Downshaw Lodge

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We identified a breach of legal regulation. From our observations, people’s experiences varied in the care they received. Whilst some interactions between people and staff were kind and caring, we also saw people were not always cared for in a dignified way or treated with respect. People were not always supported to make decisions about their care. Staff did not always communicate with people, ask their permission to give care or explain what they were doing. Staff told us they enjoyed their job, knew people well and how to support them. Staff described how they encouraged people to be as independent as possible. People's care plans needed expanding upon to reflect how staff promoted their independence and social inclusion both in home and local community.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People thought staff were friendly and caring. People said, “The staff have been first class in the short time I’ve been here,” “Most staff seem caring” and “Some of them are very caring and go out of their way to help me.” A relative also commented, “He can be resistant to personal care, but the staff are very patient with him, and he is always clean and tidy.”

Staff told us they enjoyed their job and caring for the people living at Downshaw Lodge. Staff appeared to know people well and how to support them. Staff gave examples of how they afforded people privacy and dignity when offering care and support. Staff also spoke about developing relationships with new people so they could meet their individual needs.

We were aware that Local Authority reviews were held with people to check that the care and support provided met their needs and was in their best interests.

We saw some staff engaged well with people. For example, one person asked why he could not see the TV picture moving (this was on a radio channel). The staff member patiently explained this to the person, then went through the TV channels until they found something the person wanted to watch. We observed some staff chatting with people and their visitors. Interactions were pleasant, with polite and good humoured. Whilst some interactions between people and staff were kind and caring, there were elements of care that did not meet the expected standards. Monthly reviews completed by managers in June and July 2024 identified issues in relation to maintaining people’s dignity. This included a high number of people not wearing footwear, being unshaven or with stained clothing. These issues were seen again during our observations. Our findings demonstrated a breach of regulation 10 regarding dignity and respect.

One relative we spoke with visited the service each day. They felt staff were responsive to their family members and understood their individual needs. Staff were patient and receptive to the needs of the people that they were caring for. People’s relatives had mixed views about the competence of some of the agency staff who were not familiar with people’s individual needs.

We spoke with long standing members of staff. They had a good understanding of people’s individual needs, wishes and preferences.

We observed some staff were more proactive than others when supporting the individual needs of people. Whilst some staff encouraged people to address their appearance, such as having a shave or change their clothes, others appeared more reactive, standing, and observing people, only assisting when necessary to do so.

Personalised information within people’s care plans outlining their individual wishes and feelings, likes and dislikes needed expanding upon. Training in equality and diversity and person-centred care was provided. Learning needed embedding in practice.

Not everyone had choice and control over their daily routine. Whilst some people were able to engage in activities others were not or chose not to take part. People and their relatives told us; “I have seen that they do activities each day but I’m not really one for joining in with them. I read my paper and watch the TV and that does me” and “He can no longer really grasp the activities, but the staff are very good with involving him in things that are going on. If they have singers on, they take him downstairs to see them.” People had access to necessary equipment to promote and enable them to maintain their independence. However, one person had little choice and control over their daily life. They told us, “I watch the TV in my room mostly as I haven’t got a wheelchair to go out of the room.” This was raised with staff who confirmed necessary equipment was needed to enable them to access other areas of the home and the outside community.

Activity staff spoke about how they tried to promote and support people’s independence. We were told activities were explored both in and away from the home, so everyone had an opportunity to take part depending on their needs and wishes. We were told recent events included a Blackpool themed event, with plans to visit the lights. Plans had also been made for a Halloween party, birds of prey, a remembrance singer who dresses in wartime clothing, and people planned to visit the cenotaph on Remembrance Sunday. Each Thursday people took turns to visit the local pub for lunch. Staff said for those people who chose to spend time in their rooms they would go in and chat with them, take them the papers and read to them.

We saw people’s routines varied depending on their needs and abilities. Some people required close observations from staff and were not able to freely move around the home, particularly on the 1st floor where door closures within the corridors appeared to be used to restrict people’s movement.

The aims of the organisation were outlined within the service user guide provided to people and their families. This details how people’s rights will be supported and promoted, enabling them to maintain their independence, following a lifestyle of their choosing. However, this was not always followed in practice. People’s care plans were not personalised detailing their wishes and preferences. Information did not reflect what was important to them and how they wanted to live their life.

People’s relatives said they had confidence in the staff and were kept informed of any issues or changes in need. The relative of one person said, “Any issues and they will phone me straight away. It’s a caring place.”

We were told communication systems between the team had improved so information about people was effectively and promptly shared. Staff also had access to ‘on-call’ support should any advice and support be required or in the event of an emergency.

We saw adequate numbers of staff were available. Staff supported people with specific care tasks when needed and appropriately responded when people became distressed.

The regional manager told us further employment had taken place with the appointment of new clinical staff, reducing the use of agency staff, so people received continuity in their care. Staff told us they did not have any concerns but if needed they felt able to speak with managers. Some staff did not feel everyone worked as a team. It was hoped this would be addressed by the new manager.

Staff were not provided with meaningful opportunities to provide feedback, raise concerns and suggestions to help improve the service or staff experience. Staff were provided with a handbook which include information about how the service supported staff in maintained their well-being. This includes a confidential helpline. Information also outlined the rights of staff and how they would be supported and protected in relation to areas such as bullying and harassment.