Horsell 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 received personalised care from staff who knew them well and took opportunities to spend quality engagement time with them. The provider had been responsive in dealing with an environmental emergency at the service which meant people could stay in their home. There were opportunities for people to be involved in the running of the home, and information was available in a format that was accessible to them. People at the end of their life received compassionate and pain free care.

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 said they were happy with the care they received, and felt the staff were good and knew them well. Comments included, “They do their best here. They are good, very good I think”, “They are very satisfying. I am very happy” and “They do a good job. I can’t complain.” A relative told us, “[Family member] can be in a dark mood and [wellbeing coordinator] can come in and his face will light up. She has an affinity with people.”

Staff told us they enjoyed their work and loved caring for people. Overall, staff thought people’s needs were met and they usually had time to provide quality care to people. One staff member said, “Recently we have had more time to spend with people and spend quality time with them. Like one on one. You learn so much from them, listening to them and finding out about their life.” Another staff member told us, “It is about what the residents want. I totally respect them. If they ask something, we try to make it happen. Today for example, gardening club was cancelled because of the weather so people were given another choice. We asked them. They said they did not want to play the word game, and suggested Bingo. So we did bingo and they enjoyed it.”

People were happy and engaged with the staff on duty, who attended to people’s needs promptly. There was a hair salon available which we observed people using during our assessment. There were a range of activities taking place throughout the home. Staff were attentive, offering drinks and snacks to people.

On the whole, people and their relatives felt the continuity of care had improved since there had been a more stable staffing team in place. One relative said, "We see the same staff. It has been more or less the same people since [family member] moved here. The staff are very accommodating, very friendly. They have helped [family member] settle in well.” People also confirmed that staff would support them to attend and make healthcare appointments if required. The home had recently had to manage the effects of a flood in the basement and kitchen. A relative told us, "It has been very challenging for them, but they have coped very well with it; it was business as usual for the residents. Accolades to all of them.”

The registered manager informed us the home currently does not have enough permanent nurses employed to provide nursing care. The home is therefore not admitting people with nursing needs. The registered manager said no one living at the home at the time of our site visit had nursing needs. Despite the upheaval of the service’s kitchen and there being no permanent chef employed, people received quality meals. We spoke with the long-term agency chef who knew people's needs and preferences.

As stated at the beginning of this report, we carried out this inspection due to concerns raised around the continuity of end of life care provided by the service. However, we identified no concerns in the area. There was good anticipatory care planning, Another stakeholder told us, “I feel the home managed pretty well with the flooding situation. The Manager explained that the sewage flood has been a challenge, but she and the staff have managed. Environmental Health visited a couple of weeks ago and felt the home was managing well.”

In November 2023, the home’s basement had been flooded due to an accident during construction work being carried out on a site adjacent to the home. The basement housed the home’s kitchen and food storage areas, which became unusable as a result of the flood. This presented a substantial challenge for the provider. The registered manager told us the management team had to consider closing the home and moving all residents to alternative accommodation. Having considered all available options, the management team made the decision not to close the home, but to arrange temporary buildings to be delivered to the site which would house kitchen and food storage facilities. This management team made this decision on the basis that it was the best option for residents, as they would not be forced to leave their home. It was clear from speaking to residents and relatives that the provider had managed this challenge extremely well, minimising any disruption to residents and preventing them from having to move to temporary accommodation. The provider was able to continue providing residents’ meals from the temporary buildings until the kitchen had been replaced. The newly refurbished kitchen had opened shortly before our assessment, which meant arrangements for food preparation could return to normal.

People had access to information in formats that were accessible to them. If people had specific communication needs, these were recorded in the care plans and understood by staff.

Staff felt the appropriate support was in place to ensure information was available to everyone using the service. In the provider’s information return, the registered manager told us, “We review each resident individually based upon their needs, we use numerous different ways to communicate with residents; we offer one to one activities, we have picture menu boards, large print books. Our residents are family and we take the time to get to know each of them individually and the ways they wish to communicate. We record this information in the care plans and also in their social/activity care plan.”

People’s communication and information needs were assessed during pre-admission assessments. Any needs identified were communicated within people’s care plans and were flagged on the provider’s electronic care system. People were supported to understand written information with one-to-one support from staff. Information was also made available in an ‘easy read’ format.

People said they felt involved and consulted in the running of the service. Their comments included, “Yes they consult me. There is a lot of information and they do listen to me” and “Yes they do ask me what I want. They are nice and listen to me.” People told us their views were listened to and acted upon. They said residents’ meetings took place regularly, and they were able to give their feedback about the home through satisfaction surveys. One person told us, “If you say something, they are responsive. [Hospitality manager] has been very good and made changes to the menu to accommodate me.”

The registered manager provided examples in the provider information return (PIR) of how residents were listened to and involved, stating, ‘We ensure our residents are at the centre of all we do by listening and engaging with them. Our residents were instrumental in the design of our summer project `Grandma`s Cottage`. We promote and encourage our residents to lead activities groups such as Bible Study and Arts and Crafts. We have used local Advocacy Services to support one of residents living with Dementia with decision-making on where she lives and how she can continue to engage and be supported by her community outside of the home.’

The provider had systems in place for people to give their feedback about the service. These included a yearly survey, regular meetings and a suggestion box. People were supported to raise concerns and these were listened to. The provider encouraged people and relatives to speak up when they had a concern. People were supported to be involved in the service and activities of their choice. Their care plans indicated people’s individual tastes and choices were recorded and respected.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People’s wishes for the end of their life were respected and carried out by staff. For example, one person and their family had requested for a particular item of clothing to be taken with them to the undertakers when the time came. We saw this wish had been met.

Staff were able to confirm what action was taken if a person’s health had deteriorated. They informed us they would inform the GP or the district nurses so that the appropriate care could be put in place for the person to keep them comfortable. One staff member told us, “When a person dies, the funeral directors collect the person from the front door. Resident’s doors are shut for privacy and a candle is lit in respect.”

The home worked closely with the local district nursing team to deliver compassionate and pain free end of life care. People’s care records included RESPECT forms and end of life care plans. These contained information on how and where the person wished to be cared for during their last days. All staff completed a mandatory end of life care training module as part of their induction into the service.