Cera Castleham Lodge

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

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

The provider 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.

People told us the new permanent care staff had got to know them well and how they liked things to be done. Agency staff were no longer used and support if needed could be from named staff from other Cera locations, who would be able to get to know people. People had no complaints about the staff who cared for them. One person said, “I love all the staff, we have a good time together. They know my quirks.”

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing, however there were times when people did not have choice or control and independence when staff were diverted from their care.

People had previously said the unreliability, missed visits and delays had impacted on their independence. There were now no missed visits, but people did sometimes have to wait mid visit for a staff member to go and check a Peace of Mind call in case it was an emergency. This led to the person having to wait to finish dressing or going to the bathroom, for example and carrying on their day. One person was particularly upset and worried about the staff having no breaks and being too busy. The manager was supporting them and trying to reassure them. The management team were trying to resolve this, but the nature of the Peace of Mind scheme meant calls could be unpredictable, putting pressure on the domiciliary care staff team.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

The provider did monitor and audit the Peace of Mind calls which impacted on the outcome for people who received personal care. However, a solution had not yet been found.

Staff were often called to respond to people’s requests who lived at Castleham Lodge but were not contracted to receive a care service. For example, there was an emergency call bell system connected to a national emergency call response team in another part of the country. This meant care staff were also required to respond to requests for help which could not be resolved by the call response team. These calls could be many and varied, including moving an item, helping with a task, related to cleaning or opening the front door out of hours. We could see, and people and staff told us, there was a direct impact on people’s needs being met and domiciliary care visits being interrupted regularly.

The provider told us it was a contractual requirement within the Extra Care model to answer pendant calls. They previously said, ‘Staff are trained to triage calls via handset, prioritise genuine emergencies, avoid leaving individuals mid personal care or during moving and handling tasks, and log all pendant activations.’ However, this scheme did not have a separate staff team and relied on staff already allocated to domiciliary care visits or office staff. The provider had tried to communicate expectations and understanding of the scheme with people and staff, but it was early days and people had been used to being responded to and having additional task support.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The provider had made efforts to support and promote staff wellbeing. However, the continued frustrations of having to manage the Peace of Mind service continued to be spoken about by staff. The permanent staff group had shown resilience during all the changes since Cera Castleham Lodge had registered with CQC to provide personal care. However, staff feedback still showed a level of exhaustion and disappointment with the organisation. There were still ongoing sickness issues and staff leaving as it remained difficult to do all the tasks asked of them. There were some improvements since our last assessment, but these cultural changes would take time to embed.