Littleton 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’s care needs were assessed and planned for. People received person centred care and were empowered to make decisions about their care. People were involved in the planning of their care and support provided was inclusive. People’s care plans required updating to ensure they provided staff with specific information to follow. People were able to make plans for important life changes and the provider was in the process of ensuring people were a part of their care to ensure they were in receipt of the best care possible at the end of their lives.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received person-centred care and staff ensured they responded to any changes in their needs. Whilst staff knew people well and delivered care tailored to them, their needs, wishes and preferences, their care records however, did not always include specific information. Some people and their relatives also confirmed they would like to be involved with compiling the written information for their care planning records. One relative told us, “[Person’s name] care plan may not have been updated, I don’t know, I don’t think we’ve seen it.” We spoke with the registered manager who showed us an example of an updated care plan which actively involved people through the review process.

Staff spent time getting to know people and ensured they delivered care in a way which fully involved people, their likes, dislikes and preferences. Staff provided people with choices and asked for their input regularly in case any aspect of their care had changed. Staff told us about one person whose first language was not English, and as their health deteriorated their understanding of the English language was decreasing. Staff therefore learnt phrases in the person’s first language to help the person understand what staff were saying and doing when delivering care. Staff we spoke with confirmed they knew people well and they supported people with their needs in line with what people told them and from the information within the care plan documentation. Whilst some staff informed us, they felt some care plans required further information, they confirmed they knew how to support people. The registered manager confirmed care plan updates were in progress.

Staff fully engaged with people, throughout our inspection, consistently listening and responding to people's requests. People were encouraged and supported to take part in things of an interest to them through different opportunities. For example, a tree displayed people’s wishes and staff supported them to be granted. Following one person’s request, they visited the stadium of their favourite football team and watched the match live. Another person stood behind the till in a local supermarket, following their request to do this ‘one last time’. People had opportunities to attend different cultural and occasional celebrations, for example to celebrate Pride Month, the provider arranged for a local drag artist to embrace diversity within the home. An outcome form following this event documented, “Residents had a wonderful time and danced the night away”. Pride Month is a dedication to Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex, Asexual (LGBTQIA) +, their voices, the culture and support of LGBTQ+ rights. Other celebrations people could attend included National Nurses Day, International Owl Day, and Diwali celebrations, which included external visitors with expertise in Bhangra Dancing to teach people living at Littleton Lodge. Bhangra is a Punjabi folk type dance. One person also visited the local primary school to read books as part of National Story Telling Week. All of the events included a documented form to review the outcome of the activity.

People received pre assessments prior to living at Littleton Lodge, which included input from all involved in their care to consider and share the most up to date information. One relative told us, “They assess [Person’s name] each time they are in hospital as well as when they were first admitted.”

Staff were responsive and worked flexibly to meet people's needs and ensured consideration was given to their protected characteristics. The management team ensured people’s needs were reviewed prior and during their admission to the home, to ensure Littleton Lodge was and remained a suitable place to meet their risks and needs. Staff liaised with people and their relatives, where appropriate, to ensure care was delivered in a way which was meaningful for people in line with their wishes and preferences.

External professionals working with people and staff at Littleton Lodge, provided mixed reviews about the service. One professional told us, “The home is also a little bit proactive and phone when things change for a person.” Whilst another told us, “Staff are not always following advice given, they should be accompanying us on the visit, but it is not often they do”. The health professional advised they raised this with the previous registered manager, but they had not yet raised it with the current manager. With their consent we raised this with the registered manager, who confirmed they had already identified staff were not gaining effective handovers following visits with the district nursing team. In response, the registered manager has implemented the newly appointed front of house member of staff to direct the nursing team to a member of the care staff team on their arrival. They have discussed with senior staff members to gain an update and handover following professional visits, the registered manager confirmed this would help ensure staff can effectively monitor wound care for example. Following our feedback the registered manager confirmed they would reinforce this practice with seniors and feedback to the district nursing team to make them aware of the action taken.

People’s care records were reviewed regularly to ensure changes in people's needs were followed up and actioned as needed. The registered manager was in the process of updating people’s care records to include specific details for staff to follow.

People had access to information and confirmed they could speak with staff or the registered manager when they required further details or information about a specific issue. Some people and their relatives felt they did not always have access to people’s care plans, and this was something they would like to review and be a part of.

Staff confirmed they had access to information including policies and procedures and information relating to any changes to people’s health needs or risks. Some staff told us people’s care plans required further information, however they confirmed they were provided with enough details about people through speaking with people, handover discussions, team meetings and working with staff to deliver people’s care.

The provider had systems in place to ensure people had access to information. The information was obtained and stored securely in line with data protection processes. The registered manager was in the process of updating people’s care plans and ensuring people and their relatives had input and review of the care records. People received information in line with the accessible information standard and the registered manager confirmed they would make adjustments where required to meet people’s communication needs.

People had the opportunity to feedback their views and thoughts about the service and ways they felt it could improve. People attended regular meetings where their voices were heard and listened to. We saw minutes of meetings which had been held involving people. People told us they could speak to any staff member at any time. One person told us, “We have regular resident meetings, they are helpful, for example, we had these silly serviettes that were silky, and I raised that they kept falling off your lap and now there’s cotton ones.”

Staff encouraged people to have a view about the day to day running of the service and the care they received. People had access to the complaint procedure and information on how to do this was displayed around the home. The provider kept records of complaints which were responded to and investigated in a timely manner. Records of compliments were also kept and used for some staff as evidence of their continued professional development. The Lifestyle Manager informed us they spent time with people in groups or on a one-to-one basis, whichever suited the person best, to gain people’s input into the service. This included their views, likes and dislikes and suggestions to improve aspects of the home and their care.

The provider had effective processes in place which underpinned and supported the good practice staff delivered in relation to listening and involving people. The service was trialling an alternative staff deployment approach, in response to people’s feedback from the resident meeting about staff members changing too regularly.

People were treated equally and treated as individuals. People felt respected by staff and other people living at the home.

Staff confirmed they were respectful of people's diverse needs and treated everyone in a fair and equitable way. The registered manager made reasonable adjustments for people as needed, for example, through equipment to support people with sight loss.

Professionals supporting people living at Littleton Lodge felt people were cared for in an inclusive way.

Staff provided people with reasonable adjustments when required and the processes in place supported this.

People we spoke with did not express any issues or concerns around inequality in experiences or outcomes. People received person-centred care which was tailored to their individual needs and preferences. One relative did inform us they felt people who were visually impaired were not always kept informed of the activities scheduled and felt this could improve to ensure everyone had access to this information.

The management team and staff were trained to support people with diverse needs and understood the importance of meeting the needs of people with protected characteristics. When people's needs changed, equity of access was considered.

The provider had effective systems in place to ensure people had access to care, treatment and support. The registered manager complied with legal equality and human rights requirements.

People made informed choices about their care and some people had discussed plans for their future care needs and wishes.

Staff respected and supported people with making decisions and choices about their care needs.

People’s care records included the completion of do not attempt to resuscitate forms informing staff and medical professionals of their requests. The provider supported people and their relatives to use ReSPECT forms to gather their wishes for end-of-life care and treatment. ReSPECT forms are a record containing a summary of people’s wishes for emergency care and treatment. The registered manager had devised a new care plan which contained specific details about people’s care. The new care plans included detailed information about people’s future plans, wishes and preferences in relation to their end of life.