Loyd House

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

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.

Requires improvement: This meant people’s needs were not always met.

The service was in breach of legal regulation in relation reg 9 people’s care must meet their needs and reflect their preferences.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People's care plans did not always contain enough information to reflect people's individual needs and preferences, for example not all care plans listed people's equipment they used. This was discussed during this assessment and will be addressed through the review of all care plans.

Feedback from people about involvement in their care planning was mixed. One person told us,” Staff go through my care plan with me. I wouldn’t have any problem disagreeing with something if I didn’t want it written in there.” Whilst another person told us," “No I don’t get to see my care plans. Another resident has a key worker who goes through their care plans with them, but my mine has never offered to go through it. I would like to go through my care plans, but no-one has offered in the years I’ve been here.”

Relatives mainly told us they were kept informed of any change. One person told us, “Always kept in regular contact, even called during the night if (relative) has had to go to the hospital.” Another person told us, "Anytime (relative) has a seizure I am informed.” However, one relative expressed concern: "We are concerned that the changes we noted 18 months ago have not been observed by them due to their staff changes and changes of management.

We observed notes on people's walls in their rooms with details of how staff are to support them, this was discussed with the management team who agreed this information should be on staff devices rather than displayed in people's personal rooms.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People were mainly supported by access to healthcare services when required. However, carer notes did not consistently evidence monitoring of key health indicators such as oral care or bowel movements. This limited the assurances that referrals were made in a timely way.

Staff did not always have clear information about people's needs as care plans did not contain all information such as medicines, equipment, and guidance for pressure care. This may impact the ability of new or agency staff to provide consistent and safe care, compared to permanent staff who had more knowledge of the person.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

During this assessment we noted that people did not have their care plans in their first language, This was discussed with the management team, and this was put in place, We also suggested having their service user guide and any correspondence to loved ones to be translated first. The management team told us translators were sourced for yearly care reviews. Where people had adapted tools such as picture cards in place, we were not assured these were used consistently as care notes did not reflect them being utilised, nor did we observe them being used on any day during this assessment.

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.

Most relatives we spoke with were aware of feedback surveys and how to make a complaint. Some relatives suggested that the survey needed to be updated to make it relevant to today's environment. People and their relatives told us they would be happy to raise any concerns. One person told us,"I would go either to the Duty manager or manager. When I have done always get a response. We reviewed minutes from residents meeting June 2025, it was recorded that 3 people had requested more activities at previous meetings, and nothing had changed. Changes had still not been made at the time of this assessment.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

During this assessment we noted a person's care plan was not made available to staff for up to 3 weeks and staff confirmed this. When we discussed this with the management team, they were aware of this and assured us actions would be taken to ensure this would be better going forward. As agency staff were often used and they had new staff starting, we were not assured staff had all the information they needed to ensure people's needs would be met.

Whilst areas of the home were accessible, it was cluttered with equipment. The garden was small, not suitable for all wheelchairs. One person told us, “They could easily get around in their wheelchair." Another told us, "The lift is only small, it’s hard to get my wheelchair in, we have to try and squeeze the wheelchair in.’

People were supported by access to primary care services, but refusals/missed appointments were not clearly recorded. For example, one person had missed a medical appointment, and the reasons given were not clearly documented.

The service had its own multidisciplinary team (occupational therapy, physiotherapist, psychologist and speech and language therapy team (SaLT)) and we saw evidence of some people accessing these regularly However, if people declined, we didn’t always see this revisited. Additionally, we saw no evidence of people recently being seen by the psychologist, despite in some cases people requesting the service. This was feedback to the management team during this assessment.

People were on regular observations with some being at 15-minute intervals in the day and 30/60 minute during the night, whilst these were mostly recorded we did identify some gaps, which had not been picked up through internal audits.

Staff and leaders didn’t always actively listen to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service demonstrated some positive practices, such as staff receiving training in equality, diversity, and human rights. However, we identified gaps that impacted people's ability to experience equitable care and outcomes. Although some people were supported in engaging in activities, others experienced barriers to having their preferences met. For example, there was a lack of follow-up on requests for swimming and wheelchair cushions that had been offered and the absence of alternative solutions limited equitable experiences and outcomes.

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.

Care plans were clear who had DNACPR in place and people and their relatives mainly told us they had contributed to discussions regarding end-of-life care with some confirming they had an end-of-life plan in place. The service was not currently supporting anybody with end-of-life care at present. However, we had recently reviewed a previous end of life plan which lacked sufficient guidance for staff to support the person who was in receipt of palliative care. This was discussed with the management team at the time. During this assessment we found that not all care plans contained advance planning and where they were present, reviews were not consistently completed within the required timescales.