Evergreen 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 rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

This service scored 43 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was limited evidence people were consulted or involved in decisions about their care and support. People’s goals were not always reviewed to ensure they remained achievable, reflected people’s preferences, or were updated when needs changed.
We observed the support provided was task based and there was limited evidence care was personalised. Some care plans included personal information about people, such as their likes and dislikes; however, this was not always reflected in the care they received. For example, one person’s care plan recorded they enjoyed having the freedom to walk independently around the home. Environmental controls implemented on all internal doors placed restrictions on people’s freedom of movement and meant they were unable to access parts of the building without staff intervention.
Staff told us that people were only able to go outside for a cigarette at scheduled times due to staffing availability. This did not always reflect people’s individual choices or preferences.
Routines were in place which meant care was not always delivered in a person centred way. Where restrictions were applied, such as set times for cigarette breaks and how many they were allowed, there was no evidence that discussions had taken place with people to understand their preferences. smoke. Not all staff had received training in person centred care, which meant this approach was not always applied.
 

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities. As a result, care was not always joined up, flexible, or supportive of people’s choice and continuity.
Care was not always tailored to meet people’s individual needs. Support was often provided in a way that reflected what the service could offer rather than what people required. This was evidenced by routines and restrictions that limited flexibility and choice.
The provider did work alongside other health professionals. Feedback from external professionals was positive. One healthcare professional told us, “We are always on the same page as each other and have always worked well together.” Another professional said, “I have a good relationship with the nursing staff and find them to be good at their jobs. The service communicates well.”
 

The provider did not always supply appropriate, accurate and up to date information in formats that were tailored to individual needs.
Where people lacked capacity to make decisions, assessments did not clearly demonstrate how they were supported or encouraged to participate in decision making. There was limited evidence that information was provided in ways that reflected people’s preferred methods of communication.
Care plans were often generic and included large amounts of information about medical conditions rather than focusing on the individual. Information was not always presented in a way people could understand. For example, one person’s care plan stated that staff should use short sentences to support their understanding; however, their care plan itself contained multiple lengthy sentences and complex language, which did not reflect this guidance.
People had communication care plans in place which recorded peoples preferred method of communication although these were not always followed.
 

The provider did not always make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or ensure they were informed about what had changed as a result of their feedback.
Resident meetings were held to give people living at the service the opportunity to share their views. We found these meetings were often repetitive and discussions were limited, with topics such as the weather frequently discussed. Where actions were identified, these were not clearly recorded, and it was not evident how feedback had been followed up or acted upon. Meeting minutes showed that an ‘any other business’ section was included, which gave people the opportunity to raise additional issues.
There was a “You said, we did” board displayed within the home, which demonstrated some feedback had been acted upon. For example, one person wanted to listen to piano music, and this was followed up by a pianist visiting the home.
 

Access to community activities and personal care was not always equitable. People receiving 1:1 support were able to access the community more frequently, while others had fewer opportunities. Some people who lacked capacity had set personal care routines and daily support. This included set shower days, set times for drinks and scheduled times for personal care. These routines meant people could not always access care and support when they wanted which did not support equitable access to care.
People who were able to speak up about their needs received a more flexible approach therefore demonstrating not everyone had the same opportunity.
 

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this. People’s experiences of the service were different. A relative told us, “They take [family member] if there is a singer but that’s about it.” This indicated opportunities were limited and not equally available to all people living within the service.
We saw some activities were brought into the home, such as external entertainers, which enabled more people to take part. This showed the provider had taken some steps to offer shared activities, although this was not sufficient to ensure people experienced equitable opportunities overall.
 

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 death and dying care plans in place. These recorded information such as colour coding to identify where a person was placed on the end-of-life register and whether Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) was in place.
We identified care plans were generic with the same information recorded in multiple peoples care records. This demonstrated plans were not personalised and there was little evidence people were involved in planning their future care.
Whilst case studies were shared with CQC demonstrating people had moved on to a less restrictive environment, care plans did not clearly record goals or plans to support people to move on from Evergreen in the future.