips. This had limited the number of people who could go out at a time, as many people living at the service required a wheelchair and a member of staff to support them. Staff told us, there were not always 2 lifestyle staff on duty, and their holidays were not covered, which further reduced the opportunities for people.

People told us, they had enjoyed the trips they had been on including to a wildlife park. A person told us, “I like to watch TV in my room and there are some good trips, like Wingham, Hornby Visitor Centre. I have visitors too.” A relative told us, “[loved one] goes out from the home with staff. They’ve been to Ramsgate for fish and chips, and they have a 2-1 on the minibus for them. They also like knitting scarves and blankets for charity though their sight isn’t so good these days.”

The provider did not always listen to and understand people’s needs, views and wishes. Staffdid not always respond to people’s needs in the moment or act to minimise any discomfort,concern or distress. People told us they had call bells, some had them on lanyards so they could use them while they were in communal areas. There were mixed experiences of how quickly the call bells were answered, depending on how many and the mix of staff on duty. People told us they had to wait at times when staff were busy or were unsure how to support them. There were other times when staff responded quickly.

Relatives gave examples of when they had to find staff to support other people on the unit. A relative told us, “We had to ask a member of staff to provide personal care for a woman who had been incontinent. They came in and sat on the bed and left it soaked in urine. Another time we saw someone was falling out of bed, so we let staff know.”

The service did not care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care. Staff did not feel supported to deliver person-centred care. Before our assessment we had been contacted by staff and relatives about the change in management at the service. Staff told us they were not supported and had been bullied and had decided to leave. Relatives were concerned about the number of staff who were leaving the service. During our assessment, staff expressed concerns about the level of support they received, including new staff who had not worked for the provider before. We had been contacted before and after the assessment by new staff who had left the service because they had been left to manage a unit within their first week, with agency staff. They were concerned about the risk to people and they were concerned about implications on their registration with the Nursing and Midwifery Council.

The provider had completed ‘exit’ interviews when staff had left, the management of the service had been given as the reason in 11 of the 16 interviews. We discussed these concerns with the registered manager and operations support manager. They told us, staff had not been well managed before and were not happy with the change of focus including following the provider sickness policy. However, staff told us, the sickness policy had always been followed but it was the way they had been treated during the process which was different. We reviewed evidence provided and found staff had been issued letters, by the previous registered manager about their sickness, in line with the provider’s sickness policy.