The Lakes Care Centre

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.

The service was in breach in regulation in relation to person-centred care.

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.

Staff generally had a good understanding of people’s individual needs and were able to describe how they supported them. However, we found that not all people had their needs met in a way that was tailored to their individual requirements and wishes. For example, some people’s personal care needs were not always met, and people did not always receive food that was in line with their choices and preferences. During our visit we observed that some people would benefit from having their hair washed or nails cleaned. Some people and their relatives also raised similar concerns with us. One relative told us, “My loved one sleeps a lot during the day and when I visited during the lunch time staff did not make any attempts to wake them. I’m worried about the amount weight they have lost. There was a two-week shutdown, and I was

shocked when I visited. My loved one was unshaven and had dirty clothes on.” Another relative told us, “I often find my loved one dirty and their clothes are disgrace.” Upon analysing people’s care records, we also noted that some assistance with people’s needs such as emptying catheters or helping people to change their position in bed was not done timely or in line with their care plan.

Staff knew when it was appropriate to involve other professionals to ensure people received the right support at the right time. This was confirmed by the feedback we received from people and their relatives. One relative told us, “Recently my loved one needed a medical intervention, and the staff phoned district nurses, and they were able to save a hospital visit. They then monitored the situation for 48 hours. Any problems and they[staff] try to deal with them immediately.” Despite some improvements made, people’s care plans and associated care notes did not consistently reflect the knowledge staff had about people and the support they required. There was very little evidence that care plans were updated with involvement from people and their relatives. One relative told us, “We are still waiting for my loved one’s care plan.”

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.

People did not always receive consistent, person‑centred support that reflected their individual needs, abilities or wishes. Care was not always delivered in line with what people had asked for, and this was not reliably recorded in their care plans or daily notes. For example, one person had expressed a wish to be supported with a daily shower, but their records showed this support was not provided. The provider engaged with external professionals, and we saw examples of specialist advice being sought. However, this was not always accurately reflected in people’s care records, creating potential risks. For instance, one person on a modified diet had conflicting information recorded about the correct diet level prescribed, which could place them at risk of harm.

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

There were policies and procedures in place to support people with different communication needs. However, there was limited evidence that information was consistently presented in ways that met individuals’ preferred communication styles. This was not always clearly documented in people’s care plans, reducing assurance that staff had the guidance needed to communicate effectively. Despite this, staff demonstrated a good understanding of how people communicated and how best to meet their needs. One staff member told us, “Because I know my residents I know what they want.”

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 tell them what had changed as a result.

There were policies and procedures in place to support the gathering of feedback from people using the service. Most people told us they knew how to raise concerns and felt they would be listened to. However, we received mixed feedback about communication with the provider. Some people and relatives said communication was effective and they knew who to speak to, while others reported difficulties. One relative told us, “The manager is easy to talk to, they listen to any concerns I have.” In contrast, another relative said, “Communication isn’t that good you can never find a senior to talk to.” Since the last inspection, there had been some improvements in how feedback was collected from people and staff, and there was evidence that some actions had been taken in response. However, further work was required to ensure feedback was consistently reviewed and used to drive improvements. For example, concerns about the quality of food had been raised and acknowledged by the provider, but the planned actions had not yet been fully implemented. There was evidence that regular meetings took place and people wereencouraged to share their views, with one relative telling us, “They do relative meetings where we can give our feedback.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People received appropriate support and care from relevant professionals when required. The provider worked with a range of stakeholders and external partners to ensure people’s health outcomes were met. This collaborative approach supported coordinated care and enabled people to access specialist input when required. One stakeholder told us, “If staff have any concerns they do follow up and escalate concerns when needed.”

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.

There was evidence that feedback from people and their relatives was sought.

However, there was limited assurance that the provider had effective systems to gather meaningful feedback from people who may have difficulty expressing their views, such as those lacking capacity or living with conditions that affect communication. There was also very little evidence that people were actively involved in their care planning or in discussions when their needs changed. Where these conversations did occur, care records did not consistently reflectthe information shared. As a result, opportunities to identify patterns, address recurring issues and drive improvements in the quality of care were missed.

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’s care plans did not always include information about their personal goals or future wishes, including their wishes at the end of their lives. This meant care planning did not always fully reflect what was important to each individual or support staff to understand people’s longer-term aspirations. The absence of clear end-of-life preferences also reduced the provider’s ability to ensure that people’s wishes would be respected and planned for in a timely and sensitive manner, should their needs change.

We shared these findings with the provider, who assured us that the issues would be addressed as part of upcoming care plan reviews.