Buttercup 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.
This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.
 

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not consistently placed at the centre of their care and treatment decisions, and partnership working to respond to changing needs was not always effective.
Although care plans and Positive Behaviour Support (PBS) plans were in place, they were not consistently followed. As a result, people sometimes became upset or distressed. Monitoring of incidents was not effective in ensuring staff followed agreed strategies, and adjustments to support plans were not consistently made to improve outcomes.

Observations of staff practice were not routinely carried out to check whether PBS plans were being implemented or whether any use of restraint met recognised best practice standards. Incident records lacked sufficient detail to show what actions were taken and whether these aligned with individual plans. In some cases, restraint was used without clear documentation to justify its use or confirm best practice was followed.

The manager acknowledged the need for improvement and had begun to introduce new monitoring systems.
 

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People said they had access to a range of health and social care providers when needed. People had access to advocacy services who could support them with making decisions about their care. People had been referred for assessment to better support staff in understanding their unique needs for example sensory assessments were planned.
 

Appropriate, accurate, and up-to-date information was not always provided in formats tailored to individual needs. In some cases, communication methods used by staff did not match what was outlined in people’s care plans. For example, one person was given inconsistent or incorrect information, and visual supports such as pictures or photographs were not used, contributing to their distress.

Since 2016, providers of publicly funded adult social care have been legally required to follow the Accessible Information Standard, which ensures people with disabilities or sensory loss receive information they can understand, with the right communication support. These standards were not consistently followed.

Although communication needs were recorded in care plans, further detail was needed to ensure consistent, person-centred communication.
 

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.

People said they would be comfortable to raise any issues about their care and support should they need to, and they told us they were confident they would be listened to. People and relatives told us they were involved in care planning. A relative said, “[Name] has a care plan, and I have regular meetings about it.”
 

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Recently, a health concern was not promptly escalated, and staff did not always inform managers in time when symptoms required professional attention. This was addressed once brought to the managers attention.

Staff worked collaboratively with external professionals, such as Occupational Therapists, to meet people’s needs. People were supported with medical appointments and follow up appointments. We saw health records where people had received visits from healthcare professionals. People’s care records showed that they had received medical help.
 

People’s access to meaningful activities and community involvement was limited due to staffing shortages, particularly the lack of staff able to drive. Relatives reported that, although some people had access to mobility vehicles, they could not use them regularly because there were not enough staff with driving capability. This restricted people’s ability to take part in activities they enjoyed and impacted their independence and quality of life.

While staff had access to information about people’s individual histories, preferences, and communication needs, and equality and diversity were considered in care planning, this was not always translated into consistent action. For example, although future activities such as college enrolment were being explored, current participation was limited.

Care was adapted in some cases to support people who experienced communication barriers or were at risk of inequality. The environment was homely and well maintained.

Overall, efforts were made to personalise care and support, but limited staffing, particularly the lack of drivers, created inequality in access to meaningful activities, reducing the consistency and impact of person-centred care.
 

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 were supported to set goals and make plans for their future needs but no one at the service was nearing the end of their life.