Willow Tree Lodge

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question as good. At this assessment the rating has remained as good.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider did not always effectively monitor people’s progress towards their identified outcomes. Monthly keyworker reviews referred to people’s goals and achievements. However, daily records did not consistently show whether planned activities had been offered or completed or provide sufficient detail about their duration and people’s participation and engagement. For example, there was limited evidence of regular walks and no evidence that swimming had been offered or supported, despite these being identified outcomes. Staff could describe the positive outcomes people achieved. One family member said, “They will support [the person] in activities if [they’ll] do them; they do encourage [them]. They will encourage [their] independence.” We found no evidence that people were not involved in identifying their goals or supported to achieve them. However, the recording gaps limited opportunities for people and staff to meaningfully review progress and for the provider to identify where planned support had not taken place. The provider had identified these shortfalls through its governance processes, and steps were being taken to address them, but improvements were not yet fully embedded.

The provider did not always clearly demonstrate how people’s rights around consent were supported. While some mental capacity assessments contained more information, others lacked sufficient detail or were not specific to the decision being considered. One assessment did not clearly evidence that the starting assumption was that the person had capacity, while another combined decisions about healthcare, personal care, finances and leisure activities. Some records contained limited detail about how people were supported to understand, retain and weigh up relevant information, and assessments were not evident for some restrictive practices. These recording shortfalls reduced assurance that decisions were supported by clear, individual assessments and that the least restrictive approach had been considered. In practice, staff knew people well and supported them to make choices and exercise control in their daily lives. We observed people moving freely around the service and making choices about how they spent their time. A professional told us the provider had “shown a measured and proportionate response to periods of crisis, avoiding unnecessarily restrictive or overreactive interventions.” DoLS applications were made appropriately, and oversight arrangements were in place. The provider had identified some of these shortfalls through its governance processes, and steps were being taken to address them, but improvements were not yet fully embedded.