The 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 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 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.

Systems and processes were effective in identifying people’s assessed needs and reviewing them to ensure people’s care, treatment, health and communication needs were met.

Care plans provided staff with detailed guidance of how to meet people’s care and treatment needs. Care plans were regularly reviewed to ensure guidance continually reflected people’s changing needs and incorporated people’s views and that of their relatives where appropriate.

A majority of relatives spoke of their involvement in reviewing the person’s needs. A relative told us, “I have regular meetings with the registered manager to discuss the care plan.” Another relative said, “We had a meeting after Christmas regarding their changing needs.”

Staff told us they had access to people’s care plans which were regularly updated by the management team. A member of staff told us, “We have access to care plan information, and we are all encouraged to read people’s care plans.”

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.

Recognised clinical assessment tools were used to assess and review people’s care and support needs, such as skin care, dietary and hydration needs. Appropriate observations were carried out when people presented as unwell. People were referred to health care professionals quickly, and staff followed their advice.

People who required monitoring and support with hydration and nutritional intake had a nutritional care plan in place. Nutritional care records included information about modifications to people’s food, using recognised tools. For example, International Dysphagia Diet Standardisation Initiative (IDDSI). This is important so all staff supporting people to eat, and drink would know the consistency of nutritional intake to reduce the risk of choking.

We noted there were 2 choices on the menu at lunchtime, dining tables were laid with a tablecloth, menu, cutlery and condiments. Meals were served quickly by staff and a choice of drinks were available. We saw staff offering encouragement to a person who hadn’t eaten much. Drinks and snacks were being served throughout the day. A person told us, “I prefer to eat in my room, I had mince today.” A second person said, “We have a choice of two for lunch, they ask in advance. The food is nice.”

Staff were knowledgeable about people’s dietary preferences and needs. A member of staff told us, “We don’t really provide meals on the night shift, but we do help people with snacks, any snacks they want and drinks. IDDSI information is available in people’s care plans.” A second staff member told us, “People’s care plans tell us about their preferences for drinks and snacks and when we need to particularly encourage people to eat more, food consistency, preferences, or foods to avoid.” Staff’s knowledge about people’s dietary requirements had a positive impact on their health outcomes.

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.

The provider had systems and processes that supported the exchange of information about people’s care and support needs with others.

There was a collaborative approach in supporting people’s care needs. People’s care records confirmed referrals to external health and social care professionals were made when required and in a timely manner. Care records confirmed recommendations made were implemented.

Systems and processes were in place to share information both internally and with external health and social care professionals. A health care professional told us, “Information shared during our visits is documented in the home's internal system and communicated effectively at staff handovers. This promotes continuity of care, as all team members are kept up to date with any concerns raised and the actions taken.”

A staff member spoke of how information was documented and shared to promote effective care, they told us, “District nurses visit every day, the senior carers manage this and update people’s records. If there are any changes or we need to monitor anything then a senior carer tells us, or we get a message on the system to remind us, it would be put in the handover meeting as well.”

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.

People’s health conditions were assessed and monitored using recognised clinical tools. Care plans provided staff with guidance about how to provide effective care and support. Health needs were monitored. For example, people living with diabetes were monitored to ensure their condition was managed well and people whose skin integrity was compromised received regular care interventions which included regular repositioning to maximise and encourage blood circulation.

People were supported by visits from health care professionals, a GP and district nurses regularly visited the service. A relative told us, “We are always told of doctor visits or the district nurse.”

An external healthcare professional was positive as to how well staff knew and understood people’s individual needs. They told us, “Staff appear to know the residents very well and are proactive in identifying early signs of deterioration. They are familiar with residents' histories, care plans, and medication needs, and communicate concerns promptly. Key staff such as the deputy home manager and team leads are particularly well informed and responsive.”

Staff were trained to identify early signs of health issues and raise alerts to the manager. People had access to chair based exercise sessions and were supported to take walks around the grounds, which promoted people’s physical and mental well-being. A relative told us, “A physical trainer comes round every month and does exercises.”

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.

The provider’s electronic record system informed staff of all care interventions that were required, which supported staff in monitoring people’s care and support. Care plans were regularly reviewed with updates made if people’s needs had changed.

The provider had robust systems and processes that monitored clinical care outcomes. For example, skin wounds and pressure sores were effectively monitored and evidenced the healing and recovery process. In addition, people at risk of malnutrition had their dietary intake monitored and their weight monitored. A relative told us, “Staff were fortifying the food to help her put weight on, they are checking her weight, and it’s pretty stable now.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s rights were respected. Staff had received training on the Mental Capacity Act (MCA) and understood the MCA principles. Staff we spoke with understood their responsibility to gain people’s consent before any care intervention. They told us they always explained what they were doing and asked for consent or used non-verbal cues to ensure the person was happy for them to proceed. A staff member told us, “We always ask consent and agreement, if people refuse because they don’t understand then we wait, leave them for a period of time and approach them in a different way later.”

Staff were aware of best interests decisions related to complex decisions, which were made in consultation with others such as relatives and external professionals. A staff member told us, “The manager carries out mental capacity assessments and best interest decision making, and these are available on people’s care plans.”

People’s records stated if people had a DNACPR (do not attempt cardiopulmonary resuscitation) or a ReSPECT from (Recommended Summary Plan for Emergency Care and Treatment) which recorded their wishes.

Staff were seen gaining consent before providing any care or support throughout our visit.

People told us staff sought their consent. A person told us, “Staff knock and always ask my consent.” Where people lacked the mental capacity to consent to a specific decision about their care and treatment, MCA assessments and best interests decisions had been completed. These documents clearly recorded how the assessment was completed and who was consulted. Best interests decisions recorded how the least restrictive option had been considered.