Grasmere 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 the last inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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. The assessment template did not cover the primary focus of the service; providing support for people with mental health needs and those who misused substances and alcohol. This led to staff not having the tools to assist them to identify relapse triggers, how people presented when they were well and unwell, the content of people’s thoughts when experiencing psychosis and the way staff supported people with addictions. Staff also supported people to work through reduction programmes develop for people by drug and alcohol additions services. However, there were no assessment documents in place to support staff to understand their role and therefore they did not have relevant information to develop appropriate support plans. This had been raised at previous inspections and was a fundamental gap in the assessment framework. The registered manager immediately developed the assessment tools they used, so they covered how people’s mental health and addictions affected them.

Staff planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, they needed to ensure this was always in line with legislation and current evidence-based good practice and standards. Staff worked with people at various stages of addiction from denial to recovery and provide support for people to work through reduction programmes and also supported people with complex mental health needs. Staff had an understanding of their roles when supporting people with these condition, but not an in-depth knowledge of the best practice guidance they should follow. The registered manager undertook to source additional training and ensure staff were kept aware of current best practice.

We observed people received a range of wholesome food and they could request alternatives when they wanted. People told us the food was really good and there was a good variety.

Staff worked well with other professionals 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 closely with other agencies and professionals such as community mental health professionals and addiction service workers to ensure people received appropriate support. A professional said, “We have formed a very good working relationship with the staff and they work well with people.”

Staff supported people to manage their health and wellbeing to maximise their independence, choice and control. They supported people to understand what they needed to do to live healthier lives and reduce their future needs for care and support. People and professionals reported individuals had experienced positive outcomes because of the service. A person said, “The staff have really helped me to understand how my lifestyle can badly affect my health and what I need to do to make changes and improvements.”

Staff 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 told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood and the requirements of the Mental Capacity Act and associated codes of practice. They had received training around the Mental Capacity Act 2005 and associated code of practice. Capacity assessments and ‘best interests’ were in place, but these needed to extend to cover a wider range of decisions such as only going out with staff, management of monies, access to cigarettes and healthcare decisions. The registered manager immediately took action to address this and ensured when people were deemed to have capacity they confirmed their agreement to these restrictions.

Staff worked with people who may be subject to community treatment orders and conditional discharges. Staff had a good understanding of their role supporting people to understand their right to appeal under the Mental Health Act 1983.