Sobell Lodge - Care Home Physical Disabilities

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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 did not always make sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. A relative told us, “It was rushed at the start, and the initial assessments were done in a hurry due to the circumstances of the person needing to move to a care home, but they did try to capture everything. There have been issues which the new manager has tried to put much more in place to rectify.” We noted care assessments were completed and covered people’s needs such as their physical, mental health, mobility, skin integrity, nutrition, social participation and personal care needs. However, people’s personal histories, backgrounds and communication needs were not consistently documented. For example, a relative shared comprehensive information about their loved one, including their past, health conditions and the circumstances that led to them living in the service. However, when we checked the person’s care record, none of this information had been recorded. The management of the service had identified these concerns and showed us a plan they had put in place to complete a reassessment of people’s needs.

Staff told us they had gained understanding of people's needs by working with them over time rather than from care records in place. People complained that agency staff or new staff did not always know their needs.

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 supported people with their nutritional needs and dietary requirements, preferences, and any associated risks. Where individuals were identified as being at risk of malnutrition, screening tools such as the Malnutrition Universal Screening Tool (MUST) assessment were used effectively, and appropriate referrals were made to dietitians and Speech and Language Therapists (SALT) to ensure people received timely specialist input.

People with swallowing difficulties were supported in line with the IDDSI (International Dysphagia Diet Standardisation Initiative) framework. Staff understood texture‑modified diets people needed and demonstrated confidence in preparing food and drink safely. Care plans contained clear, up‑to‑date SALT guidance, and we observed that was followed. Adaptive equipment such as plate guards and specialist cutlery was available for those who needed assistance to promote independence. A person told us, “I’m very happy with my food choices.” A relative commented, “Staff arranged for the SALT team to be involved, and they adjusted loved one’s diet as needed. Loved one always has a choice, and they tell them what they want to eat.”

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.

When we reviewed people’s care records, we found that key information, including assessments of needs, risks and support requirements, was not always updated and often lacked important detail. We also found that not everyone had a hospital passport or personal profile, and where these documents did exist, they were not always shared in a timely or consistent manner with external services. People and their families raised concerns about the high use of agency staff, explaining that agency workers did not always know people well or understand how best to support them. A person told us that staff did not know how to communicate with them. Professionals we spoke with also reported occasions where they were unable to obtain necessary feedback because permanent staff were unavailable or the agency staff present did not know people or the information being requested. Staff told us they try to accompany people to hospital appointments or when someone is admitted to hospital; however, this did not always happen reliably due to staffing pressures. This increased the risk of important details being missed and caused delays in ensuring other services had the information required to support people safely and appropriately.

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 were supported to access appropriate healthcare services, and we saw evidence of regular medical appointments and visits recorded within people’s care files. There was clear involvement from external professionals, including district nurses, who supported staff with the management of pressure sores and other clinical needs. These collaborative approaches helped ensure people received the healthcare input necessary to maintain their wellbeing. A healthcare professional told us that staff contacted them when they had concerns or questions about people’s health. We saw evidence of regular liaison with external services to ensure people received coordinated care. For example, staff worked consistently to follow Speech and Language Therapy (SALT) recommendations to support a person’s swallowing needs. Another person was supported effectively to meet their nutritional needs.

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.

Staff monitored people’s bowel movements each day and recorded these accurately. This information was reviewed during handovers, where any changes or concerns—such as irregular bowel patterns, constipation, or signs of distress—were discussed openly within the team. Staff knew the actions to take if a person was at risk of constipation or if patterns suggested a potential underlying issue. This included increasing fluids, offering prescribed laxatives, monitoring pain or discomfort, and escalating concerns to healthcare professionals when needed.

People’s skin integrity and pressure areas were checked regularly. Staff were confident in recognising early signs of pressure damage, such as redness or changes in skin condition, and understood when to reposition people or apply preventative measures. Where required, staff used pressure‑relieving equipment and liaised with district nurses or other professionals to ensure appropriate treatment was in place.

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

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service.

Staff had completed training in the MCA and DoLS and demonstrated a clear understanding of their responsibilities in line with these principles including the need to assess capacity and act in people’s best interests. We found that people’s rights and freedoms were upheld within the service. Individuals who wished to go out were supported to leave and return safely, and measures in place to promote people’s safety were not unnecessarily restrictive. They took time to explain care interventions in a way residents could understand and supported them to make their own decisions about day‑to‑day life, such as personal care, activities, and routines. When residents lacked capacity to make specific decisions, staff followed best‑interest processes and involved families and relevant professionals to ensure decisions reflected the individual’s needs, preferences, and known wishes.

Staff supported people in a way that upheld the least restrictive principles of the Mental Capacity Act. We observed an example where staff worked collaboratively with the person, their family and external professionals to review and remove restrictions that were no longer necessary. This promoted the person’s autonomy, rights and dignity, and demonstrated a commitment to delivering care that avoids unnecessary limitations on a person’s freedom.

The manager had resubmitted applications to the local authority for DoLS where necessary.