Homelands Nursing Home

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 people not receiving person-centred care.

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.

Staff did not always treat people with kindness, empathy and compassion, respecting their privacy and dignity. Staff in the Manor House spoke to and about people in a kind and respectful way. People were supported in a dignified way and told us they were happy with how they were treated. Comments included, “Staff are very friendly but very busy.” And, “The staff are alright, they are good at taking care of people no problem. I have got to know them quite well; they have got to know me too.” On the first and second day of our assessment, we observed people in the Coach House were not always afforded the same respectful approach. A staff member was argumentative with a person who was asking about the menu choices for the day. The person accidently used the wrong word, the staff member publicly corrected them and walked off without answering their question. Another person was being supported in a wheelchair, staff had not placed their feet on footrests, once this was highlighted by an inspector, the staff member placed the person’s feet on the footrests without any communication. Staff had not completed any training in respect and dignity, this was evident in some practices. On the third day of our assessment, the registered manager had changed some staff over from the Manor House to the Coach House, there was a marked improvement to the atmosphere, staff showed patience and kindness to people.

Staff and managers 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’s care records did not contain information to guide staff on their individualities or protected characteristics. Most people residing in the Coach House lived with advancing dementia, we observed they were not offered choices, such as, where they wished to spend time or what they wished to drink. The television was on throughout our visits but no person was asked what they wished to watch. People in the Manor House were able to express their individualities, for example, a person had a love of owls, their bedroom contained owl ornaments and pictures, they also enjoyed crafting and had plenty of art material to use. The registered manager told us a local church minister visited to provide communions and private services for people who wished to practice their faith.

Staff and managers 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. Staff received little guidance on how they could support people to retain their autonomy. People living in the Coach House were not in control of their day to day lives, people’s right to decline support was not always respected. During our three days of assessment, we observed one activity session taking place in the Coach House, the activity worker initiated a music session which people appeared to enjoy. Besides this there was no social stimulation for people, they spent their full day in the lounge or in bed, the television was on at a low volume, a person living on the ground floor was calling from their bed, people in the lounge could hear the person calling out for a period of time. We asked a staff member in the Coach House what activities were planned, they told us a cup of tea would be the afternoon activity, however, this not an activity but a basic need. The staff member followed up by saying most activities took place in the Manor House but as the weather was cold people did not like to leave the Coach House meaning people would not be involved putting them at risk of social isolation. We did not see people being offered to go to the Manor House. We reviewed people’s activity records and noted 2 people had 5 recorded activities in December 2024 and 2 people had just one record of activity documented in December 2024. We observed activities taking place in the Manor House throughout our assessment, people attended baking, music sessions and a show by an external entertainer. People and their visitors appeared to enjoy the various activities.

Staff and managers did not always listen to and understand people’s needs and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. On the second day of our assessment, people in the Coach House were expressing they were cold, some people had blankets. One person told a staff member they were still cold, the staff member replied by telling the person they had 2 heaters nearby and a blanket then walked away. They did not offer any solution to the person such as another blanket or warm drink. People in the Coach House did not all have call bells to alert staff if they needed support, they relied on staff checking them hourly. Staff were seen to respond to people’s needs in the Manor House in a timely and friendly manner. One person told us, “They (staff) might be held up but they're pretty good, you get to know the staff here.”

Managers did not always promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care. Risks to staff were not always assessed, for example, the safe handling of cytotoxic medicines had not been risk assessed; these medicines have the potential to damage normal tissue when handled directly by staff. Some staff were working up to 72 hours per week, there was no mechanism in place to ensure they felt supported to promote their well-being and deliver high quality care. Staff told us they felt content working at the service, comments included, “I'm very happy here it's nice because of the residents and the staff.” And, “It's alright here, I lasted more than 5 years.” Following our feedback, the provider made arrangements for an external company to provide well-being support to staff. The provider told us of an electronic staff planning system they were implementing to avoid staff working excessive hours in the future.