Cera Castleham Lodge

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• 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 the provider met people’s needs.

This is the first assessment for this service. This key question has been rated Requires Improvement. This meant people’s needs were not always met through good organisation and delivery.

The provider was in breach of legal regulation as people were not supported in a person-centred way.

This service scored 57 (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 work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People were not routinely involved in the development and review of their care plans.This is despite the service user guidestating, ‘You will be fully involved and included in everything we do. Your care and support needs will be assessed and reviewed to ensure you receive the right care and support at the right time.’

People told us the service was not always responsive when they raised concerns about their care. They said they were tired of hearing there would be improvements in the management of the service when for many months this had not been forthcoming. However, during our visit to the service, interim management arrangements had begun to address late reviews, which people said was a positive change.

The provider did not always ensure there was continuity in the service.

People did not always receive continuity of care with the same staff. Several people said they saw many different agency care staff which made it difficult to build relationships or experience a consistent approach. People expressed frustration frequent changes in staff meant new care staff were often unfamiliar with their routines.

The provider did not always ensure there was appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The provider had not ensured people’s care plans were current but had provided accessible information about the service.

A staff member told us they were reviewing everyone’s care plan to ensure everyone had a copy created by Cera Care Castleham Lodge rather than the previous provider as they had found this was not the case for some people. This meant there was the potential for information to be out of date and the risks to people inaccurate or not recognised as their needs had changed.

People told us they had a service user guide for Cera Care Castleham Lodge. We saw it provided details regarding assessments, care planning, reviews and how to make a complaint, which were clearly written and laid out.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not involve people in decisions about their care or tell them what had changed as a result. The provider’s approach to consultation and leadership did not address people’s complaints or reassure them.

People said they were unhappy with the constant changes in leadership resulting in ineffective oversight of the service and poor staff morale. People described losing faith in the promises of positive change when they did not see improvements in the management of the service. The recording of complaints was inconsistent.

Quality assurance processes included provider meetings at Castleham Lodge which people using the service could attend and ask questions. Minutes from one of the meetings noted for 4 recent meetings, the management representative had been different at each one. This added to people’s sense of an inconsistent service. The provider told us ‘All service users have been provided with Service User Guides detailing the complaints pathway. In addition, a written communication outlining escalation processes was sent to all residents. Both residents and staff received letters detailing the management team and escalation contacts, and these details were also displayed on the staff room board.

The provider made sure that people could access the care support and treatment they needed when they needed it. The provider enabled staff to access training to provide them with appropriate skills.

Staff records showed they had access to a range of training, most of it was online. A manager said they were arranging training which was also face to face to enable learning through the opportunity to discuss the topic. This showed recognition that adult learners have different ways of learning.

Equality and diversity training was included in the provider’s training programme and records showed 6 out of 9 staff had completed this course. The remaining 3 staff had been in post over a year, so it was unclear why it had not been completed.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider ensured staff had equality and diversity skills, which helped them to respect and be empathetic to people’s experiences and chosen lifestyles. Staff spoke respectfully about the people using the service. For example, they showed an understanding on what was important to people and what impacted on their mood and well-being. We saw this was reflected in one person’s care plan stating,’ Carers to support me with my wellbeing, encourage me to be independent, take an interest in social activities and support me to see family and friends.’

People had the opportunity 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. However, staff did not benefit from training in end of life care, which meant they might not have the skills and knowledge to meet people’s changing needs.

Care plans contained a section for people to detail their decisions regarding how they wanted to be supported at the end of their life, including their decision on whether they wished to be resuscitated. One person had chosen to log the details important to them regarding future medical intervention but for other people it was logged they did not wish to discuss their future plans.

However, according to the training matrix staff did not have access to end of life care training despite the age range of many of the people using the service, including those with multiple health needs.