Burntwood 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 person centred care.

This service scored 50 (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 did not always receive care and support that was consistently person-centred. Whilst there were some positive examples of staff understanding people's needs and providing support when required, we found several areas where there was a lack of evidence that care was fully tailored to people's individual preferences and wishes. For example, 1 member of staff told us they knew activities people liked. However they confirmed they had not considered using alternative communication aids to explore with people other external activities.

Staff didn’t focus on setting outcomes with people looking at people aspirations and planning events that would be of interest to individuals. However, relatives felt that staff knew people well. One told us, “They understand her. They will tell if something needs changing but very rarely any changes but we are always told.”
People were also supported to attend healthcare appointments and access medical treatment when required.

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.

The provider did not always ensure that care was well coordinated, fully integrated or planned to ensure continuity across services. Assessment processes were not always sufficiently robust to determine whether the service could appropriately meet people's needs.

Pre-admission assessments were not sufficiently detailed and did not fully consider the people’s individual needs, the suitability of the placement, compatibility with other people using the service or whether staff possessed the required skills and knowledge to provide effective support.

However, people received care and support that met many of their day-to-day needs, and there was evidence that staff supported people to access healthcare services when required. People attended health appointments, were supported to access hospital treatment where necessary and had hospital passports in place to help ensure important information about their needs, preferences and communication requirements was shared with healthcare professionals. Staff worked together to provide continuity of care within the service and generally understood people's routines and support needs. One health professional told us, “Burntwood Lodge requested dementia awareness training and ensured as many staff attended as possible. The training was well attended, and staff were engaged and keen to learn.”

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

The provider did not always ensure information was provided in a way that met people's communication needs. Whilst staff knew people well and were able to explain how some individuals preferred to communicate. Communication plans contained limited information about how people communicated and expressed their needs. There was insufficient detail regarding individuals’ preferred methods of communication, communication needs, or the support required to enable effective communication. This meant that staff did not always have clear, person-centred guidance to ensure people could communicate their wishes, choices and needs effectively.

There were no alternative communication aids, such as easy-read information, pictorial formats, symbols, visual prompts, social stories or other accessible communication tools. This was of particular significance given the service specialised in supporting people with a learning disability, some of whom may require information to be presented in different ways to support understanding and participation. One member of staff told us of a pictorial menu, “I don’t find we are needing one.” Another told us, “We don’t use visual aids here, if you say things nicely they [people] can understand.”

The absence of accessible communication tools reduced assurance that people were always able to understand information about their care, make informed choices or express their views and preferences fully. It also limited the provider's ability to demonstrate compliance with the principles of accessible information and person-centred care.

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.

The provider had systems in place intended to gather people's views and involve them in decisions about the service. For example, resident meetings were held, and people had opportunities to attend and participate in discussions about aspects of their care and daily lives. However, these arrangements were not always meaningful or effective. Records showed that complex questions were often asked during resident meetings without sufficient consideration of people's communication needs or their ability to understand the information being discussed. The provider did not use alternative communication aids, such as easy-read documents, pictures, symbols or visual prompts, to support people to understand information and express their views. As a result, the provider could not be assured that people were able to participate fully in discussions or make informed contributions.

There were no recent satisfaction surveys that had been undertaken to seek people's feedback about the quality of the service they received. This reduced opportunities for people, and where appropriate those important to them, to share their experiences and influence service development and improvement.

In addition, key worker meetings were not always meaningful. One member of staff told us of these key worker meetings that they were to, “Roughly plan what’s going on, make sure any medical appointments, they [the key worker] oversee everything.” However, the records relating to the meetings did not consistently demonstrate that these meetings explored people's views, wishes, goals or experiences in a person-centred way. As a result, the provider could not clearly evidence how people's feedback was gathered, acted upon or used to shape their care and support.

There had been no formal complaints raised about the service. Relatives told us they were satisfied with the care provided and said they would know how to raise a complaint if needed. One told us they would speak to the registered manager and that, “I have no concerns at all, [registered manager] is very nice.” Another said, “If I had a complaint I will certainly complain. They are very competent with what they do.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

The provider could not consistently demonstrate that people had equitable access to opportunities, information and experiences that promoted inclusion, independence and quality of life.

People's opportunities to participate in community activities were limited, particularly during evenings. The provider could not demonstrate that people were routinely offered choices about going out at night or accessing activities that reflected their individual interests and preferences.

There was also limited evidence that information was made accessible to people in ways that met their communication needs. Alternative communication aids, such as easy-read information, pictures, symbols or visual prompts, were not routinely used. This reduced assurance that people had equal access to information, were able to fully understand decisions affecting them and could participate meaningfully in discussions about their care and support.

However, people were able to access some services that supported their health and wellbeing. For example, people attended health appointments when required, were supported to access hospital services and had hospital passports in place to help healthcare professionals understand their individual needs. Staff also supported people to attend day centres, which provided opportunities for social interaction and structured activities.

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.

The provider did not always ensure that people experienced equitable outcomes or that opportunities were tailored to support each person to achieve their individual goals and aspirations. People did not always have equitable access to their local community and opportunities to develop meaningful local connections. There was limited access to public transport and community-based activities reduced people’s opportunities to access local amenities, participate in community life and develop relationships outside of the service. There was limited evidence of proactive planning to expand people’s opportunities, build independence and support them to become more connected within their local communities.

However, people experienced some positive outcomes in relation to their healthcare needs. They were supported to attend health appointments when required, access hospital services and had hospital passports in place to help ensure their needs were understood by healthcare professionals. Staff generally knew people well and there were examples of caring interactions, including providing reassurance when people became upset or distressed.
 

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.

Although end of life care plans were not in place, people were supported to receive compassionate care at the end of their lives. Staff feedback and records showed people were supported to access healthcare services and end of life support when required. However, the absence of documented end of life care plans meant people's wishes, preferences, cultural needs and decisions about their future care were not always clearly recorded to help ensure care was delivered consistently in line with their choices.

Comments received from one healthcare professional regarding the support provided to a person at the end of their life demonstrated staff had cared for the person well. They told us, “[Person] was supported by care staff that he knew well and felt safe with. We were very grateful for the care and compassion they showed that gentleman at the end of his life.”