South Haven Lodge Care Home

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We did not assess all quality statements within this key question. Therefore, the scores identified at this assessment will be combined with scores based on the rating from the last inspection completed where caring was considered, which was completed in April 2020 and received a rating of good. We assessed 3 quality statements within this key question. We found 1 breach of the legal regulations in relation to dignity and respect and our findings in relation to responding to people’s immediate needs and treating people as individuals further supported the breaches in relation to safe care and treatment, safeguarding and staffing. The overall rating for this key question is requires improvement. People were not always receiving care that was kind and caring. Some staff spoken with expressed a desire to want people to received effective, kind and dignified care, however felt this was not always achieved due to lack of staff, staff attitudes and limited training. Some staff made little effort to communicate with people and made decisions for them. We observed multiple incidents where people’s emotional wellbeing was not prioritised, people being ignored by staff and people sitting for long periods within the communal areas of the home with little engagement. People's care plans did not always contain information about their personal, cultural, social and religious beliefs and those we reviewed contained limited and basic information about people’s interests and what was important to them.

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.

We received mixed feedback from people and relatives about the kind and caring nature of the staff. Positive comments included, “Some of the girls are brilliant and we have good banter”, “Staff speak nicely to me”, “I am really well looked after” and “They [staff] are very gentle.” However, other people commented on how they often felt ignored by staff. While most of the relatives we spoke with expressed they were generally happy with people’s care, our assessment found care did not meet the expected standards and there was a closed culture at this service. People did not always experience a culture of kindness and respect. Some staff made little effort to communicate with people and made decisions for them. People’s emotional wellbeing was not prioritised: some staff and leaders did not demonstrate compassionate care which centred around each individual.

Staff spoken with expressed a desire to want people to received effective, kind and dignified care, however felt this was not always achieved. A staff member said, “Staff don’t always want to engage with the residents.” Another staff member told us, “I’m here for the residents, but every time I leave, I feel like I have let them down because they don’t always get what they need.” A third staff member said, “Some people have challenging behaviours, and these people are often neglected by some staff. They (staff) don’t know how to manage it, so they just ignore them and walk away. Although sometimes they are just being lazy.” The treatment of people demonstrated little consideration had been given to people’s needs, wishes and emotional wellbeing. Staff and the management team lacked insight that they did not always treat people in a kind and caring way, with dignity and respect and their actions and behaviours would have a detrimental impact on people’s lives.

Although we observed some staff spoke kindly to people, this contrasted with staff who did not interact or show any interest in people. We observed multiple occasions when people were not treated in a kind, compassionate and dignified way. Observations included but were not limited to; one person was sat in the lounge, calling out for staff, staff did not respond. A staff member described to us how they supported people’s privacy and dignity, however we observed they failed to put this into practice by leaving a person exposed while supporting them with a meal. One person who was living with a cognitive impairment was speaking to a staff member affectionately. This staff member did not show any compassion during this and ignored them. One person who was living with a cognitive impairment was continually walking around the communal areas of the home, they approached different staff members on multiple occasions asking them if they had seen ‘the artist.’ All the staff (with the exception of one) asked would respond with, ‘No’ or walk away without responding. No reassurance was given to the person and none of these staff members attempted to provide reassurance or distraction to them who was becoming more frustrated and agitated. During lunchtime on 1 October 2024 two people who were on different tables were shouting and swearing at each. A staff member tried to intervene however their involvement appeared to exacerbate the situation as they were raising their voice at the people involved. During this time one of the people showed signs of heightened anxiety and was visibly upset by the altercation. Throughout this incident other staff members came in/out of the dining room yet none of these staff offered assistance, reassurance or attempted to de-escalate the situation by providing distraction.

Some people and relatives told us they felt they or their loved one was treated as individuals and their wishes, choices and abilities were respected. A relative said, “It’s really good here, the staff do a really good job and although [person] can’t walk far the staff really encourage them.” Another relative told us, “I’m really pleased with how [person] is looked after. They [staff] will always ring me and keep me updated with any changes.” However, we could not be assured this was the case for all people, particular those who had limited communication, cognitive impairments or those that were cared for in bed. Although some care records noted people’s likes, dislikes, interests, abilities and wishes we were not assured these were always considered. For example, one person’s care record made it clear they required assistance with personal care and liked to have a shower every other day, however on review of their daily records we found they had not received or been offered a shower during the week of 9 to 15 September 2024 and they had only received 2 full body washes and one hand and face wash within this time frame. Other people’s records highlighted their preferences in relation to personal care, however daily records indicated these were not adhered to. Additionally, we identified people’s food and fluid likes and dislikes were not always considered or respected and consideration had not always been given to people interests when cared for in their rooms. For example, one person with a cognitive impairment and limited ability to communicate was often left alone in their room without effective lighting or any means of stimulation yet their care records clearly noted particular music they enjoyed and highlighted to staff to consider putting this music on for them. Throughout all of our assessment visits we found music had been put on for this person on one occasion only and this was likely to not be music of their choice.

Some staff had a good understand of people and were able to explain how they should be supported in line with their assessed needs and describe their likes, dislikes and wishes. However, other staff had less knowledge and understanding in this area. We could not be assured where information was available to staff in people’s care records about their specific likes, dislikes, wishes and abilities this information was correct or followed by staff. Staff shared they would like to have more time to spend socially with people and talked about care being task focused. A staff member said, “People are choosing to stay in their rooms more and more, the lounge and dining room is too noisy for them. It not a relaxed and peaceful environment.” Another staff member told us, “There is not enough staff to allow us to just sit with people and engage them.”

We observed people sitting for long periods within the communal areas of the home with little meaningful activity or engagement. Although on 3 of the assessment visits we observe some activities taking place, we found these activities were often interrupted. This was because the staff member providing these activities would often have to stop what they were doing to support people with anxiety or meeting their basic needs. People were often in their bedrooms with no entertainment, for example radios and televisions were not on. People's care plans did not always contain information about their personal, cultural, social and religious beliefs. Those we reviewed contained limited and basic information about the person, their interests and what was important to them. Within some people’s care plans it was recorded they, ‘like to spend time outside when the weather allows’, however, despite the sunny weather during the assessment visits, we did not hear staff offer or encourage people to spend time outside.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

People confirmed staff did not always respond in a timely way should they use their call bell. Other people told us, and we observed people did not always have access to their call bells, therefore we could not be assured they had the means to request support should it be required. One person said, “I was throwing up the other day, I could reach my bell, and I was shouting, but no one came.”

Call bell responses were discussed with the registered manager who confirmed call bell audits to look at staff response times were not completed. They agreed to complete these in future. The registered manager was unaware if a policy was in place which detailed what was an appropriate length of time for call bells to be answered within. This meant staff did not always respond to people’s immediate needs. We did note there was a reduction in call bell response times following our concerns being brought to the attention of the registered manager. There was a mixture of responses from staff about whether they had time to spend with people when they were anxious or to meet people’s immediate needs. Some staff attributed to lack of engagement with people, the timeliness of responses to call bells, the limited provision of personal care and the management of health needs to the numbers of staff available, while other staff members felt it was down to staff skills, competency and laziness of some staff members.

During our assessment visits we observed call bells ringing for long periods without being responded to. People’s requests for support were often ignored by staff, particularly in relation to requests to fluids. We observed staff were not always responsive to people’s needs ensuring their safety and comfort. For example, there were not always enough staff available in the communal areas when there were people present and staff failed to respond to people’s escalating anxieties or periods of frustration or distress in a timely way.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.