Dawson Lodge

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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 assessed two quality statements within the caring key question. People were involved in their care and chose how they wished to spend their time. Staff involved people in day-to-day decisions and supported them to be as independent as they were able. We saw people involved in a range of activities and enjoying the home’s garden. People were free to receive visits from family and friends. Staff had been through a challenging period but spoke positively about the direction of the service under the acting home manager. There had been a high turnover of staff. Staff feedback indicated there were areas of division within the team, including along the lines of ethnicity and length of service. The acting home manager and representatives of the provider were actively working to address this and bring the team together. Staff had opportunities to provide feedback and told us they felt comfortable raising concerns. They told us they felt valued and there were opportunities to develop in their careers. However, the process for obtaining consent to care and treatment by the relevant person was not always completed in line with the Mental Capacity Act. Following our inspection the acting home manager provided evidence they had reviewed this process and would be making changes.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People and relatives spoke positively about their experience of the support they received. People's comments included, “I like it here. I can have a bath when I want one and I have my own kettle, I don’t have any problems.” Another person said, “I keep a fresh jug of milk in my fridge. I like the option of making a drink when I want and also for my family to have one in here, it gives me a little bit of independence. The staff still ask me if I want a drink every time they come round.” People were able to move freely with the home and everyone had equal access to communal areas, the garden, activities and the company of others. A person said, “We have a visiting farm come in the summer, we all enjoy that” and a relative said “The garden looks nice, we can see they’ve made a real effort, especially as the weather hasn’t been good.” People were also encouraged to participate in familiar everyday activities such as chopping vegetables and laying tables. Vegetables from this activity were used in the daily meals and we heard a staff member talking to people about their memories of preparing food at home.

The acting home manager and staff told us there were no restrictions on visitors to the service and people were supported to maintain relationships with their friends and family. A staff member told us each person had a ‘key worker’ who provided a consistent link with the person’s family/representatives. Another staff member said, “It’s a rewarding part of his job I love being close to my key person and to have a closer connection to one resident.” A full-time activity staff member was employed, who told us care staff also provided activities. Along with a planned programme of activities, the activities staff member said they and other staff could respond flexibly to people’s interests and needs. Staff told us how they supported people to make choices and decisions. For example, a staff member said, “I always ask before I do anything for them [people] and prompt them all the time and ask if they are happy for me to do this or like this. You give them room to make their own decision and it is working well so far.” Another staff member said, “One of the residents who has difficulty cutting food up, I won’t just do it for [person] straight I will ask if they would help to cut up their food and if they show me that they do want help then I will cut it up.”

Areas of the home supported people’s choice and independence such as a ‘Happy to chat’ bench in the main lobby of the home which invited people to 'Sit here if you don't mind someone stopping to say hello.' Sun hats and bags with trowels and gloves for gardening were available at the entrance to the garden for people to help themselves. People’s rooms were personalised according to their wishes and doors were decorated with their photos and/or personal objects. We saw staff interactions with people were kind, patient and respectful. We saw people being reassured, encouraged and offered choice by staff. We saw people were engaged in activities during our visits, including physical exercises, and a visiting entertainer who encouraged people to sing. People were enjoying the company of their visitors and the garden.

The process for obtaining consent as to how people’s needs were met did not always follow the principles of the Mental Capacity Act. Whilst staff acted with people’s best interests in mind, records did not always show consent had been given by the relevant person (either the person or, if they lacked capacity, someone with legal responsibility, or a best interest decision). Following our inspection, the acting home manager had reviewed the process in place to address these shortfalls. More time is needed to fully embed this approach into practice. People’s care records were person-centred and included what the person was able to do for themselves and how staff could encourage and support them to maintain independence and make choices Records showed people have been involved in making decisions about how they spend their time, what support they needed, their preferences and wishes. Records showed when staff had spent time engaged with the people on a 1-1 basis and how they had spent the time. This was monitored to check people’s needs were met. A ‘You said – We did’ board in the lounge showed actions taken in response to people's feedback. This included improvements to the garden and activities, and we saw these actions had been taken which meant people’s feedback was acted on.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

The staff team had changed significantly in recent months, with staff leaving and new staff joining. In our conversations with staff, it became apparent there were areas of division within the team including along the lines of ethnicity and length of service. Some staff said they had witnessed behaviour or heard comments towards colleagues that were hurtful and inappropriate. One staff member said, “There is a clear divide on who has been there for years and who hasn’t. Newer staff support one another rather than the older staff. I am a white English person, but people from Asian heritage experience a lot of racial divide, a lot people not getting on and comments made about them.” Leaders were aware of these allegations and described the action they were taking to encourage dialogue, promote the provider’s values and work with the team. Some staff felt the team was coming together. Comments included, “The morale has been really poor beginning of the year, in the last month fabulous. I can feel us all bonding now, working together.” Staff spoke positively about the direction of the service. They shared how they had been through a challenging period but said morale was improving. One staff member said, “New [acting] management have been brilliant they are very approachable.” Another told us, [Acting home manager] makes me feel no question is a bad question or a silly question. There is a buzz about the place again. The staff are happier.” The acting home manager told us they were, “Moving on the journey as a team.” She told us she was coming in for handovers to meet and get to know the team, including the night staff. Staff felt positive about the service and their roles. They told us they received support. One said, “I feel comfortable here. When carers are busy the managers support. There is a hierarchy but when it comes to care there is no hierarchy.”

The acting home manager was working to bring the staff team together. There were regular shift handover meetings and the first team leader and all staff meetings had taken place. In the minutes of these meetings, we noted staff had been encouraged to speak up and to share their feedback and ideas. The acting home manager and representative of the provider were alert to areas of conflict within the staff team. Staff had been invited to attend values and behaviours training in April and a listening event was booked for the following week. This listening event was an opportunity for staff to speak openly of their experiences to a designated ambassador from within the provider. More time was needed to see the impact of this work and to ensure a good experience for all members of the team. Information detailing the support available to staff was displayed within the home. There was information on the provider’s diversity and inclusion networks and contacts for the provider’s customer relations team and whistleblowing line. An employee notice board included wellbeing tips and suggestions, contact information for a colleague assistance helpline made available by the provider and information on support available from the provider in the event of personal financial difficultly. A suggestions box had been added to the main foyer of the home, enabling staff to provide anonymous feedback if they wished. There were opportunities for staff development, including champion roles and support to complete diplomas in health and social care. An employee recognition scheme had been relaunched within the home.