- Care home
Shore Lodge - Care Home Learning Disabilities
We issued Warning Notices to Leonard Cheshire Disability on 3 April 2024 for failing to meet the regulations relating to safe care and treatment, need for consent and good governance, management and oversight at Shore Lodge – Care Home Learning Disabilities.
Report from 8 February 2024 assessment
Contents
On this page
- Overview
- Kindness, compassion and dignity
- Treating people as individuals
- Independence, choice and control
- Responding to people’s immediate needs
- Workforce wellbeing and enablement
Caring
We assessed 2 quality statements in the caring key question and found areas of concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Though the assessment of these areas indicated areas of concern since the last inspection, our rating for the key question remains good.People were not supported following ‘Right support, right care, right culture’ guidance. There were not always enough staff to meet people’s needs when they required support. People were not able to eat together or go out together. Staff did not always treat people in a dignified way or used undignified language when they referred to people. Staff did not always have the skills to communicate with people effectively.
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.
Kindness, compassion and dignity
We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.
Treating people as individuals
Relatives told us that people’s individual needs and preferences were understood and they could get involved with people's care planning. One relative said their loved one, “can make [their] needs known” and added, “if anything does come up we ring the manager or assistant manager and they sort things out and they listen to us”.
Staff told us the minibus could only take 2 people in wheelchairs at one time. 7 out of 8 people used a wheelchair. Staff said they were limited in being able to take people out. Staff told us the minibus had recently required repair and was therefore off the road. People were not able to go out during this time.
Staff did not always support people to express their views using their preferred method of communication. Staff were not trained to use a specific communication support tool with people who expressed themselves using that method. People’s bedrooms were bare, with little in the way of personal items or a reflection of their personality or favourite colours. Bedroom furniture was grubby and scratched. One person’s clothes were in their wardrobe in a crumpled heap, no item of clothing was hanging up. People’s en-suite toilets were cluttered with equipment and clearly not used.
People’s individual needs were not always met. Although personal information was included in people’s care plans, these were not followed up in practice. One person’s care plan said their religious and cultural needs were met by the day centre and their family. However, they no longer attended the day centre, and a replacement was not in place. Another person’s care plan stated they were Roman Catholic but no longer practiced their religion. The person was non-verbal and there was no explanation how this was known. The person had a Roman Catholic religious artefact hanging on their wall which would suggest it was a personal item that may have been important to them. One person’s care plan recorded they used a specific sign language as a communication method. No staff were trained in the communication method to support the person to be involved in their care and support and to prevent social isolation. There was no evidence people, or their family members, had been involved in planning and reviewing their care. We found instances of undignified language in some people’s care records. One person’s record stated, ‘Seems to want more attention. If not instant shall be aggressive’. The person experienced episodes of anxiety and distress.
Independence, choice and control
People were supported to see their friends and family regularly. One relative told us that their loved one, “comes home every other weekend and [the person] is more than happy when [they] return”. Another relatives told us, they were welcome to visit their loved ones at the service when they wished, “they make us feel welcome, make us a cup of tea”.
Staff told us about activities and days out that were planned for people and about the importance of finding things to do with people that would make them happy. One staff member told us, “we go to Dartford Park, Shorne Country Park, the Prom at Gravesend, watch the boats go past” and “they like to go to Bluewater and get food” and “trips to the coast sometimes when it’s nice”. However, accommodating people was a challenge, staff told us “we’ve got a lovely big minibus but it only takes 2 wheelchairs”.
Staff did not always support people so they had control of how they wished to spend their time. During our visit, we saw that some people were left unsupervised for long periods and they did not have the right support when they became distressed. People were not given a choice of food. During our site visit, people were served quiche, potatoes and vegetables. People were not asked if this was what they wanted, staff told people, "we have quiche potatoes and veg".
Some people's care plans said they loved to meet people and liked going to the day centre. People were no longer going to the day centre. Opportunities to meet people had not been considered and there was no explanation why people no longer went or who made the decision. Opportunities for people to access the outdoors and their local community relied on the availability of the provider’s minibus. Only 2 people were able to use the minibus at any one time. Sometimes the minibus was used to take people to hospital appointments so was unavailable at these times. This meant people were not able to go out when they chose. When people’s capacity was assessed to determine their ability to make specific decisions, there was no evidence that individual communication methods had been explored to take account of people’s communication needs. Staff only used Verbal communication, many people did not use verbal communication.
Responding to people’s immediate needs
We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.
Workforce wellbeing and enablement
We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.