Stoneacre Lodge Residential Home

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 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 requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulations in relation to safeguarding, specifically, paperwork and processes which were had not been completed correctly or organised effectively to evidence how people were supported in the least restrictive way when they were deprived of their liberty.

This service scored 42 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People's needs were not always routinely assessed or reviewed with people or their families. There was limited improvement in the quality and content of people’s care plans following our previous assessment. The management team told us they were in the process of updating care plans and risk assessments and commented they were ‘about 70%’ completed. However, we found reviews of people’s assessed needs had not always taken place for people whose care plans had been updated.

The provider did not plan and deliver people’s care and support with them, including what was important and mattered to them. Care and support was not always delivered in a way which was best practice or evidence based. For example, a person had a dietary intolerance but there were no details about alternative food or drink preferences in their care plan. We saw other examples where delivery of care was not evidence-based including a person who needed support to reposition through the use of a slidesheet but there was no information in their care plan about how to use the slidesheets and how often the person should be re-positioned. Another person had an identified patch of sore skin but there were no logs or records of skin integrity checks or visits to the local GP.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. Members of staff did not work well together and we observed examples where people waited to be moved, receive drinks or care and support. There was a lack of leadership and modelling of expected practice. Members of staff indicated there were not sufficient numbers of people on duty to meet people’s needs.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. People were referred to local health and care services for additional specialised support. However, feedback from people and their families identified shortfalls in care needed ensure people lived healthier lives. We observed a person’s drink was inaccessible at their bedside and they appeared to be thirsty. When they were offered a drink, they drank nearly 2 glasses of juice. One relative told us, “I don’t think [family member] can get their drinks because the tables are too low in the sitting room.” A person told us, “The diet isn’t very good. I would like something other than a couple of dollops of mashed potato and some meat.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent or met both clinical expectations and the expectations of people themselves. There were inconsistencies in how care plans were organised which meant outcomes for people could not be monitored effectively. Some care plan information was kept in electronic records and some information was kept in paper records. Not all information was accessible to all members of staff. People told us they were not any opportunities to engage in any exercise activities. One person said, “We don’t do any exercise; I would like to do that.” People and their families gave mixed feedback about how members of staff helped or supported them appropriately. One person said, “They don’t help me if I get in a tangle with my clothes. They expect me to do it all.” A relative told us, “I do feel like [the members of staff] know what they are doing.”

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. The management team lacked understanding about the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Acts 2005 (MCA) paperwork and processes. Some people had conditions attached to their DoLS but the management team did not have a clear overview of who had a DoLS in place and some conditions required MCA and Best Interest (BI) decisions to be completed. Where some people had bed sensors in place, we did not see evidence of discussions with people that confirmed they were the least restrictive option. Bed sensors had been put in place as a standardised approach rather in response to an identified risk. When we asked people about consent, a person told us, “They don’t ask my consent. They just say, ‘Do this and do that.’”