Littleton Lodge

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People’s needs were assessed, reviewed and discussed to ensure people received the most up to date treatment, care, and support which was in line with good practice and individual choice and preference. We found however; people’s care plans required further specific detail to ensure staff had detailed information to follow. External health and social care professionals supported the care staff to provide guidance and support, so people received quality outcomes, although some felt the communication could improve. People were supported to maximise independence, choice and control. People were encouraged to make their own decisions, and the required support was offered to enable people to do this. When required staff sought support to ensure people were in receipt of the best care possible.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were happy overall about the care they received and were able to speak with staff and management about their care needs. However, some people we spoke with wanted more opportunity to be involved in their care planning reviews. This was fed back to the registered manager who confirmed they would ensure people, and their relatives were involved in and had access to their written records. One relative told us, “I think they [Person’s name] had a care plan, but I have never seen it or been involved in it”.

Staff we spoke with confirmed they had enough information to meet people’s needs. They found working with the team and getting to know people was how they obtained the correct information about people’s assessed needs. Some staff members found people’s care plans required further information, however, they were confident of their knowledge of people and what was important to them, without specific information in care records. Staff recognised a change in people’s needs or a deterioration. Staff raised concerns with senior members of staff and the management team to ensure required attention was sought and care records reflected any updates.

Staff and leaders used assessment tools to ensure people’s needs were reflected and understood. The registered manager was in the process of updating people’s care records to ensure they contained required information for staff to follow to effectively care for them. The provider adopted a resident of the day process, where each person’s care record was reviewed monthly to ensure it remained accurate and up to date.

People’s care and treatment was reviewed and discussed with required health professionals which ensured when advice about health, care and support was required, it was readily accessible and available for people.

Staff sought advice from other health and social care professionals about people’s care needs as and when required. The management team worked well with partners to ensure they were up to date with good practice and required standards of care.

The provider had processes in place to ensure people’s care records were reviewed and up to date. Whilst we found care plans required further specific information, the registered manager demonstrated a care plan they updated to include this detail. This would ensure staff were supported to deliver effective care.

People shared positive responses about the permanent members of the staff team, however, some felt the agency staff members did not always support them as effectively as other team members. One person told us, “A lot of agency staff can’t speak English well. I don’t understand what they say to me.” People and their relatives provided mostly positive feedback about input from visiting professionals. One relative told us, “I have regular meetings with the mental health team that come in to talk about [Person’s name] condition.” Another relative confirmed, “[Person’s name] had a sore on their ankles, and they [Staff] have really looked after them and got the Doctor in, they got the Chiropodist, and they got the incontinence nurse out when needed.” Some people and their relatives felt GP visits could increase and access to dental care could be improved.

Staff told us they worked well together and there were processes in place to enable them to effectively share information about people they cared for. Staff confirmed they received and shared regular updates about people including their care, wellbeing, likes and preferences. The management team had handovers with staff to ensure essential information was shared as required. The registered manager told us said, “Staff are aware and see signs with people, they like to keep an eye on what is going on, they know the residents well. Staff know and share any concerns.”

External professionals provided mixed reviews from working within the service, some felt staff reported and acted on concerns raised efficiently, others felt an increase in communication was required to ensure people’s care needs were consistently met. One professional, however, told us, “They [Staff] seem to be very quick to have sorted out likes, dislikes choices and preferences of people as they move in.”

The provider had processes in place to ensure staff members were aware of any updates or changes to people’s health conditions. We found where some care records required updating to reflect a change in a person’s need, the registered manager confirmed they would ensure this would be completed. The processes in place reflected what people, staff and partners had told us.

People received the care and treatment they required, and support was available and accessible to support people to live healthier lives. People had access to information about their health, care and support and this enabled people to make informed decisions about their health needs. Staff encouraged and supported people to maximise their independence. People and their relatives informed us of how people had regained their independence following their admission at Littleton Lodge. One person shared their mobility progression, they confirmed when they arrived at the home they depended on the use of a wheelchair, since living there, they now walk with support and no longer required their wheelchair. This meant this person had increased their independence, which resulted in a positive outcome for their health and wellbeing. The person told us, “I feel safe and comfortable, they [Staff] look after me very well really.” We were told of another example where a person’s mobility had increased since living at Littleton Lodge. The person’s relative informed us how staff maximised and encouraged the person’s independence. The relative told us, “They [Staff] look after [Person’s name] really well, the staff have got them mobile, and they [Staff] are not taking independence away from [Person’s name], they are trying to help [Person’s name] gain more, they cater to [Person’s name] needs.” This provided the person with positive outcomes and supported them to live a healthier life.

Staff supported people to manage their own health and wellbeing, where possible, and worked alongside health and social care professionals to maintain people's health and well-being. One staff member told us, “The staff are all great, the staff are a really good team. That’s how we work, as a team, it’s not them and us, we all work as a team.” Another member of staff informed us of seeking health professional support for one person when using a piece of moving and handling equipment was no longer meeting their needs. The member of staff told us, “We [Staff] have spoken to the Occupational Therapist (OT) and General Practitioner (GP) about this. [Person’s name] now has a hoist which is a lot better and a lot safer.”

The provider had effective systems in placed to enable people to live healthier lives and this was evidenced by the care we observed people receiving.

People received coordinated care and were treated well and as an individual. People were seen and treated as individuals each having their own needs assessed and reviewed.

The management team worked with care staff to ensure people’s outcomes were positive and consistent. Staff took the initiative and raised any concerns, and shared information effectively to ensure people’s care was monitored in a timely way. There were continuous improvements made to people’s care and treatment.

The provider had effective systems in place to monitor people's health conditions and improve their outcomes. People’s care records showed where people’s health needs required regular monitoring. Staff documented as required to review any changes or identify if further monitoring was needed.

People’s consent was gained before staff supported them. We observed staff asking people for their consent prior to delivering their care and informing them of the specific support they were providing during their care delivery.

Staff we spoke with told us how they supported people to make their own decisions and in line with people’s best interests. We observed staff supporting people to make decisions about their day-to-day care and treatment. Staff were patient and supportive in enabling them time to process their options and make their decisions. Staff had completed Mental Capacity Act Training and told us how they used the training to ensure people were given choice and control over their care and treatment needs.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguarding (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. People’s care records contained mental capacity assessments, as needed. Where necessary, Deprivation of Liberty Safeguards (DoLS) applications were made to ensure where people were being deprived of their liberty, records we reviewed showed this was done lawfully.