Byron Lodge Care Home Ltd

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

The provider had systems and processes in place to understand the diverse health and care needs of people living at the service. The service was being supported by a frailty nurse from the GP surgery and the GP, all of whom conducted regular visits as well as support by telephone. People had care plans in place, they had not always been involved in developing these. Some care plans were not as detailed as they could be to help staff understand people’s care and support needs. We observed communicating effectively with people. There were way marking signs and information around the service to help people orientate. Menus and activities were on display, these were available in different formats on request. People attended meetings with the management team to feedback about the service.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they had not been involved in developing their care plans. However, people told us, “They look after me very well” and “The staff know how I like to be supported.” We discussed activities with people. They told us, “The staff will let me know what is going on and I can then choose what I want to do go to the lounge or stay in my room”; “I like to stay in my room as I am in a lot of pain when I move and enjoy doing my crosswords and watching quizzes on television” and “The staff will ask what I want to do.” People had personalised care plans in place. Some were quite detailed, others required reviewing to ensure staff had all the correct information. For example, 1 person’s care plan did not detail the size of catheter bags to be used and what signs staff needed to look for if the person had a urine infection. Diabetes care plans were in place but were generic, so they did not detail what range of blood glucose levels were normal for the person. did not fully correspond with information that had been shared at the daily briefing about their mental health needs.

The management team said, “We would like to see and encourage more family involvement in care planning and reviews and one aim is, with the person’s consent, to make [care plans] accessible for relatives to view (not edit/amend) but to see logs and care plans. We also want to make activities and opportunities for social stimulation more meaningful and at the level they would enjoy best; if we can sustain people’s interest in the hobbies they had, reignite happy memories and former knowledge. The management team explained they planned to recruit another activities staff member. A staff member told us, “Many people are able to tell us exactly what they like or don’t like and we make sure that this is in their care plan.”

We observed staff supporting people in a person centred way, offering reassurance and kindness. We observed that activities schedules were on display which showed a variety of activities on offer. These included: church services in the lounge and visiting clergy, singers, visits from children, choirs, arts/crafts for the summer fete, board games, bingo, shopping trips, reminiscence sessions, movie and snack afternoons, singalongs, games to encourage movement such as throwing games and the monthly “Around the World Day”. We observed no activities took place on the day we visited the service as the activities staff member was on holiday.

We observed some good practice with staff responding with kindness and compassion, tailoring their responses to people’s different needs. Staff were courteous and kind with people, listening and respecting their personal choices and were at eye level and speaking quietly and respectfully with people. For example, asking questions like, how are you feeling today? How did you sleep? What can I get you? Where would you like to sit? Are you feeling hot in here?

Staff told us that there was continuity of support for people living at the service. Most staff had worked at the service for a long period of time. The management team told us agency staff were occasionally used to provide care and support when there had been absences. Agency workers were staff that had worked at the service many times, so they knew people and the staff well.

A healthcare professional gave us positive feedback about the service. Staff supported people well and took timely and appropriate action when people’s health changed.

The provider had systems and processes in place to understand the diverse health and care needs of people living at the service. The provider ensured care was joined-up, flexible and supported choice and continuity. For example, when agency staff were used it was staff members that had been used before.

We observed there was some way marking in place to help people navigate around the service. Doors to people’s rooms were the same colour and had little personalisation on the outside. However, most people did not walk around the service independently so this had little impact on the people. Communal areas such as toilets, bathrooms, dining room and lounge were signposted with pictures as well as words and there was some waymarking, for example, on the lift door there was an arrow pointing down indicating the dining room was down in the lift. The menu and activities schedule were on display, these were available in an accessible format.

The management team told us, “Our residents have different communication needs, and these are exploited to get their voice heard.” They gave examples of a person using a picture board and stylus to express their wishes about the style of haircut they wanted when the hairdresser was visiting. They also told us about another person who used laminated picture cards to communicate. We observed staff using these with the person during the assessment visit. The management team told us, “We have a welcome handbook which can be transcribed into any format such as braille and pictures.”

Since 2016 all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard. The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication. The accessible information standards were followed. Care plans detailed people's communication needs. Complaints processes were on display, menu and activity information was on display.

There was mixed feedback from people about how well they were listened to and involved. People could not always remember about being asked for feedback or attending meetings. A person we spoke with said, “I will chat to staff if I need to.” All relatives we spoke with said they have never had cause to complain about anything but felt confident that anything they may raise would be acted on promptly.

We observed good practice from staff in relation to listening and involving people with the care and making decisions. The management team told us, “We send out regular emails with updates and we get lots of feedback this way.”

The provider shared with us meeting records to show that they had met with people living at the service. The last meeting had taken place on 24 April 2024. Only 6 people attended along with 4 relatives. The meeting records showed they discussed communication, redecoration plans, activities and outings. The management team had commented in the meeting records that generally the meeting attendance was poor and meeting times and days had been changed to see if this improved attendance. It was not clear from the meeting records how people who spend time in their rooms or those that were cared for in bed were involved in providing feedback.

People were supported with medical appointments and follow up appointments. People told us they had access to the nursing staff within the service as well as visiting health professionals.

Staff gave us examples of when they had recognised people were not acting in their usual manner and the action they took. For example, if a person was experiencing a seizure. Staff were knowledgeable about how to recognise signs of deterioration and care workers and nursing assistants said they would report health changes to the nurse on duty if necessary.

A healthcare professional told us staff at the service were good at escalating concerns in health deterioration or changes in medical condition to ensure that timely action was taken.

There were processes in place to ensure that people could receive care, support and treatment when they needed it. The GP carried out a weekly ward round and the service received healthcare input from a visiting frailty nurse weekly. People were also supported to attend healthcare appointments at the hospital when required. Records showed that TVN’s (Tissue Viability Nurses) provided input and support to manage wounds where people’s skin had broken down.

People told us, “They support me the way I want to be supported. I sometimes like to have a nice soak in the bath” and “I do as much as I can for myself, they help with the bits I can’t reach.” A visitor said, “The staff know how she likes to be supported and know her well.”

Staff knew people’s care routines and risks well. We observed that staff used effective communication when supporting people. The management team told us, “We ensure staff are up to date with the relevant training and have learned to keep with people’s changes. We have made care plans more personalised and move beyond the generic statements like ‘We prompted’ to describe how we prompt, encourage, educate, and support our people.

The processes to gain people’s views and experiences were in place. Meeting records showed that only a small number of people had attended the last residents meeting. Some people we spoke with were unable to recall attending a meeting or being asked to feedback. The provider may wish to consider how they will gain feedback from people who do not attend the meetings to make these more inclusive and to ensure people whose voices are seldom heard are included.

Records showed that people were supported to plan for important life changes. Conversations with people had taken place about advanced care wishes and people’s wishes had been recorded.

Information for staff about people’s wishes were recorded in their care plans. Staff shared how they had supported one person who was a practicing Muslim at the end of their life. They worked closely with the person, their family and the funeral company to ensure they fully understood what actions they needed to take at the time of the person’s passing.

The provider had systems and processes in place to understand the diverse health and care needs of people living at the service. Some people had a DNACPR (Do not attempt cardiopulmonary resuscitation) form in place. This is an advanced decision not to attempt CPR. It is not about other treatments or care. People had ReSPECT (Recommended Summary Plan for Emergency Care & Treatment) forms in place. A ReSPECT form records a person's wishes about a range of care and treatments. End of life care plans were as comprehensive as the person wanted it to be and plans were clear in cases where people had chosen not to discuss this element of their care. The service provided a lot of care to people at the end of their lives. The management team were passionate about providing training for staff in this area. They worked closely with the hospice teams who had recently provided training for staff in using equipment to provide people with medicines at the end of their lives to keep them comfortable and pain free. More training in this area was planned for staff who were unable to attend previous sessions. People were appropriately referred to dementia specialists, speech and language therapists and occupational therapists when this was required.