Loganberry 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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Recommendations had been made at the last assessment regarding the provision, variety, choice of meals. Improvements had been made, and people received a good dining experience.

This service scored 75 (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.

An assessment process was in place before and when people moved to Loganberry Lodge to ensure the service was able to meet their needs. People and their relatives were invited to look round the service and to meet staff and see the facilities. A family member told us, “It was an emergency admission, and we had no choice of home for [relative]. Looking back, I’m not sure why we worried. Staff always chat, make a cup of tea, and keep us up to date.” A professional told us, “We have a very good working relationship, and this has a real impact on the people we support. The team is quick to respond, and referrals are acknowledged within minutes by the registered manager or deputy manager. They let us know what they plan to do next, such as reviewing the referral, contacting the family, offering a tour, and following up once they have the information they need. This helps everyone stay clear about what is happening and gives families reassurance during what can be a stressful time.”

People’s needs were comprehensively assessed and included consideration of their physical, mental health, sensory, social and communication needs. Assessments were carried out by staff with the right skills and abilities to assess people’s needs. People and their family members/representatives were involved in these discussions. Care plans were reviewed monthly, with details of who had been involved. Any changes in the person’s care needs at any time were clearly documented so they were kept up to date. Staff kept clear, comprehensive care records to support reviews and evidence of appropriate action taken in response to changes noted.

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 registered manager used national standards and evidence-based good practice guidance in areas of the service. Staff used recognised tools to assess people’s level of need and risks in relation to aspects of their health such as skin integrity and nutrition and hydration so their care could be tailored to their needs and wishes. The registered manager told us how the service had participated in the local authority Prosper project, trialling and implementing new methods and guidance to reduce the number of falls, pressure ulcers and urinary tract infections which had seen good outcomes for people.

We observed there was a lack of adequate facilities in the environment for people living with dementia to enjoy such as tactile objects of reference or areas providing stimulation and interaction. A family member told us, “[Relative] is in bed, so doesn’t participate in activities. She needs stimulation and an interest.” The provider acknowledged more work was needed to ensure the environment was ‘dementia friendly’ and met people’s needs. They advised us following the site visit that they had contacted their head of dementia care to review the dementia environment, enhance engagement and order additional resources for the service.

Food quality and people’s dining experience had improved, with more variety and appetising meals. One family member said, “Food was a problem for a while but recently the chef seems to have taken on the challenge. [Relative] will now say they had a really lovely lunch today, or didn’t fancy anything, so they had a boiled egg.” Another family member added, “With regular, good quality meals and snacks, my [relative] has put on a bit of weight and looks much better.”

Nutritional and hydration needs were met according to the required standards. People had enough to eat and drink, including those with complex needs like diabetes or swallowing difficulties. A family member said, “[Relative] struggles to eat as much as they ought to. The staff tried fortified drinks, but that was difficult so now it’s an extra dessert. At least they’re trying to help.” Another family member told us, “[Relative] likes their food, there are always drinks around in the lounge and in their room.”

Meals were ordered a day in advance. One person said, “The food is very good, they come the day before so I can pick from the menu.” Some people couldn’t remember the choices they had made. Staff showed examples or offered alternatives. Visual plates and pictorial menus were available. The wording on the menus could be difficult for some people to see easily. The provider told us they would look into redesigning the menus to make them more accessible.

We observed positive interactions between people and staff over lunchtime. People appeared comfortable, sitting together and chatting. Staff were attentive and knew people’s needs and personalities. We saw staff helping people to eat in their rooms and they were not rushed.

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.

Staff, teams and services worked together with people to effectively deliver coordinated, timely, person-centred care, support and treatment. Plans for transition, referral and discharge considered people’s individual needs, circumstances and ongoing care arrangements and expected outcomes.

Information was effectively shared between teams and services where they worked together to deliver a person’s care. This meant all relevant staff understood people’s needs, how they would be met and by who, for example when clinical tasks were delegated or when people were referred between services.

Staff were proactive in working with other services when multidisciplinary involvement was required, and any actions are followed up on as needed. Staff gave us many examples of how they worked together to ensure people got the support and care they needed, especially from health and social professionals. A staff member told us, “We have professional involvement to support people’s health and wellbeing from the community nurses, paramedics, GP, social workers, dietician, occupational and speech therapy teams. They are here to advise and are very supportive to us.”

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’s day-to-day health and wellbeing needs were met, and people experienced positive outcomes related to these needs. A person told us, “The district nurse comes in every morning, and my glucose levels are taken. I am happy with the care I receive from the staff and district nurses.” Another person said, “I am confident they would call a doctor for me if I felt unwell. The staff understand what my illness is and support me accordingly.”

People were encouraged and supported to understand and make healthier choices including their diet, lifestyle, physical activity, personal and oral hygiene. A family member said, “My [relative] is now taking an active interest in their health.” Another family member told us, “[Relative] must have a catheter which the district nurse sees to. Staff maintain good hygiene because no infections now.”

People were involved with regular monitoring and reviewing of their health and wellbeing by regular health checks with healthcare professionals. We saw in the care plans clear information relating to people’s oral health care and access to dentists as needed. A chiropodist visits weekly for anyone requiring this service.

The service identified risks to people’s health and wellbeing and prioritised support to prevent deterioration as much as possible. For example, supporting people to remain as active and mobile as possible. A staff member told us, “There are many moments when I feel I have helped someone. I have called ambulances or doctors when I felt something was not right, or I have asked a request to be made for a GP review for people who seemed to decline. One person was unable to sleep for several nights and became frustrated; I reported this, and the GP prescribed some medicines for them. Since then, their sleep and mood have improved.”

The service made sure referrals to appropriate health services were made quickly when people’s needs changed and acted swiftly on their recommendations. A professional told us, “When we get a new referral, we talk with the staff who are well informed on any new person who has been admitted. If there are any concerns, staff are good at communicating that with us. If we have any recommendations on any manual handling of a person for example, the staff work well with us to adhere to our care plan, especially with progressing a person’s independence.”

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.

There was a robust approach to monitoring the effectiveness of people’s care, treatment and support and action was taken to continuously improve it. The registered manager sought and considered feedback from people, their families, staff and partner agencies when monitoring individual outcomes. A professional told us, “I’ve reviewed quite a few people at Loganberry Lodge. I’ve found the home to be very accommodating when I visit, with management and the senior staff being happy to take their time to give me information, answer any questions and let me view the care records when I need to. I see good outcomes for people.”

People’s care plans detailed all aspects of people’s care and treatment and described the ways in which monitoring occurred such a dietary intake, skin integrity checks, repositioning charts, weight, emotional wellbeing and engagement with activities. We saw that they were routinely reviewed.

People had support to improve and maintain their quality of life. A person told us, “I’m very safe and comfortable; the staff give me that feeling of security and the care is excellent. “A family member said, “[Relative] had a fall in the summer which knocked their confidence. Their friends and staff are doing a good job getting them back to fitness.” Another family member said, “[Relative] is now getting outpatient assessment and treatment. They have put on weight and is generally much better.”

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

People told us they were able to make their own choices, and these were respected. A person told us, “Staff always ask me where I want to go, or join in, but I don’t always want to. They respect my wishes.” A family member said, “Staff are very gentle with my [relative] and make sure [relative] agrees to washing and dressing before this is undertaken.”

We checked whether the service was working within the principles of the Mental capacity act (MCA), whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty; CQC had been made aware of these via statutory notifications.

People’s care plans included capacity assessments which detailed how their capacity to make decisions had been reached. This included photography, bedrails, medicines administration, personal care, use of sensor mats and alarms, lap belts on wheelchairs and if people could not leave the service unattended.

Staff had received training in the Mental Capacity Act (MCA) and had a good understanding of protecting people’s rights. They were able to explain to us how they ensured people’s consent was sought. A staff member said, “We respect people’s choices: when they want to go to bed, when they want to get ready for the day, and if they are hungry during the night we make toast, sandwiches, or a hot drink. I feel we have the resources we need to care for them properly in a way they like to be.” Another staff member told us, “We check with people every time. We always ask them what they want and to involve them and gain their consent.”

We observed staff gaining consent from people in a respectful way during our site visit, including lunchtime and when staff were attending to people’s personal care or moving and handling them.