Downshaw 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

People and those important to them were not involved in the development of their care records, reflecting their individual needs, wishes and preferences, including how they wished to be cared for at the end of their life. Information was not provided in an accessible format such as different languages and print so people understood information held about them. Opportunities to seek people views about the service and their experiences were needed to help identify and drive improvements.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and those important to them had not been actively involved in the assessment, planning and reviewing of their care records reflecting their individual needs, wishes and preferences.

Staff told us new staff would spend a period of time shadowed more experienced staff, leaning about people and the support they wanted and needed. Staff said they were kept informed of people’s changing needs through the handovers and group chats. Staff told us they had received training in person centred care and dementia awareness as part of the programme of e-learning.

We observed positive interactions between people and, their relatives and staff were polite and friendly. Most staff had a good understanding of people’s needs and were aware of their likes and dislikes, whilst other staff were task focused.

People had access to services to help meet their individual needs.

Staff told us the service worked closely with people and their families to make sure they received care and support that met their needs. One staff member told us, “The more information we have the better it is for the individual.” Staff training was provided in Person Centred Care.

The local authority continued to monitor and review the service in line with their commissioning arrangements.

Staff were notified when people’s needs changed so that they could continue to provide person-centred care. Any changes to care and support were reflected on the app that staff logged in to prior to delivering care and support.

Not everyone was provided with information in a way they could understand.

Staff were aware of people's communication needs and how to support them. However, there was little in place in relation to accessible information standards. Staff said they did not have specific equipment to support people’s sensory needs.

People’s care records required further development, so information was personalised and clearly outlined their ability to communicate their wishes and feelings. People’s information was securely stored. The service had introduced a picture board displaying the daily menu. However, this did not reflect what was being served that day. We were not assured that the accessible information standards were met such as providing information in a different language or different size print to people where needed.

There was little evidence that people and those important to them had been involved in the planning of their care and support or their views sought about living at Downshaw Lodge. Some people’s relatives regularly visited the home and appeared to have a good rapport with staff. We were told they felt able to raise matters with staff should they need to. Comments from people and their relatives included; “[Staff member] is brilliant, she checks on him for me and keeps me in the loop. I’ve no complaints and I would definitely recommend the place to others” and “I’ve never had to make any complaints.” One relative said they had raised a concern about their relatives belongings going missing. This had been raised at a recent meeting however had yet to be resolved.

Staff said they tried to involve people and their families as much as possible. Staff were seen to have a good rapport with people’s visitors, interactions were polite and friendly.

People were provided with a copy of the service user guide which outlined what they could expect from the service and what to do if they had any issues or concerns. This information needed updating in relation to the local authority details and the sharing of information with the Care Quality Commission. Information also stated regular resident, and relative meetings are held to enable everyone to have an opportunity to discuss their concerns and their suggestions in aspects of the running of the home. Whilst these had not taken place on a regular basis a recent meeting had been held and plans were in place for a further meeting. The guide also outlined feedback surveys would be sent out to people and their relatives to complete. Responses would be summarised and displayed within the home. The care manager would also be available to discuss any concerns and ran a manager’s surgery once a week where people or their relatives were able to drop in. Whilst people felt able to speak with managers and staff we found no evidence surveys and surgery’s had been carried out.

People were supported to access a range of services to help maintain their emotional, social, and physical well-being.

Staff understood their responsibilities in supporting people to access the care, support, and treatment they needed. Staff had a weekly contact with a GP to discuss people’s health needs and raise any concerns.

We didn’t receive any direct feedback from partners in relation to this category, but we are aware people were supported to access relevant healthcare services available to them.

Care plans did not always clearly demonstrate how people’s healthcare needs were to be met. The service had a contingency plan in place in the event of an emergency. On-call staff were also available to offer additional advice and support outside of ‘office hours’. The building was adapted accordingly to meet people's needs. Relevant aids and adaptations were in place to aid people’s safety and mobility. All areas were accessible and serviced by a passenger lift. There was level access to the home, which was easily accessible by wheelchairs and ambulances.

We received mixed feedback about activities and opportunities. Not everyone was able or wanted to join in the activities. We were told, “They have activities people who are very good, but some of the activities are a bit childish for me but I will help out occasionally.”

Activity staff spoke about exploring opportunities for people in the local and wider community. Where this was difficult for some people due to their individual needs, events were arranged in the home, so people were able to participate. Staff had developed a good relationship with a local pub, which people visited each week. Staff said under the previous management they did not have a budget but some money was now available each month. Staff said they also provided additional support for some people, so they too were able to access the local community.

The home had an open visiting was policy, which was confirmed by people’s relatives. People’s right to family life was encouraged and respected. Robust systems were not in place to ensure lawful restrictions were in place, so people’s rights were not always protected. Information was available about advocacy support available for people, where necessary. Training in equality and diversity was completed by staff to help develop their knowledge and understanding.

When speaking with people living at the home, they were not able to or did not wish to discuss this information.

Nursing staff spoke about how the service had supported people who were at the end of their life. Staff said they would liaise with other healthcare teams to ensure people had the equipment and treatment needed to ensure their comfort and safety. We were told one person remained in hospital until such time they were stable and appropriate arrangements were in place to provide the care they now needed.

A policy and procedure was in place with regards to end of life care. This referred to staff having responsibility to complete relevant training. However, training records provided showed end of life care training was not provided. The procedure also outlined advanced care planning, plans in the last weeks of life and involvement of family would be in place outlining peoples wishes. However, a review of care plans provided little information in relation to how people were to be cared for at the end of their life.