Harrier Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.The service was in breach of legal regulation in relation to person centred care.

This service scored 39 (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 make sure people were at the centre of their care and treatment choices. They did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Relatives had raised concerns about how changes in their family member’s needs had been managed including wounds and infections. They had been concerned the agency nurses did not know the person and had not received a detailed handover of their needs. There were handover sheets in place, which contained essential information such as how people mobilise. However, there was no information about people’s choices and preferences. People told us agency staff did not always know how to support them in the way they preferred.

We reviewed handover sheets for the week before our assessment and found very little had been recorded on them. We could not be assured changes in people’s needs were being communicated effectively between staff.

There were significant shortfalls in how the service understood the diverse health and care needs of people and their local communities, so care was not joined-up, flexible or supportive of choice and continuity. People, relatives and staff had all raised concerns before and during our assessment about the continuity of care being provided. People and relatives were concerned about the turnover of staff and the large amounts of agency staff used. A relative told us they had not felt safe leaving their relative when they were unwell because all the staff on duty were agency staff who they had not seen before. People told us they were not confident when agency staff were supporting them, a person told us, the number of agency staff is too high especially at the weekends when they said, “There are usually more agency than our own staff, and they’re not so caring.”

Staff told us, when they were working with a lot of agency staff, they felt under pressure. They described not wanting to go on their breaks and leave people with staff who did not know them. Staff told us, relatives and people would only speak to them or wanted only them to provide the care as they knew the person.

The provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The service did not provide information in any additional formats. We observed menus displayed in written format only, there were no pictorial versions in the units supporting people living with dementia. We requested copies of resident meeting minutes, activity plans and the service brochure. These were all provided in a typed format, we were told there was no easy read or pictorial format available. People did not have access to all the information available.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. People and relatives had the opportunity to attend meetings. However, these meetings had been poorly attended. It was unclear how feedback was gathered from those who did attend the meetings or how feedback was provided to relatives. The lifestyle staff told us they would ask people if they wanted to suggest anything at the meetings and would be given the meeting minutes. However, this was not in an accessible format, and the minutes were not displayed around the service. There was no information in the minutes about the action taken in response to issues raised. .

People and relatives told us they knew how to complain, although, people told us they did not always get a direct response to tell them what action had been taken. The provider has a complaints process, and most complaints were investigated by the registered manager. When this was not possible due to the nature of the complaint a senior manager would be responsible. We reviewed complaints received from relatives and these had been investigated and responded to following the provider’s policy.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Staff were not always available to support people when they needed it, people had to wait for support when 2 staff were needed such as using the hoist or personal care. The bathrooms had baths which had been adapted to support people to get in and out. However, during our initial walk round the building, the bathroom on Oyster unit had been used to store equipment such as wheelchairs. People would not have been able to use the bath without all the equipment being moved out or using a bathroom on another unit which may not be available at the time they wanted to use it.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. People’s care plans did not always contain information about their cultural or spiritual needs and other protected characteristics. People had not always been protected from discrimination, as people living with dementia had not been given information in formats easier for them to understand.

People told us they had access to healthcare professionals and were seen regularly by the GP practice representative.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. People had end of life care plans in place, anticipatory care plans had been completed by the GP surgery. There was information about what treatment people wanted to receive including when they wanted to go to hospital.

However, the care plans were generic and did not include any personal requests, 1 person’s electronic care plan had another person’s name in it. All the plans we reviewed stated funeral plans would be discussed in the future or at the time, there was a risk people’s wishes would not be known and accommodated.