Archived: Sonia 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 that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to inadequate. This meant people’s needs were not met.

The service was in breach of legal regulation in relation to person centred care and receiving and acting on complaints.

This service scored 36 (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.

People were not always well supported to meet their needs. For example, we observed one person’s nails were very dirty. Staff told us they had attempted to cut the person’s nails 3 days prior but the person had declined to have some nails cut. Their care plan noted they routinely refused care and staff should allow time and try again, there was no evidence staff had attempted to cut the person’s nails again in the three days since.

Care was not always person centred. For example, one person’s care plan said they used to like gardening and now they liked to sit and watch the garden. The garden was not well tended. One person told us, “It needs some love and attention and would be nice if it was something to look at, but it’s not, it makes me feel sad.” One relative said, “The garden is a mess.” It was a nice day when we visited but no one was supported to access the garden.

There had been a significant change in staff at the service over a short period of time and a lot of new staff had started at once. Views on how this impacted on care varied. One partner told us care had started to improve again since the new staff had started to settle in. However, one relative told us communication was much more difficult, and they struggled to get regular information about how their relative was getting on despite requesting to be kept informed.

Care plans were also lacking information on how to support people to promote consistency. Care plans also included conflicting information which could impact on how well people were supported. For example, one person’s care plan stated they were not able to request assistance from staff when they needed support. However, later in the care plan it set out how the person requested assistance. One staff told us, “I will ask [people] before doing anything -if someone does not say anything I will read the care plan to understand what I am meant to do.” Poor care plans created a risk new staff and agency staff would not recognise when the person wanted help.

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

People did have communication plans in place. However, a number of care plans were generic in places such as stating how people wanted information shared with them. All of the care plans we looked at included the same wording regarding what format people wanted information in.

Staff told us they mainly shared information with people verbally. However, we observed the menu was not on display during lunch and a group of people were discussing they did not know what they were having to eat that day. One person asked a staff member, “What are we having for lunch?” However, the staff member did not respond, and the person continued to not know what they were having for lunch until it was put in front of them.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. We were not assured the provider had investigated and acted upon complaints.

The provider told us there were no complaints. They told us, “I speak to people and relatives and let them know if they have any concerns they can speak to me. We have not had any complaints. We discuss things with people.” However, relatives told us they had raised complaints and there were no complaints recorded. One relative told us, “I feel if I raise anything with [the management] it will kick off into an argument. We haven’t always had a solution to issues we have raised.” Another relative told us, “When we raised concerns no one replied. We asked about the clothes going missing, but we never heard anything. It’s disheartening.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. During the inspection we had identified people had not always been referred to health care professionals for support when this was needed.

There was a lift to support people to access up stairs areas where needed and there were bedrooms downstairs. Access to the garden was not fully accessible. However, no one at the service needed the support of a wheelchair to access the garden at the time of the inspection.

There were assessments in place of people’s equality support needs such as religion and sexuality. The activities co-ordinator had arranged from a religious service to be provided for people to attend regularly if they wanted to do so.

Staff and leaders did not always actively listened 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.

People were supported by staff to complete a survey to provide feedback. However, the provider told us there were no complaints about the service or low-level grumbles. This was not accurate, and we were not assured people’s views were fully listened to. There were regular meetings for relatives and residents and most comments from people were positive. However, when concerns had been raised it was not clear what action had been taken. For example, some people had raised they wanted more fresh vegetables and concerns about the décor had been raised. The provider told us repairs were being undertaken. However, we had identified concerns about the environment. There was also a newsletter, but one relative told us they had not had a newsletter for months. The provider sent us a copy of a newsletter for August, however, this included very little information and was not reflective of what was happening at 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.

People had end of life care plans in place although these were basic and lacked personal details such and final wishes the person might have. There was information in people’s care plans about any religious support needs they many have. There was also information about if people wanted to remain at the home during the end of their life or move to hospital and any funeral plans purchased. Staff at the service were supported by local paramedics who could support people to remain in the service if they wished to do so. At the time of the inspection there was no one at the service who was actively dying. However, there were anticipatory medicines in place if these were needed to support people at the end of their life.