Saxon Lodge Residential Home Limited

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 and responding to complaints.

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 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 detailed person centred guidance. There were not always details about people’s choices, preferences and what was important to them and how it affected their behaviour. There was mixed feedback in relation to care planning. Whilst some relatives told us they were not involved in developing care plans, other people and relatives told us they had been involved in reviewing their care plan.

Relatives told us they were kept informed about changes to people’s needs and when incidents happened.

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. Some people and relatives did not always feel staff understood their needs especially around dementia and distressed behaviour. The feedback from relatives was mixed about how the service worked with them. Some relatives found staff supportive, while others found it difficult to build a relationship with staff especially when their family member displayed anxiety or distress.

People were supported by a small stable group of staff. Staff knew how to contact health professionals when people’s needs changed.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People were not always provided with information at the time and in a way they could understand. For example, people were asked what they would like for lunch in the morning. We observed during the lunchtime meal, people being given meals they could not remember ordering and staff did not tell them what the meal was. One person did not eat their lunch as they did not like what they had been given, they were not offered an alternative. Following our onsite visit, the registered manager introduced a photo menu and told us the meals are now dished up in the dining room so people can see what they are being offered.

Information was displayed around the service in pictorial form and there were pictorial signs to help people identify the communal areas.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Relatives told us, they had raised concerns and made complaints, but these had not been listened to, or the response had been defensive. Records we looked at confirmed this. They told us there had been no improvements to the service or the support people received. One relative told us, they had decided not to attend the relative meetings any more as their concerns had not been listened to and very little change had happened. Relative meeting minutes showed when concerns had been raised such as staffing levels, the response from the relationship manager, had been staffing levels were correct according to the dependency tool. Relative’s concerns had not been investigated to ensure staffing levels were correct. A relative had asked to support their family member at the residents meeting to express their view, they were told they could not attend. The relative was not sure their family member would express themselves without support and there was a risk their views would not be heard.

Relatives told us, the management team had been defensive when they had raised concerns or questioned what had happened following an incident. They told us they felt the attitude of the management had changed for the worst, to them once they had raised concerns. The provider told us, they were working to rebuild their relationship with relatives and their response to feedback.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. People and relatives told us, they had not been supported by staff to access the outside patio area. A relative told us, “They have not gone out there this year, no flowers and the furniture is poor as it was left out all winter.” At our last inspection, people were outside gardening and there were flowers and hanging baskets around the patio. At this inspection, the patio was empty with no flowers and people told us they had not gone outside.

People had moved rooms when it had been assessed as being in their best interests including moving a person downstairs following an incident when they shouted at other people talking outside their room. Following the inspection, the provider told us they had made improvements to the patio space and people were spending time outside.

Staff and leaders did not always 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. People and relatives told us they had concerns about people being discriminated against. A relative told us, “(Resident) was put on their own in the lounge and eats on their own, staff said it was due to their behaviour.” People who were living with dementia did not always have planned support to make sure they were not discriminated against. For example, how to reduce the risk of incidents of distress.

People’s physical disabilities were managed and people attended health appointments. A person told us, staff arranged for a wheelchair taxi to take them to a hospital appointment as they had to wait too long for hospital transport.

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. People had end of life care plans, there were anticipatory plans in place about when people wanted to go to hospital. However, when people followed a specific religion, the care plan stated the relatives would tell staff what to do. There was no general information or guidance about how to maintain the person’s religious beliefs if they died suddenly or the family was not immediately available, so staff would know what to do.