Alsley 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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected, compared to similar services.

This service scored 88 (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 and relatives confirmed they were involved in creating care plans and monthly reviews. A relative said, “I have always been involved in [person’s] care plan. Managers give us a regular update and if anything needs changing, they do it. We have access to the system and can access care plans when we want to.”

Managers ensured people’s needs were comprehensively assessed. Care plans included detailed information relating to people’s routine, needs and preferences; and accounted for the different levels of care and support people needed when anxious or unwell. People’s communication needs were fully assessed to enable them to engage positively in their day-to-day care.

Staff kept detailed records to support reviews. There was a good standard of information recorded on the digital care planning system. For example, regular wellbeing checks detailed people’s presentation, mood, support needs and what worked well; enabling information to be shared with the team and care adapted to improve future outcomes.

The provider always 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, evidence-based good practice and standards.

The registered manager kept themselves up to date with changes to guidance, sharing information with staff to ensure people’s care and treatment continued to be delivered in line with current standards.

Managers ensured people’s nutrition and hydration needs were met in line with good practice, and they were supported proactively to manage their dietary needs and risks. A person had needed intensive support from the district nursing team to manage their diabetes, so managers worked collaboratively with healthcare partners to introduce a continuous glucose monitor. Kitchen staff were provided with enhanced training and used regular readings to understand the person’s blood sugar levels, adapting meal timings and food options to help stabilise them. This had resulted in reduced insulin dependency and less reliance on healthcare partners.

Managers had recently introduced a second sitting at mealtimes, to provide a calmer environment and adequate staff support for people who needed help to eat and drink.

Kitchen staff had an excellent understanding of people’s dietary risks; and expressed enthusiasm for learning about good practice guidance, to improve diet and nutrition at the home. At the time of our inspection, de-caffeinated drinks were being trialled to assess the impact of caffeine on mobility and behaviours such as sundowning. Sundowning is a behavioural pattern, in which people living with dementia experience increased confusion and agitation at certain times of the day.

The provider worked well across teams and services to support people and made sure people only needed to tell their story once.

Managers ensured information was effectively shared amongst the team. Records documented intervention from healthcare partners and included information about delegated clinical tasks. Staff confirmed information was shared in daily handover meetings, and alerts on the digital care planning system informed them of changes to people’s needs.

Managers and staff worked proactively with other services when multidisciplinary involvement was required. For example, there was a national shortage of a person’s behavioural medicines. Managers worked collaboratively and at pace with the pharmacist, GP and mental health team, to ensure an alternative prescription was agreed in a timely manner. Their relative told us, “[Person’s] medicines ran out and there was no supply. Managers advocated for [person] and insisted on alternative arrangements. The new medication actually improved their alertness. It’s been a good outcome.”

A healthcare partner told us, “There is excellent communication between us and the managers. Alsley Lodge is one of the homes I find particularly enjoyable to work with due to their joint working and positive approach to working with us.”
 

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

Managers were knowledgeable about risks to people’s health and wellbeing, implementing the appropriate support to help prevent deterioration. One person living at the home had suffered repeat falls which managers had linked to underlying infections. The GP would not prescribe antibiotics, so they advocated for the person to be seen by a specialist nurse, who diagnosed their condition and supplied the necessary treatment. The registered manager explained how this helped prevent further deterioration and had resulted in a reduction in falls for the person.

Managers regularly reviewed data and had introduced systems to better identify and respond to signs people’s health was deteriorating, which has helped prevent unnecessary hospital admissions. For example, staff were trained to observe for warning signs of infection and be proactive at escalating concerns early; and when people showed signs of malnutrition, fortified diets or supplements were implemented.

Staff encouraged and supported people to understand and make healthier choices to their diet, lifestyle and physical activity. Kitchen staff told us air fryers and meat free options had been introduced to help make meals healthier, and fresh locally sourced foods were prioritised. Light exercise was included in the home’s monthly timetable. For example, music and movement sessions, ball games and walking.

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

Care plans were outcome focused, and managers ensured there was a robust approach to monitoring the effectiveness of people’s care and treatment. Appropriate monitoring tools were used, and concerns were discussed at team meetings or shared with the relevant healthcare partners.

Relatives were reassured people’s clinical needs were effectively met. A relative said, “[Person] has a medical condition. I was worried at first, but they have a daily dedicated carer to check on them and staff are very vigilant. I have no concerns about [person].”

Staff supported people to improve outcomes relating to their health and quality of life. A person was wheelchair dependent and expressed a wish to improve their mobility and independence. A physiotherapist provided regular input, and staff were proactive in supporting the person’s recovery with daily exercises. As a result, they were now able to walk short distances with support, and their wellbeing had improved. They told us, “I have so much more independence now. My mobility is much better, and I am not in as much pain.”

Managers and staff approached concerns about people’s care holistically. They used situation, task, action, result (STAR) methods to monitor outcomes, and share key learning about the positive impact actions had on people’s quality of life.

The provider carefully explained to people what their rights around consent were, made sure they fully understood them and respected these when delivering person-centred care and treatment.

Staff understood the importance of obtaining consent before delivering care and support. MCA principles were displayed in the staff room for ease of access, and MCA had been discussed in a recent team meeting as ‘policy of the month’.

Managers ensured consent to care and treatment was sought in line with legislation and best practice guidance. Detailed consent forms had been signed by people or their next of kin; and for those lacking capacity, decision specific MCA assessments and best interest decisions were recorded.