Buttercup 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.
This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.
 

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Clinical assessment tools were available but not consistently used, and reviews of care and treatment were not always carried out promptly. Monitoring records did not always highlight emerging health issues. Care plans for people with complex communication needs lacked sufficient detail to guide staff. In particular, when people used methods such as pictures or photographs alongside words, this was not clearly documented to support consistent communication.

Overall, care plans did not provide enough specific guidance to ensure individual needs were met consistently. While people and relatives were involved in planning care, and changes were discussed with them, improvements were needed in how communication and health needs were assessed and reviewed.
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Staff told us they helped people to make their meal choices if they needed it. We found records that highlighted staff had placed unnecessary restriction on people food choices which had left them upset. This was discussed with the manager who took action to address these concerns.

People’s dietary needs, including cultural needs, and preferences were assessed and planned for. Staff spoken with knew about people’s dietary needs. People had their risk of malnutrition and dehydration assessed. Care plans were in place for specific dietary needs such as cultural diets. Staff monitored people’s weight and acted when required, for example referrals to the GP or the dietician.
 

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 worked well with external professionals to ensure transitions were well coordinated and planned in line with people preferences. The provider had a process in place to escalate health concerns and records confirmed health professionals were involved in people care. People had information about their health available to them in ways they could understand. Staff told us they were well supported and had regular opportunity to share their views and now a consistent manager was overseeing the service they were confident action would be taken. The management team told us they worked closely with health and social care professionals to ensure people’s needs were met.
 

Support for health and wellbeing was inconsistent, with missed monitoring undermining otherwise good access to healthcare. Staff did not consistently support people to live healthier lives or help reduce future care needs. Charts, used to monitor health and guide the use of PRN medicines, had not been completed for several weeks. This made it difficult to determine when medication was needed.

These concerns were shared with the manager, and immediate action was taken. Despite these gaps, people were supported to access healthcare services. GP visits took place when needs changed, and healthcare appointments were attended as required. Dental check-ups were recorded, and relatives confirmed that staff supported access to health professionals.
 

The provider did not always routinely monitor people’s care and treatment to drive continuous improvement. Outcomes were not consistently positive or aligned with clinical expectations and the individual expectations of people themselves. Although systems and processes were in place to monitor clinical care and treatment needs, they were not used consistently. Behaviour monitoring lacked robustness, which contributed to people not always experiencing positive outcomes or consistent care.

While care plans were reviewed regularly and updated when people’s needs changed, they often lacked sufficient detail to ensure people were consistently achieving their goals or outcomes.

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

People’s rights around consent were explained and respected. Where people had capacity, consent was given for care and treatment. For those who lacked capacity to make specific or complex decisions, mental capacity assessments were completed, and decisions were made in their best interests, in consultation with others. Legal authorisations were obtained where required, and restrictions were the least restrictive necessary to keep people safe.

Staff showed a good understanding of the Mental Capacity Act and how to apply it in practice.