The 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 good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.
 

This service scored 64 (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.

At the last inspection, care planning and activities were not always effective. At this inspection, some improvements were evident, with staff demonstrating knowledge of people’s preferences. However, records and activity provision were not consistently tailored, and some people experienced limited engagement. Further work was required to ensure consistency.

Care plans did not always include personalised detail that staff were aware of. The registered manager had commenced improvements in this area to ensure any additional information known by staff be included in people’s care plans to personalise them further.

Some people experienced limited meaningful activity and engagement. Observations during the inspection showed people spending extended periods in communal areas without stimulation or structured activity. A person living at the service told us, “There’s not much to do really.”

One staff told us they felt more could be done to stimulate people, they described several people that could be easily stimulated to engage them more. They told us, “[First person’s name] is always singing we could just engage into singing activities to personalise more. [Second person’s name] would love to do more in the garden and [Thirds person’s name] likes helping around the home or gardening. Many lay idle, but if more interesting things were going on they would be kept livelier.” We observed some activities happening in the home, that did stimulate people. However, some people were asleep throughout the day and not receiving as much engagement as others. Feedback showed that activities required more work to ensure they were tailored to individual interests or preferences.

The registered manager assured us the garden would be utilised more with the change in weather and was in the process of reviewing the dependency tool to ensure appropriate staffing levels to support more person-centred activities.
 

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.

Handovers and communication systems supported continuity; however, reliance on verbal communication remained. Records did not always reflect current needs, meaning there remained a risk of inconsistent care delivery. This created a risk of variation in how care was provided. While some improvements in partnership working had been made, this was not fully embedded.

Feedback from professionals indicated mixed experiences of integration. Some reported improved communication, while others felt recommendations were not always followed. One professional told us that communication had improved but added there were, “Times when advice hasn’t been followed through,” highlighting inconsistencies in joined-up care. Although internal handovers supported day-to-day continuity, reliance on verbal systems increased the risk of information being missed or misinterpreted.
 

The provider did not always ensure people received clear, accurate and up-to-date information about their care.

Care documentation was not consistently detailed or accessible, which limited how effectively staff could communicate information about care and support needs. This also reduced opportunities for people and relatives to be fully informed and involved.

Relatives told us communication was variable, with updates not always provided consistently. One relative said, “Sometimes you have to ask for updates rather than being told,” indicating information sharing was not always proactive.

Although staff communicated well with people in day-to-day interactions, systems did not consistently support clear and reliable information sharing. Improvements were required to ensure people and those important to them were consistently well informed.
 

The provider had worked with people and relatives in various ways to obtain feedback about the service and the care people received. Staff involved people in decisions about their care and told them what had changed as a result.

Involvement in care planning was inconsistent. However, the provider had tried to obtain feedback and engage with relatives in several ways. Barriers to engagement had been identified, such as, relatives not living close by or having limited time due to work commitments. They were focusing on this area and had started to distribute a relative and health professionals survey in different formats to gather feedback.

People and their relatives provided positive feedback about day-to-day communications. However, this was not consistently supported through formal systems due to several identified barriers outside the control of the provider. A relative told us, “They do talk to us when we’re here, but there isn’t really anything formal,” highlighting that the provider had to obtain feedback in different ways. The registered manager was continuing to look at ways to improve systems to encourage listening and involvement of people and relatives or advocates.
 

People were generally able to have equitable access to care and support when they needed it. Staff were responsive to people’s day-to-day needs and ensured support was available.

People told us they were able to access assistance when required, including support with personal care and healthcare appointments. A person said, “They help me when I need it,” reflecting consistent access to support. Although systems required improvements in other areas, these did not significantly impact people’s ability to access care.
 

The provider generally ensured people experienced equitable care and achieved positive outcomes. Staff demonstrated a good understanding of people’s individual needs, preferences and backgrounds, and used this knowledge to provide personalised care. One staff member told us, “We work together to bring a smile to the people that we do take care of,” and described how care was adapted so people could, “Feel their life is the same as they used to live.” This reflected an approach that promoted dignity, inclusion and consistency in people’s experiences.

People and relatives largely reported positive experiences of care. One relative told us, “I’ve every confidence in them,” while another said their loved one was, “Very happy and that’s all that matters.” Feedback also highlighted that people were supported to maintain independence and choice, helping to ensure outcomes were meaningful and tailored to the individual. Staff promoted access to activities, outings and social engagement, supporting people’s wellbeing and inclusion within the service.
 

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.

Records included information to support people’s end of life choices and preferences, such as preference of where services were to be held for people. Where people and/ or their relatives had chosen not to discuss their end of life wishes, this had been respected by staff. We recommended where these wishes had been explored, that these were documented to ensure they were revisited as required in the future if their needs changed.