Lotus House

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 good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.
 

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.

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

People’s care plans were up to date and reflected physical, mental, emotional and social needs. People were proud to show us their co-produced folders which had information about them which they confirmed was up-to date and accurate. Communication needs were clearly documented including how people expressed themselves and made their wishes known. For example, a staff member told us, “[Person] will understand more complicated things if they are explained to them using signs, gestures, pictures, and relevant objects.” This was consistent with communication we observed during our visits.
However, daily records were not always clear, detailed or person-centred to support reviews to people’s needs. There was not always evidence of appropriate communication/action when people were upset, distressed or anxious.
Where information was lacking the provider took steps to ensure records were up to date during this assessment.

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.
Staff knew people’s needs really well and were confident and competent when providing care and support. People and their relatives understood the measures the service had put in place to mitigate risks. People could eat and drink when they wanted to.
Diet and nutrition care plans included people’s preferences and identified risks including risks of overeating and allergies. However, for one person who was at greater risk of choking there was not a clear plan of how staff should respond if they were to choke. Staff addressed this immediately following our feedback.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.
Staff had positive relationships with other professionals and services and held clear records of appointments.
Staff supported people to their health appointments and care plans clearly recorded professionals involved in monitoring people’s health and regular reviews attended. Care plans detailed the support people needed to book and attend appointments and if support was needed to follow any advice. If people were anxious attending appointments care plans detailed the reassurance needed.
One relative told us, “I’ve no concerns because [person] has regular checkups with the mental health team, sees the GP and has dental checkups.”
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff balanced the promotion of people making their own choices and encouraging healthy lifestyles. Staff encouraged people in making healthier choices such as around their diet. One relative told us, “They do look after [person’s] diet, and their weight has reduced a bit and stabilised now.” People told us that staff reminded them about healthy eating, but we also observed people eating the food of their choice and walking to the shops with staff to buy their favourite treats.
One person told us how they talk to their key worker about exercise and like to dance to keep fit.
 

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People told us they had regular meetings with their keyworker where they would discuss outcomes and achieved goals for example, saving money for their birthday. People were supported to access social opportunities, develop new skills and build independence. For example, independence with laundry, personal care routines and managing money. People decided when they felt they had achieved a goal.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
Where people were considered not to be able to safely make choices, the provider undertook mental capacity assessments to confirm this. Where this was the case, best interest decisions were made on people’s behalf which involved wider professionals and people’s representatives to advocate for them. These were regularly reviewed to make sure that any restrictions remained appropriate and the least restrictive option.