The Lodge

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 did not assess this key question, at our assessment published 14 August 2019 we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 55 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

We received positive feedback from people about the care and compassion shown by staff, which was confirmed by relatives. A person said, “I find them friendly, generally I have a good laugh with the staff.” Another person said, “All [staff are] good, really do respect me.” A relative told us, “I have been impressed by how kind and persuasive [staff] are… I admire the quiet empathy caring nature of the staff.”

We saw thank you cards and letters sent to the service from people and their relatives. One stated, “Thank you for all the care and kindness you gave [family member] throughout [their] stay with you. [Family member] was very fortunate to be looked after by such a compassionate and professional team… it made a very testing time more bearable.”

When people were being provided with support with their meals, they were given a blue plastic apron to wear to prevent soiling of their clothing, these did not look dignified, and as all people did not wear them, those that did stood out. The day was hot and we pointed out these aprons might cause people to be hotter. The registered manager confirmed they would consider the use of the aprons, including reviewing people’s choices.

Whilst we did see staff act to ensure some people’s privacy and dignity be maintained, such as adjusting their clothing when being supported using the hoist. However, we fed back to the registered manager an instance where a person’s dressing gown had opened and showed their underwear. The registered manager told us they would look into this.

Although people told us they felt their privacy was respected. A person told us, “[Staff] always knock on my door… I can be as private as I want.” We pointed out to the registered manager where a person’s continence aids were on show in their bedroom and another person’s bedroom had mobility equipment charging in there. The registered manager assured us this would be addressed.

The provider 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 included information about their diverse needs and how they were met. Staff had received training in mental health, learning disability and autism, and training relating to dementia.

People’s aims and what they wanted from the service were documented. However, a person’s records referred to their anxiety and how staff should spend time speaking with them to support their wellbeing. In the ‘What is important in about me’ section of the care plan, it was recorded, ‘not being lonely’. We reviewed their daily notes, which did not show social interactions and meaningful engagement from staff. This was also the case for another person. A person told us, “Staff are too busy to sit and talk, most are helpful but always busy.” We did see staff speaking with people in the shared areas. The registered manager assured us that staff did speak with people, when supporting them, for example, with their personal care, but this had not been always recorded, and they would ensure this was addressed.

Relatives told us they could visit their family members with no restrictions. During our visits, we saw people having visits from their relatives.

The provider 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.

During lunch we saw people had a choice of where they wanted to eat their meals and what they wanted to eat. People were assisted to make their choice of food, by staff showing them plated meals. However, when the meal was served people were not given the choice of if they wanted gravy on their meal or where they wanted it. Some people who were to be assisted by staff to eat, remained in the lounge, until the other people had eaten their meal. This meant the lounge was busy as people were returning from the dining room, which did not provide a calm atmosphere for people who were being supported.

There was a range of shared spaces people could use and we saw, where people could mobilise independently, these were being accessed freely.

People told us their independence was being respected. A person told us, “I shave myself.” However, the daily records of people did not always demonstrate people’s independence was being respected in line with their care plan. For example, a person’s care plan stated they independently brushed their teeth, but there were some entries in the daily records which stated the staff had supported them to brush their teeth, but this was not daily. The registered manager assured us this would be reviewed and could possibly be a recording error.

People’s daily notes demonstrated people’s choices were being respected, such as when they had refused personal care, however, there was no follow up in the care records to show people had been offered support later. We received mixed views from people about if they were supported to shower when they wanted to. One person said, “I had a shower today, have one most of the time, [staff] just offer.” Another person said, “They say it is too awkward for me to have a shower.” However, we received mainly positive feedback from relatives about how their family members looked well cared for. A relative told us, “[Family member] looked well, clean, clothes were clean, hair done and nails clipped, [family member] is looked after well.”

People in the Coach House unit had access to cooking facilities should they choose to use these as well as the meals and drinks provided by the service. This assisted them to develop their independence living skills when they moved from the service. A person told us, “I can make my own routine.”

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

During the afternoon of our first visit, we heard loud swearing coming from the television from the lounge, which was not being picked up by the staff. There were some people watching the film, however, there was continuous swearing, which did not create a comforting and calm environment. We spoke with the registered manager who showed us the staff meeting minutes from the month prior where staff were advised on the suitability of things on the television relating to people and visitors, some who could be children. Despite this, staff had not intervened. The registered manager told us where some people chose to watch specific things on the television, they had been provided with televisions to use in the privacy of their own bedrooms. Whilst it was positive to note people had the autonomy to change channels and put what they wanted on the television, there needed to be consideration of other people and if the amount of swearing and volume could cause distress and anxiety.

People told us the staff were available when they needed assistance, which was confirmed in our observations. One person said, “I get up at 7.00am, rang the bell this morning at 1 minute past just to let them know I was awake.” Another person said, “Buzzer they are fairly quick [to respond].” A relative told us, “Very good numbers of staff. Always staff in the day room monitoring the residents do that they do not fall. The staff seemed very skilled in looking after people with challenging behaviour.”Another relative said, “The staff are generally cheerful and helpful and do a difficult but tremendous job, it would be great if more staff were available but on the whole things are dealt with pretty promptly when needed.”

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The registered manager told us staff attended monthly meetings, which was confirmed by records. Records did not always demonstrate staff were provided with one-to-one supervision meetings which give staff the opportunity to receive feedback about their work practice, raise any concerns and to identify any training needs. The registered manager told us they would be increasing supervisions, and annual appraisals had been planned for the day of our first visit, this would be ongoing. However, staff told us they felt supported and did have supervisions and attended staff meetings. A staff member said, “I receiveone-to-one supervisions and attend staff meetings frequently, which helps me feel supported in my role…. I feel supported by both my colleagues and the management team.”

The registered manager told us spot supervisions were undertaken to address improvements needed and also to advise of any observed positive work practice.

A member of the management team told us they ensured any needs of staff were considered when completing the staff rota. They told us the management team had an open-door policy where staff could raise any concerns they had.