Castle Lodge Independent Hospital

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment, the rating has changed to outstanding.

Outstanding: This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

At our last assessment we rated caring as good. At this assessment, the rating has changed to outstanding. Staff treated all patients with compassion and kindness. They respected patients’ privacy and dignity. They fully understood the individual needs of patients and supported patients to understand and manage their care, treatment or condition. Staff involved patients in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately and compassionately.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

During our site visit we completed a SOFI (a short observational framework for inspection) which is used to capture the experiences of people who use services who may not be able to express this for themselves. Our observations showed staff attitudes and behaviours when interacting were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it.

Staff supported patients to understand and manage their care, treatment or condition, whether this be assistance with aspects of daily living, assistance with medication or access to external services such as hospital admissions.

Staff we spoke with spoke compassionately and tenderly about the patients. Staff were responsive to patient needs, provided care with an open mind, reflected and reviewed care needs as a team. Staff spoke about all patients getting “lodge love”.

Staff directed patients to other services, such as general hospital, GPs, dentists and podiatry when appropriate and, if required, supported them to access those services.

We spoke with 3 patients and reviewed written feedback from 2 patients. All patients said staff treated them well and behaved appropriately towards them and one patient told us “They go out of their way to help me”, another said “The staff are lovely and kind”. The service also conducted regular patient and carer surveys. The most recent survey was being conducted at the time of our assessment, and we reviewed 6 returns in September 2025. The feedback received was highly positive about the staff and the care they received at the hospital.

Staff we spoke with understood the individual needs of all patients, including their personal, cultural, social and religious needs. This was reflected in the 6 care records that we reviewed. Families also confirmed that the service understood their loved ones, knew their interests and one relative told us “They are so good at keeping them calm. They know their interests and staff chat with them all the time.” Another relative said “Staff are supportive, kind, knowledgeable and well trained.”

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences, and told us they were confident that leaders of the service would listen and take appropriate action.

Staff maintained the confidentiality of information about patients.

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service could support patients’ additional needs such as mobility needs, by ensuring all people could access the premises and by meeting patients’ specific communication needs with the use of communication aids, were appropriate.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain. This information was readily available in the ward environment and welcome packs were also provided for new admissions to the service.

The information provided was in a form accessible to the patient group, leaflets could be made available in different languages and staff could access interpreters and/or signers if required. We observed that patient forum minutes were produced in large print and with pictures to make these accessible to the patients.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerance's.

Staff encouraged and developed ways for people to access things that were important to them, for example, cultural and spiritual support. The service celebrated national holidays and would make this relevant to the cultures, values and customs of the patient group.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

The feedback we gained from patients, their families and external partners indicated that people had access to a range of activities and monthly community meetings. People were supported to maintain relationships. Relatives told us they were kept well informed and confirmed that the service had a range of activities, one relative said “They do take her out and the Art Therapist is very good. They made cards and sent to the family.”

During our assessment we gained feedback from 6 staff and the hospital director and deputy hospital director. All staff had a good understanding of the Mental Capacity Act; they supported people to communicate and make informed decisions about their care. A staff member we spoke with said “working with people to maintain their independence, opportunity, keeping sense of self and choice”.

The staff made every effort to ensure patients could access meaningful activity by sourcing the most appropriate and relevant equipment, collaborating with external agencies, involving families and making necessary adjustments to enable patients’ independence.

The service linked in with external teams to support patients to maintain independence and control and external partners told us “Castle Lodge maintains contact with other services such as GP’s, falls teams, dieticians, podiatry, diabetes, Parkinsons teams, and others to meet the diverse health and care needs of people.” The service was looking at ways to continually improve documentation within the service and accessibility to communication methods.

SOFI observations showed the staff promoted people’s independence and enabled choice and control over their own care, treatment and activities, for example patients were given choices regarding activities and food choices. We observed staff supporting a patient to access their phone when becoming distressed, to stay connected with family and friends to reduce their stress and anxieties.

We looked at 6 care and treatment records which had detailed positive behaviour support plans in place to maximise independence, choice and control. Patients had wellbeing profiles and communication passports. If patients were admitted to hospital, for example, a member of staff would accompany the patient to facilitate communication between the external service and the patient.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

On admission, the service completed a risk assessment support which was designed specifically for older adults. Staff used recognised rating scales to assess and record severity and outcomes such as National Early Warning Score (NEWS) to identify acute deterioration, including sepsis and the benefits of a standardised early warning system. Nurses also showed an awareness of new medication, device safety alerts and current practice guidelines.

Staff were aware of and dealt with any specific risk issues, such as falls or pressure ulcers. All patients were assessed using several evidence-based tools such as the Waterlow pressure ulcer risk assessment, Malnutrition Universal Screening Tool (MUST), Cornell scale for depression in dementia and a falls risk assessment. Staff identified and responded to changing risks to, or posed by, patients by referring to the tissue viability nurse and referrals to speech and language therapy.

Staff completed a range of training to ensure they were skilled in responding to people’s changing needs such as nurse prescribing, phlebotomy training, tissue viability, dysphagia and choking and training on learning disability and autism. Staff were also accessing support from the specialist learning disability and autism team at the local trust to provide guidance and support to implement strategies to meet the needs of a recently admitted patient.

Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. The hospital committed to reducing the use of restraint and restrictive practices, promoting human rights and person-centered approaches. The provider was a member of the Restraint Reduction Network (RRN).

During our onsite inspection, a patient sustained an injury following an accident. Whilst undertaking a SOFI, our observations showed the presence and attentiveness of staff post incident, staff responded to any sign of distress or discomfort, ensured family were informed and took appropriate actions to ensure the wellbeing of the patient and the relevant treatment was provided.

We scored the service as 4. The evidence showed an exceptional standard. The service always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

All staff we spoke with felt respected, supported and valued. Staff told us they liked working at Castle Lodge and said there is a “good feeling of honest and open communication at all levels”.

Staff felt positive and proud about working for the provider and their team. Managers and staff were passionate about their roles and keen to be involved in service development and quality improvement initiatives to be at the forefront of best practice and delivering high quality care. A member of staff told us “any concerns if raised would be valued and fed into the care of any patients”.

Staff had access to support for their own physical and emotional health needs through an occupational health service. All staff had access to a range of resources on an app accessible on their phones.

The service’s staff sickness and absence were low, and retention of staff was good. In the last 12 months the service had an average sickness absence of 1.9% and turnover rate was 24% howeve;, the service also had a high number of long-serving staff. Exit interviews were also offered to staff leaving and the reasons reviewed by the leadership team.

The provider recognised staff success within the service through several different initiatives. The service chose an employee of the month and celebrated long service and retirement of staff, which staff were rewarded for. The service regularly celebrated events such as carers week, National Nurses Day, National housekeepers’ week, Pride month, patient birthdays and UK holidays. The service posted on social media, and we saw pictures and posts relating to all these celebrations and events. This created a happy culture where staff felt valued and respected and patients were also recognised and their individuality celebrated. The hospital manager then created a newsletter every quarter which valued, recognised and appreciated staff efforts over the previous 3 months.

The hospital staff were encouraged to become champions in different areas to support health and safety, palliative care, infection, prevention and control, continence, dementia and prevention of falls champions. There was a dignity champion within the team who had created a dignity poster highlighting key actions to ensure individuals feel respected, valued and empowered. The staff team consisted of wellbeing champions and a freedom to speak champion to support a positive culture and work environment.

Staff appraisals included conversations about career development and how it could be supported. Staff were encouraged to undertake a range of learning and development opportunities to develop professionally and improve care delivery for patients.

Staff were invited to team meetings and quarterly coffee mornings and managers would organise for staff to be covered on shift to enable them to attend. Staff attended de-briefs following incidents, lessons learnt and sharing good practice was embedded within all meetings.