Derwent 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 Good. At this assessment the rating has changed to 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.

Care plans did not consistently contain sufficient detail about people’s needs, which meant there was a risk care was not always planned or delivered in line with people’s current requirements.

Care plans did not consistently include sufficient information to support staff to recognise and respond appropriately to changes in people’s condition, which included changes in their mental health. Support plans were not always reviewed as regularly as expected by the provider. We were told following the assessment visit that care plans and support plans were being reviewed to ensure they all contained sufficient information. We were told that the registered manager, nurse, clinical lead nurse and quality team were involved in this process.

However, other care plans contained detailed information on clinical needs including diabetes which included information on symptoms of deterioration and when to request further medical advice.

A relative said, “I had a lot of involvement at the beginning and have kept in touch with regular updates after that.” Another relative told us that they provided a lot of information when their family member first came into the home and had had regular communication since.

The provider did not always follow current evidence-based good practice and standards.

Care and treatment mostly reflected current best practice and guidance; however, staff had not consistently monitored a person’s blood sugar levels in line with their diabetes care plan. We were told that the person had not suffered harm and their blood levels were stable, however, this lack of consistent monitoring meant that there was a greater risk of harm.Evidence was provided following the assessment visit demonstrating additional systems in place to ensure this monitoring was consistently completed.

We observed lunchtime on the first day of our assessment. The dining room tables did not have any tablecloths or condiments and staff told us that the food had been pre-seasoned. This did not support people’s preferences and independence and we raised this with the manager to address.Evidence was provided following the assessment visit demonstrating tablecloths were in place with systems in place to ensure they were kept clean.

People were happy with the food provided. A person said, “I like the food at the home.”Another person said, “I do like the food, it’s good quality. On Sunday we had roast chicken dinner, in the evening we have a choice of sandwiches.” A third person said, “I have cereals for breakfast but do like a fried egg, the staff will make this me for me.”

People could access kitchenettes to make food and drink for themselves when they wanted it, and some people went out for food or ordered it in.

Staff were confident in referring to other organisations and where concerns were observed, appropriate referrals to partner healthcare partners were made in a timely way.

A professional commented, ‘Communication is always good, we either visit or phone for updates and the staff and management appear knowledgeable.’ Another professional commented, ‘I have always found staff at Derwent Lodge supportive to our patients, very caring, knowledgeable and at times go above and beyond to help us facilitate a fast but safe transition to their service.’

Staff described good communication within the service and managers were described as knowledgeable and approachable.

The provider had systems in place to support people to manage their health and wellbeing to maximise their independence, choice and control, however, they were not fully effective. We identified concerns during this assessment regarding support provided a person regarding their diabetes care.Evidence was provided following the assessment visit demonstrating systems in place to ensure the person received consistent diabetes care.

Care records for a person with a learning disability did not include a health action plan. This meant there was not a structured or personalised approach to supporting the person to understand and manage their health needs. A health action plan is a key tool to ensure reasonable adjustments are made and to support people to access healthcare.Evidence was provided following the assessment visit demonstrating that a health action plan was now in place for the person.

External health and social care professionals were involved as required to support people to live healthier lives and care plans referred to this support including exercise and a healthy diet.

People told us of visits made by external professionals. A person said, “I have a dentist’s appointment next week.” A relative said, “[My family member] has access to a dentist and the chiropodist comes in. The GP practice is really good and knows my family member well.”

The provider mostly monitored people’s care and treatment to continuously improve it; however, staff had not consistently monitored a person’s blood sugar levels in line with their diabetes care plan.Evidence was provided following the assessment visit demonstrating systems introduced to ensure the person's blood sugar levels were consistently monitored in line with their diabetes care plan.

Regular reviews of people’s care all considered outcomes and how to improve outcomes for people. External professionals were involved in helping to address these needs.

A person said, “I am supported with my medication for my [mental health condition] and have regular blood tests.”

A professional commented, ‘Whenever guidance has been offered regarding individuals care needs, the staff at Derwent Lodge have been receptive and responsive. They take recommendations seriously in my experience and implement them thoughtfully, I have also found they have followed up to ensure that any changes are having the intended positive impact on their service users.’

People’s consent was sought and respected.

A relative told us that mental capacity and best interests had been considered appropriately for their family member.

Policies were in place and mental capacity was considered where appropriate. Advanced decisions were documented in care records.

Staff demonstrated an understanding of the Mental Capacity Act. Staff had completed training on consent and the Mental Capacity Act.