Lonsdale Midlands Limited - 164 Walker Road

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 outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. Feedback described it as exceptional and distinctive.

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.

All of the people living at the home had lived there for several years. The registered manager regularly reviewed their needs to ensure people’s care met their individual requirements. People and relatives were involved in these reviews. One relative told us, “We have meetings there a couple times a year but if ever they aren’t sure of anything they will get in touch and talk about it. We can’t fault them.”

Records showed how people had been involved in discussions about their care. Staff recorded how people had answered questions using signs, and pictures to support verbal communication.

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. They worked to develop evidence-based good practice and standards.

The registered manager had knowledge of and implemented the principles of the Right Support, Right care, Right Culture guidance. Staff were well trained and demonstrated a good knowledge and insight into the needs of people living at the home. Staff explained their approach was focused on the needs of each individual and every day people’s support was led by the person themselves. For example, people chose which staff they wanted to support them each day as well as how they spent their time. This led to a reduction in people’s anxieties and enabled them to enjoy their day with staff who shared their interests. On the day of the inspection, everyone who lived at the home was out being supported by staff members to do things they enjoyed. This included shopping, bus travel and bowling.

Staff demonstrated an excellent understanding of the needs of people and how their behaviours could impact a person’s well-being. They shared examples with us of how conversations with people about their interests, could inadvertently trigger a person’s anxiety or cause them distress. Staff told us they used guidance available in people’s care plans to support them well and any new triggers, or things the person was observed to enjoy, were documented and shared with the wider staff team.

The home was designed and decorated to support the needs of each individual. People’s bedrooms and bathrooms were furnished and designed around their needs and preferences. Communal and functional areas of the home were also designed to reflect people’s personalities and interests. The walls of the laundry areas were painted with 4 individual clothing designs, each reflecting the personalities of people who lived there. Specifically designed bird feeders had been created in the garden to support a person’s interest in birds. This led to an increase in the person’s wellbeing as they could spend more time outdoors which they enjoyed.

The home was designed in a non-restrictive way and consideration had been given to how the environment could affect people. For example, in the dining room, which looked out onto the garden, pictures had been placed on windows as this had been found to reduce 1 person’s distress.

The provider understood and followed the principles of STOMP (stopping over medication of people with learning disability, autism or both) and ensured people had regular reviews in relation to their prescribed medicines. Staff also monitored the use of ‘as required’ medicines which were sometimes administered to reduce people’s anxiety or distress. Records of incidents showed how the registered manager and team leader had reviewed the use of these medicines to ensure they were only given in people’s best interests. Where people required support to manage distressed behaviours, staff recorded any interventions and their effectiveness. This enabled the registered manger and team leader to consider whether further training or de-escalation techniques were needed to support the person in the least restrictive way possible. Where local services had been unable to suggest any new or innovate approaches, the staff team had sought advice from a positive behaviour support practitioner employed by the provider. This enabled them to ensure any incidents were reflected upon so learning could be taken and approaches could be adapted to ensure they worked in the best interests of people and in the least restrictive way.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The staff and management team worked together to effectively meet the needs of people living at the home. One staff member told us, “It's rewarding, when you've got a very good staff team, we all gel very well. This works well for residents, as we all work well together.” Staff told us the registered manager encouraged them to challenge any decisions if they thought they were not working in the best interests of people. A staff member commented, “[Name of registered manager] says ‘you are supposed to challenge us on it’. They are all about people, all about giving them the lives they want.”

The staff team worked together to generate ideas that were tailored to people’s individual needs. For example, a festival had taken place in the garden of the home, which was specifically designed for people who found large gatherings overwhelming. Staff supported people to plan and design the festival to include the things they enjoyed such as hair dyes, personalised mocktails, food and music.

The staff team worked alongside other professionals to positively develop people’s independence. One person had recently been supported to go on holiday for the first time. In preparation for this the staff team planned and slowly built up the person’s confidence to spend time away from home. The staff team documented each day of the person’s holiday and recorded their successes and things they particularly enjoyed. This included meals they had enjoyed, places they had visited and their reactions to films they had watched and places they had visited. Following the holiday a holiday journal was created by staff, which recorded their time away and gave them an opportunity to review their experiences and memories.

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

People were supported by the staff team and external professionals to manage their health. The registered manager tracked people health appointments to ensure they got the support they needed with their prescribed medicines, nutrition and hydration, annual health checks, eye care and oral health. The staff team supported people to attend appointments and shared any concerns or changes with people’s relatives. One relative said, “[Person] had to go to hospital once. It was managed well.”

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.

People’s outcomes were monitored and used to improve their quality of life. Relatives shared with us their views about how people were supported to live full and interesting lives. One relative told us, “[Person] has got better at doing more things than they could ever do. Like going out shopping with staff and goes for drives in the car. I could never imagine them doing those at home.” Another relative shared how the staff support enabled them to maintain more frequent contact with their family member. They told us, “The staff support me, if I want to take [person] out, there’s always a member of staff to support me as I can’t take her out on my own. Staff will come and support me so I still can spend time with [person].”

A third relative spoke of how the staff team’s knowledge of their family member had impacted their life. They said, “[Person] has thrived there. It gives us peace of mind knowing that they are settled. It’s like the staff want to be there; it’s not a chore. We are more than happy.”

Positive outcomes were recorded for people when they achieved something new or reached a goal. For example, 1 person had been supported to use the self-checkout machine when shopping and another had demonstrated independent living skills by emptying the bin and doing part of their own laundry. Another person, who had previously been unable to go grocery shopping, had been gradually supported over a period of time to develop confidence to go into shops. Staff had supported them to go into a small local shop first to gain confidence and then increased the size of the shop and the items purchased slowly over a period of time. The person was now able to go into a supermarket and do their shopping with the support of staff.

Another person was supported to improve their skills in social interaction. To do this staff had encouraged them to visit another home owned by the provider. With support, the person was able to visit others in the home and ask for a cup of tea on arrival. Something they had not previously been able to do.

Staff spoke with enthusiasm about the support they were able to provide and told us they felt pride when people achieved their goals. One staff member said, “When I go home, I can think we've fulfilled their needs, they are warm, well fed, safe and very content. Residents are always laughing, [person] gives you a hug, [person] gives you an elbow. I go home knowing their needs have been met. Their scrap books are filled with memories for them.”

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

People’s mental capacity had been assessed and clear guidance was in place for staff to follow to ensure people made as many decisions for themselves as possible. Staff were aware of the decisions people could make for themselves and supported them to do this as much as possible.

Staff had received training in the Mental Capacity Act and demonstrate a good understanding of consent. One staff member told us, “People pick their clothes, their food, what spray or fragrance they are wearing. If someone approaches the door and wants to leave, we’d say, ‘where do you want to go? Let’s go.”

Mental capacity assessments were recorded and where decisions had been made in people’s best interests, records showed the reasons for this and the people involved.