Charlotte Goddard visits CHD Living’s Kings Lodge Care Centre in West Byfleet, Surrey, and finds out about the home’s role in supporting local hospitals to free up beds.

It is the anniversary of VE Day, and residents at CHD Living’s Kings Lodge Care Centre in West Byfleet gather in the lounge to watch costumed performers singing period songs. The residents have created some fantastic decorations, including cut-out Spitfires and bunting, and are discussing rationing.

The home supports a number of people with high levels of complex needs from multiple sclerosis to Parkinson’s to advanced dementia. Posters, photographs and displays on the walls of the corridors recall past activities and promote future events, with residents’ preferences kept front and centre. “The residents wanted a pantomime dame in, so we got a dame and they performed for us,” recalls manager Josh Barlow, indicating pictures of the event. “Our receptionist holds a book club twice a week, they have read some Charles Dickens and now they have gone on to a more modern one.” Events yet to come include a magician and a holiday camp-style music show.

Barlow has been manager of 43-bedroom Kings Lodge for the past two years, having joined CHD Living in 2019 as a team leader. “I have always tried to soak up all the knowledge I can within the service, and made it known I had a desire to progress in the industry,” he says. He quickly moved to the role of deputy manager at another Surrey CHD home, The Summers in West Molesey, and during the pandemic became manager at St Catherine’s in Guildford, taking it from Requires Improvement to Good. Shortly after becoming manager at Kings Lodge, the CQC paid a visit and again Barlow was able to secure an overall rating of Good.

He’s not resting on his laurels though, and is full of plans to improve the home, from extending the lounge area to improve engagement, to partnering with local colleges that run agricultural courses to enhance the outdoor environment. About to compete his Level 5 diploma in leadership and management for adult care, Barlow also oversees CHD Living’s work with the Surrey Heartlands Health and Care Partnership which aims to free up beds in hospitals. For the past three years the partnership has funded 60 beds across three CHD Living Homes, including Kings Lodge.

“We support people out of hospital who have been deemed medically fit for discharge, but where it is uncertain as to what the next best step might be,” says Barlow. Individuals will move from hospital and spend up to four weeks in a CHD Living home while they are assessed and supported to their next step. CSH Surrey, which delivers services on behalf of the NHS, works with CHD Living, local authorities and residents’ families to decide on that next step, which may be returning home with a care package, live-in carers, or a residential or nursing placement. As well as freeing up beds, the scheme also prevents hospital readmission, by ensuring people do not return to an unsafe environment.

The Kings Lodge team has had to get used to a new way of working, with a rapid turnaround of residents in the block beds. “Sometimes it takes longer than four weeks due to different complications, sometimes it can be as quick as within a week,” says Barlow. “A resident can leave like they did yesterday, and then we have a new admission coming in today.”

On occasion an individual who has arrived to take up one of the block beds ends up staying at the home. Others come back to visit or to take part in events. “We have had one or two relatives who really enjoyed their loved one’s stay in our environment, who have come back in and spoken to residents they had developed a relationship with,” says Barlow. “It doesn’t always end with discharge.”

Although residents in the block beds are only there for a short period of time, it’s important not to differentiate them from permanent residents when it comes to care, says Barlow. The team will try to get as much information as they can about needs and preferences. “We look at the same information for a short-term care plan that we would look at from a permanent perspective, there is no difference in terms of the content,” he explains.

The initiative is currently being redeveloped to bring in CHD Living’s home care expertise, with a view to supporting more hospital leavers at home. Not one to miss an opportunity, Barlow is taking advantage of the reduced number of block beds to refurbish the rooms, ready for more permanent residents.

Barlow is clearly a hands-on manager and is enthusiastic when talking about the improvements he has made and plans to make in the future. A library has been transformed into a sensory room for residents living with a more advanced level of dementia. “They may not be able to take part in the activities our wellbeing co-ordinator has on offer, but here is a space for them and their loved ones where they can be stimulated by sound, touch, and so on,” says Barlow. The room includes a well-stocked fish tank, musical instruments and toggle blankets to fiddle with.

Also on the ground floor is Kings Lodge’s own pub, complete with bar, sofas, and doors leading out onto a large grassy space. Usually open to residents, the pub is currently full of staff undergoing moving and handling training.

Training and development plays an important role in building a successful team, says Barlow. “Giving the staff opportunities and support to develop themselves means I have a team that are able to manage situations – whoever is on duty, whatever the scenario, there is a team there that can manage that.”

Some team members don’t want to progress, in which case Barlow finds training to help them upskill within their existing role, perhaps improving their knowledge of dementia care for example. “Others who identify they want to progress into another role, it is about giving them the chance to experience what that would look like, so maybe working alongside some of the team leaders or the nurses, and giving them some responsibility so if they decide they want to progress into that role, they already have an understanding,” says Barlow

One example of supporting staff to progress is newly appointed wellbeing coordinator Christine. “She was already working in the service as a laundry assistant, but was identified as someone we felt would be great in the wellbeing role, so we posed the idea to her,” says Barlow.  “She was a little bit dubious at first, but she has done amazing work, has really enjoyed the job, and the residents are responding well to her.” So well that Christine was voted the home’s first employee of the month, as part of a scheme she helped to set up.

Navigating through the ground floor of Kings Lodge takes you on a journey around the home and returns you back where you started. “We recently had the local authority come out to review the home, because it had been identified as a good layout, and a standard for potential new builds,” says Barlow. “It is essentially a rectangle, but it doesn’t feel like that when you walk round it. It means people who like to walk with purpose, who may get confused from time to time, are essentially going to come back around to where they started.”