Highgate Lodge Care Home

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 resulted in good outcomes and promoted a good quality of life, based on the 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 71 (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’s individual care and support needs were assessed and planned for, and guidance for staff was regularly reviewed. People and their relatives were engaged in discussions about assessments and care plans. The registered manager told us they assessed people’s needs based on their individual requirements. We saw care plans were regularly updated, and staff had knowledge of people’s 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. The provider actively worked with external professionals to review care regularly. The provider had systems and tools in place to support evidence-based practice. There were a range of evidence-based tools in place, that covered a variety of risks, such as skin risk assessments and pain assessment. Staff were aware of these tools and used the available guidance to meet people’s needs. Care plans were in place for individual diagnosed health conditions which were based on best practice and captured individual needs. Staff were observed following care plans to ensure people’s needs were met. People’s nutrition and hydration needs had been assessed and care plans detailed how to meet these needs.Staff were observed offering choices and following the guidance contained in people’s care plans to ensure people’s nutrition and hydration needs were met. One person told us, “The food is smashing; good quality and we have choices” and “Oh yes we do get plenty to drink.” Another person told us, “I feel the food is very good and if you don’t fancy something they would get you something else.” Staff understood people’s specialised diets. Where people could not verbally communicate their food preferences, pictorial meus were provided to enable them to make a choice. Relatives told us that people were offered food and fluid regularly with a range of options.

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 provider told us they had systems in place to ensure people received coordinated and joined up care. There was a handover process in place where important information and changes to people’s care needs could be shared with staff. The registered manager told us they had weekly ward rounds with health professionals, and we saw staff had engaged with a range of different health professionals to ensure people received support to meet their needs. Partners confirmed the provider and staff supported people effectively and worked with other agencies as required.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives. People and their relatives were positive about how staff supported them to maintain a healthy lifestyle and meet their individual health needs. People told us, “I do think that they are trained well to look after me.” A relative told us, “[Person’s name] looks a lot healthier since being at the home, they are well fed, always clean and looked after well.” Staff were aware of how they needed to support people to maintain their health and wellbeing and sought advice from doctors and other health professionals when needed. The provider had systems in place to document people’s health needs in care plans and ensure people had the care they needed to maintain their health and wellbeing. Partners told us meals were nutritious and appetising. We saw a survey completed by people, the results showed 83% of people were happy with the food. Partners also told us they advised the provider to consider an activities coordinator to improve the range of social and physical activities for people. However, some people told us that there were no activities to partake in. One person told us the staff “sometimes” have activities to take part in. Another person told us, “They could do with more activities here.” On the day of the inspection, we observed staff engaging people in activities.

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. The service demonstrated a proactive approach to monitoring and reviewing people's care needs. The registered manager told us care plans and risk assessments were reviewed monthly and updated promptly when people's needs changed. For example, when 1 person’s condition deteriorated and they required palliative care, staff implemented additional support measures. Although the person was not previously at risk of falls, a falls risk assessment was introduced to ensure their safety. This was evidenced by records showing no falls had occurred. As the person’s condition improved, the risk assessment was reviewed and updated to reflect their current needs. This showed the provider’s commitment to delivering responsive and person-centred care.

The provider did not always tell people about their rights around consent or respected these when delivering person-centred care and treatment. On the whole, care records showed that individual mental capacity assessments and best interest decisions were recorded and linked to people’s care plans. However, this was not applied to all areas where consent was required. For example, people had not signed consent forms or had their capacity assessed for the use of CCTV. The registered manager informed us the documentation would be updated to consider this. However, staff told us they had received training in the Mental Capacity Act 2005 (MCA) and they sought consent before providing day to day care. People and relatives confirmed staff sought consent before delivering care.