Franklyn Lodge 9 Grand Avenue

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 rated this key question good. At this assessment the rating has changed to 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. We found that the provider had not always ensured care was assessed, designed and delivered in such a way that took account of people’s individual needs including their social, recreational and communication care needs

This service scored 46 (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 make sure people were at the centre of their care and treatment choices.

The service did not operate within a culture of person-centred care. Although people’s support plans showed their social, emotional and cultural needs were assessed and described, staff did not support people in a way that ensured these were met.

People’s communication needs were assessed and described in their support plans, but we did not see staff effectively using this information to communicate with people. Two people’s support plans said they used Picture Exchange Communication System cards; however, these were not available for people to use. One person had a tray of cards however many of these were not relevant to their day-to-day life and staff did not use them to communicate effectively with the person.

Staff met people’s individual needs relating to their direct, day-to-day support such as support with personal care, eating and drinking. However, staff did not support people to develop their individual skills, to identify goals and aspirations and to work towards them.

On the first day of our visit, staff supported three of the people to go swimming. The senior support worker told us that staff supported these people to regularly go swimming, however records showed that this was the first time they had been swimming in a month. Swimming was described in their support plans as a favourite activity they enjoyed.

People’s social needs weren’t met outside the service. Although people’s support plans described them as ‘sociable’, staff did not support them to have an active social life or undertake any regular or structured activities outside the care home.

Records showed that only two of the six people had a regular activity, which was to visit a day centre. Otherwise, three of the people did not routinely leave the home.

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.

The service had not worked to ensure that one person received the coordinated support they needed. All of the staff that we spoke with seemed to accept that the person staying in their room without any engagement from staff was acceptable, despite the person having a poor quality of life. The registered manager and the person’s keyworker had not taken effective steps to ensure the person’s changing needs were assessed and met by the relevant professionals.

However, People received care from staff who understood their individual health and social care needs. The service facilitated access to health services where required. We saw that the registered manager had arranged for domiciliary visits from health care professionals for people who found visiting these professionals in outside venues distressing for example, the psychiatrist.

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

The provider was not able to demonstrate compliance with the Accessible Information Standard (AIS). The AISsets out how providers and commissioners of NHS and publicly funded adult social care services should ensure disabled people and people with impairments or sensory loss can access and understand information about NHS and adult social care services.

The service did not provide information to people in ways they could understand. Although in many instances people’s communication needs were met, and staff understood people’s gestures, body language and vocalisations, communication resources as described in people’s support plans were not available for people or staff to use to enhance communication.

The provider had not considered whether people’s care records could have been provided in an alternative format for them to be able to access the information they contained. Support plans were all text-based and not available to people in alternative formats.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. There was a formal mechanism in place for people to do so, however it was not in an accessible format. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Relatives were invited to complete yearly surveys however there were none in place for people or staff. These surveys were just yes or no answers with no action plans or follow up in place and we could not see evidence of how feedback was gained and used to help improve the service. One relative said, “They do send questionnaires for feedback,” another told us, “I’m not sure if a complaint would be acted upon.”

The provider ensured people could access the care, support, and treatment they needed, when they needed it. Discussions with the manager demonstrated a clear understanding of how to access specialist health and social care services, including referrals to external professionals such as speech and language therapists, when required and care records evidenced this.

Out of hours support was in place, covered by the management team to ensure staff always had access to advice and support.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

The service did not have mechanisms in place to facilitate removing barriers for people, so they experienced positive outcomes from their support. The provider did not make reasonable adjustments for people who required these, such as ensuring there were enough staff for people’s social, emotional and cultural needs to be met.

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. The service did not foster a culture in which people were supported to identify their aspirations and work towards goals.

People’s care plans did not evidence how they were actively involved in planning for important life changes or discussing their future care needs. However, the registered manager had started conversations with relatives and told us about one person’s wishes around their end-of-life arrangements. One relative told us, “The General Manager did have a conversation regarding DNACPR, there’s currently no plan in place.”