The Lodge

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 – this means we looked for evidence that the provider met people’s needs.

At our last assessment we did not assess this key question, at our assessment published 14 August 2019 we rated this key question requires improvement. At this assessment the rating changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 told us they were included in decisions about their care; this was confirmed by relatives. A relative told us, “I think the home is excellent they have residents with the most challenging behaviour and the staff manage very well. A good care home is not just about adequate paperwork and good decor. The most important part is residents being cared for properly and safely.”

The registered manager told us how they supported people with complex needs, sometimes when they had lived in previous services who could not meet these needs. The registered manager told us how they provided person centred care and worked in partnership with people, relatives and other professionals to meet people’s needs. This reduced the risks of people having to move again.

Care plans of identified people’s person centred and diverse needs and how they were to be met. This included the person’s aims of what they wanted to achieve while living in the service, such as support to develop their independence skills. Some would benefit from additional information. For example, two people’s care plans referred to a relative dying, there was no date of this to ensure the staff were aware of if this was historical or recent, so they could adjust their interactions to not cause distress. Another person’s care plan identified they had an issue with one of their relatives; however, it also stated they had good relationships with all of their relatives. The registered manager confirmed this was an error and would be addressed.

Another person’s records identified how the person’s dementia affected their daily living, including how they would often refer to their past home and job. The care plan did not guide staff in how to respond to the person to ensure they were not contradicting what the person believed which could cause distress. The registered manager told us this would be added.

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’s care records included information about their diverse needs and how they were met.

In the Lodge, people had access to dolls, which we saw a person carrying around and a staff member interacted with a person and the doll to distract them. However, there was a lack of items in the service for people living with dementia to use to stimulate their senses and meet their individual needs. The registered manager told us they had previous had ‘fiddle’ items made and would consider additional ones and other things people could engage with. There was signage on people’s bedroom doors to support them to recognise which was their room. However, there was minimal additional signage around the service, to assist people, especially those living with dementia, to find their way around the service independently. The registered manager told us they would consider this.

There was an activity staff member employed in the service; however, they were on leave during our visits. We saw group activities provided on both visits by the care staff in the lounge. In addition, there was a programme of external entertainers who visit the service. The registered manager told us how they empowered people to organise activities if they wished to, this included quizzes.

People’s daily notes did not always identify they had access to social activity and interaction, if they did not take part in the group activities, or if they chose to remain in their bedroom. The registered manager told us the activities staff provided one to one activity; however, records did not demonstrate this for all people. Some daily notes identified the task-based support provided but very little in the way of engagement and interaction.

Where people chose to, they had access to the grounds, we observed a person doing the weeding on the first visit. The registered manager told us how new plants had been placed in the garden, however a person had removed some to plant in another area, the registered manager said, “[Person] butchers the garden, but it what they like to do.” This demonstrated people were supported to do what they liked in a safe and supportive way. A person told us, “I go out into the garden.” Another person told us it was difficult for them to go into the garden independently, and they had arranged with staff to go into the garden later in the day.

A staff member told us how some people went out into the community, such as to have a meal out and shopping. Some people did individual activities in the service, for example, a person liked to help fold laundry and add labels, which contributed to their wellbeing.

In the Coach House, people had access to external support staff who supported them to access the community.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s care records identified their communication needs and how they were met. The registered manager told us how they had sourced support when a person had moved into the service and due to their distress reactions had reverted to their first language.

There was a notice in the service which stated documents could be made available in different accessible formats if required.

The provider told us about the welcome pack provided to people had been developed into audio to support people who did not wish to or were unable to read it.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

There was a complaints procedure in place. Complaints and concerns were investigated and responded to in line with the procedure. During our assessment we received feedback from a relative about a formal complaint raised. This was in the process of being investigated by the registered manager, who told us some actions had been taken immediately, including replacing furniture. A relative told us when they had raised a concern, it was addressed promptly and the reported missing item had been retrieved.

Relatives told us communication with the service was good and they were kept updated about their family member’s wellbeing, A relative told us, “If [family member] has a fall, knock or something happens [staff] are on the phone about what happened and what they are going to do about it. Open communication, they rectify things when needed.”

Surveys were undertaken which were analysed and actions taken where required.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People told us they had access to health care professionals when needed. This was confirmed in records, which detailed the support provided and outcomes.

Staff and leaders actively listened 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.

A member of the management team told us how they had identified local dentist services, who were able to provide a service to people using the service, when they did not have their own dentist.

The registered manager shared examples actions taken when there had been a failed discharge from hospital to ensure the person received the support they required.

People were 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.

People’s records included their decisions about how they wished to be cared for if they became unwell or needed end of life care.

A member of the management team told us how they worked with the GP surgery, when people were at the end of their life to ensure they received the support they required, including pre-emptive medicines. A relative told us how their family member’s needs had changed and how they were being kept updated and consulted.