Norton 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 their relatives were not aware of the care planning process and had not seen a care plan. We were not assured people were receiving person centred care due to the lack of personal information held within care records. Staff told us they did not have the time to provide care in a way they knew was person centred. There was limited evidence of meetings held with staff, relatives, and people living in the home, therefore there was limited opportunity for information sharing to drive improvements within the service. People living in the home, relatives, and staff informed us they found the manager approachable and were able to share concerns. However, one staff member told us these concerns were not always acted upon. We identified that where people living in the home had raised concerns, there was limited evidence to assure us that these concerns had been addressed.

This service scored 39 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We found that people did not always receive person centred care, as care plans did not contain the relevant information regarding people’s needs, preferences and wishes. Feedback we received from people indicated they were not regularly involved in discussion about their care.

During discussions with staff, there was no mention of the home’s values and beliefs. Opportunities for staff to provide feedback on any ideas they had were minimal, although the manager was approachable. One staff member we spoke to told us, “I can raise things with [manager] but nothing ever happens.”

Care plans were not consistently accurate or up to date, and therefore did not fully capture people’s physical, mental, emotional, or social needs, including those associated with protected characteristics under the Equality Act. Care records lacked evidence that people were regularly involved in planning and making shared decisions about their care and support, limiting the ability to provide care that was truly centred around their needs. Observations indicated that care was often "task-oriented" rather than person-centred. For example, people did not appear to have meaningful choices about where or how they wished to spend their day or eat their meals. We observed 2 people sitting in the lounge for over 9 hours.

People and their relatives we spoke with told us they were not involved in their care planning. People were not aware they had care plans in place.

Staff told us that information sharing between day and night staff was poor and there wasn’t always a handover of information. However, staff working on shift together told us they work well together. One staff member we spoke with said, “We have a really good staff team.”

We were unable to obtain evidence to score this category

Processes did not consistently ensure continuity of care, support, and treatment for people. Care records identified that decisions about people’s care were sometimes made without consulting other relevant agencies, resulting in care that was not always coordinated or responsive.

People and their relatives told us there were no meetings to share information. Not all staff had received specialist dementia training, which made communication with people living with dementia difficult. Written information regarding people’s needs was not always accurate and up to date.

Staff informed us there were some staff meetings; however, they were not frequent, and not all staff members attended. The manager informed us meetings for people and relatives were advertised, however no one had ever attended.

Information was not consistently presented in a way that was accessible to everyone. For instance, one individual required communication cards to support their ability to communicate, but not all staff were aware of this need. Additionally, information was not always provided in formats that were easily understandable for people.

People and their relatives reported feeling able to raise concerns if needed. One relative told us, “If I have any issues ever, I feel comfortable to approach with manager who deals with it straight away.” However, resident survey responses indicated that 3 out of the 4 individuals had previously raised concerns, but there was no information to identify what steps had been taken to improve things for the people living within the service. All relatives and people we spoke with informed us there had been no meetings to enable them to share feedback and for information to be shared.

Staff we spoke with told us they could raise a concern, however not all staff thought they were listened too.

Processes for sharing of information were poor. Whilst staff meetings did take place, they were not frequent and not attended by all staff. Updates shared at staff meeting in June 2024 had still not been actioned at the time of this assessment. This included creating a staff room for staff to use.

People were not actively involved in their care planning, making it difficult to evidence that people were provided with the opportunity to be in control of their care and support.

Staff we spoke with ensured people were supported to appointments were possible. We observed a staff member attending the home on their day off to support a person to their appointment. We were informed by staff this was to ensure people could get to their appointments and the home was not left short staffed. One member of staff told us, “I am not even sure I am being paid to come in to take [person] to their appointment, but they [person] need to go.”

We were unable to obtain evidence to score this category

Not all staff had received training on equality, diversity, and inclusion. Limited opportunities for people and their relatives to provide feedback meant there was no evidence that the provider was actively listening to people to ensure they could access the care and support they needed or desired. The home’s design did not effectively support or promote independence, particularly for individuals living with dementia. Additionally, the service did not ensure that all individuals, regardless of their communication abilities, had a voice in their care or access to advocacy services when needed.

Due to people not being involved in their care plans, outcomes documented were not personalised.

Some staff complained about the lack of handover and the continuity of care between day and night staff. Staff we spoke with told us they knew people well and enjoyed their job because of the people who were living in the home. However, they expressed frustration at the staffing levels, as it prevented them for doing their job effectively.

Care plans did not provide evidence that people were actively engaged in their care planning or in defining meaningful goals and outcomes. Consequently, there was limited assurance that the provider effectively empowered people to share their views and preferences.

We did not see any evidence of people being encouraged and involved in planning for their future.

We were unable to obtain evidence to score this category

We identified some people had end of life care plans in place, however we were not assured people had been supported to make these choices about their future care. End of life care plans that were in place did not always contain correct information. One person’s care plan stated to inform family about any changes, however the care plan also stated they had no family. Only 6 staff members had received end of life training. Therefore, we were not assured that people, when it was their time, would receive end of life care tailored to their individual wishes.