Sutton 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 changed to requires improvement: This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to, people’s safe care and treatment and good governance at the service. We have asked the provider to take action to improve the service.

This service scored 54 (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 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.

Although staff interactions were observed to be kind, care delivery was task-focused due to time pressures. Staff told us they were unable to provide person-centred care as they were required to respond to “red flag” alerts on electronic recording devices. Red flags are alerts that appear on staffs electronic recording devices of what tasks needing to be completed. Records showed that all people requiring support with incontinence pads were checked two-hourly, rather than having individual, person-centred continence plans in place. This meant people did not receive care that reflected their individual needs, preferences, and what mattered most to them.

There were significant shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not joined-up, flexible or supportive of choice and continuity.

Care plans did not reflect health professionals’ advice, and guidance was not always followed. For example, the district nursing team were contacted after staff identified concerns with a person’s skin and could be skin pressure damage. A nurse advised that the person required specific care to reduce pressure, this advice was not followed.

Prior to our visit, a health professional raised a safeguarding concern relating to poor moving and handling practices. During our inspection, we found these concerns had not been fully addressed, as we observed a person supported using a hoist without a completed health assessment to confirm the equipment was safe and appropriate to use. There were no strong examples of effective teamwork, and gaps in staff knowledge, documentation, and care coordination were evident. As a result, people did not always receive care that was well‑integrated or consistently matched to their ongoing needs.

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

Most relatives told us they were not aware of what care and support had been planned. Where appropriate, relatives were not given the opportunity to read their loved one’s care plans or be involved in care plan reviews.

We received mixed feedback about communication. One relative said, “I supply the toiletries and am not well informed, which hasn’t improved over time. I don’t know who the manager is, and we could have been informed about events such as the Summer and Christmas fairs.” However, another relative told us, “We are kept well informed and visit weekly.”

We were not assured that information was tailored to meet the needs of people living with dementia. We observed limited dementia-friendly signage and a lack of accessible communication aids. For example, the menu displayed in the dining room did not include photographs to support the understanding of people who were no longer able to read due to their dementia. This meant people were at risk of not having information provided to them in a way they would understand.

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.

Relatives told us there were no effective arrangements to gather formal feedback. One relative said, “I have not had a questionnaire for four years; I think I have only ever had one,” and another relative told us, “There are no relatives’ meetings.” We found there was no systems or processes in place to involve people, or those who knew them well, in reviewing the care provided. Relatives also told us they had raised complaints; however, these were not always formally recorded in line with the providers policy, although relatives said they felt concerns were generally addressed.This meant there could be missed opportunities to learn from complaints and to gather valuable feedback about where improvements could be made.

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

A GP completed a weekly ward round to review and support people who required medical support. People were supported to access eye checks, and a chiropodist visited the service. People did not have access to routine dental checks at the time of our assessment; however, the provider told us arrangements had been made for a community dentist to visit. The home was accessible to all, there was walk in shower, wide corridors so people with wheelchairs could access the home without barriers.

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

Everyone living at Sutton Lodge were treated equally, we found no concerns in relation to discrimination. Reasonable adjustments were made where needed to ensure people did not experience discrimination. For example, where people could not assess opticians in the community the provider arranged for a community optician to visit the home. This meant the provider could be assured everyone received fair and equal access to support, and opportunities.

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.

End of life care plans were in place, however, they were not always detailed enough to provide staff with clear guidance on how people wished to be supported. We receive mixed feedback from relatives. One relative said,” We have discussed end of life and there is a DNR [do not resuscitate] in place as well as the RESPECT form [Recommended Summary Plan for Emergency Care and Treatment] form.” Another relative told us, “There is a DNR in place. I have been told that there are end of life medicines in place, but we haven’t talked about it. I would like to talk to them about this and as a family we do discuss it.”

This meant people and families were not always supported to think ahead and make informed choices about their future care. Their wishes may not be understood and respected as their needs changed.