The Lodge - Dementia Care with Nursing

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 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 were effective because they did not always check people’s health, care, and wellbeing plans contained accurate information.

We noted that some care plan’s lacked detail, for example around the use of ‘safe holds’. However, managers undertook assessments of people’s health and wellbeing, and these were recorded on an electronic system. Staff accessed care plans via handheld devices and recorded daily notes on these. Staff said sometimes they did not have enough time to read people’s care plans, especially if they were asked to move units at the start of their shift.

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.

The provider used recognised tools to help monitor people’s health and wellbeing such as to assess for risk of weight loss and falls. Meals were nutritionally balanced, and staff made sure that people’s dietary requirements were met, for example for people that had diet-controlled diabetes, or people that required pureed meals. Care plans recorded information about nutrition and the risk of dehydration.

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 staff worked well as a team and said team working was particularly effective when staff teams were consistent within the unit. Staff worked well with other agencies and made sure people’s needs were communicated to health professionals such as the GP and mental health teams. Visits from health professionals were documented within people’s care records and important information or changes were communicated during staff handovers.

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.

Although there was a wellbeing team dedicated to supporting people to live healthy lives, we saw limited examples of this. We did not observe many activities or people supported to exercise during the assessment and relatives told us they thought people could do more. The provider was recruiting more activities co-ordinators and had recently purchased a minibus to take people out.

Staff supported people to eat healthy meals and snacks, and the meals provided were nutritionally balanced according to people’s specific 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 knew how to monitor clinical outcomes and kept records about how much people ate and drank. If people were at risk of weight loss staff recorded their weight at regular intervals.

Staff also recorded when they provided pressure relief to people so that this could be monitored to make sure appropriate time intervals were maintained.

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

Staff assessed people’s capacity to make decisions about their care and treatment, and these were recorded in care records. Staff sought consent throughout their caring tasks.

The managers made applications to the local authority when someone was at risk of being deprived of their liberty, and these were reviewed and monitored.

Consent forms were filled in and contained in people’s care records.