Hunter's 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 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. Before people moved into the service, a full assessment of their needs was completed to ensure the service could meet their needs effectively.

People and their relatives were invited to visit the service, supporting them to make informed decisions about whether it was the right place for them. Assessments were completed by the registered manager in discussion with the person, their relatives and relevant health professionals, ensuring a holistic and person-centred approach was taken from the outset. From these assessments care plans were developed to support staff in understanding people’s individual needs. However, whilst care plans contained relevant information to support staff, we found some records lacked consistency in how information was recorded. In some instances, some information was missing, duplicated or conflicting across different sections of the care plan. Whilst this did not mean information was absent overall, the inconsistency in recording had the potential to impact the staff’s ability to access it clearly and accurately, which could affect the consistency of care and support people received. This was raised with the registered manager during the inspection, who took immediate action to address this.

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.

Where people’s needs changed, staff took appropriate action by making prompt referrals. A family member told us, “Staff noticed [name] eating their food quickly, they got the SALT (Speech and Language) team in who suggested mashing their food.” The relative confirmed this was working well and noted the care plan would be updated to reflect this.

People had access to food and drink throughout the day and were supported according to their preference. Although set mealtimes were in place, people were not confined to these and could eat at other times if they chose. A staff member told us food was available outside of scheduled mealtimes and no one was ever rushed. This flexible approach showed the provider placed people’s comfort and choice at the centre, rather than strictly following routine. Staff responded creatively and practically to people’s nutritional needs. For example, 1 person who had difficulty eating was encouraged to have soup served in a familiar mug, which supported their intake. A relative told us, “[Name] doesn’t eat well, they [staff] are creative with [name] diet and put soup in the mug [name] always has their hot chocolate in.”

Care plans captured individual dietary preferences, requirements and support needs; enabling staff to assist people with eating and drinking in a dignified and respectful manner. Meals were prepared flexibly, with the chef responding to people’s preferences each morning and offering a choice at mealtimes, including an alternative if people did not want what was on the menu.

Where people had rehabilitation goals, staff supported them in a structured and encouraging way. One relative told us, “[Name] had been encouraged to use their left hand after having a stroke and within 4 weeks they were able to use it.” This demonstrated staff were able to understand the importance of enabling people to maintain and develop their independence.

Relatives spoke positively about communication with the service and felt confident staff would contact them promptly if their loved one’s health changed or if healthcare professionals had been involved in their care.

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 were kept informed of people’s needs through structured handovers at the beginning of each shift and ongoing communication throughout the day. Staff told us they used an electronic system which played a key role in monitoring people’s well-being and helping to identify any concerns at an early stage, such as when a person was not consuming enough fluids, allowing prompt intervention.

Feedback from a professional visiting the service was positive. They spoke highly of the management and staff team and the collaborative way in which they worked together to support people’s needs. One professional described their overall experience of visiting the service as “fantastic, no concerns, [staff member] amazes me with the amount they know about the residents.”

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.

Staff had a good understanding of people’s individual health needs and knew when and how to seek input from relevant healthcare professionals. Staff demonstrated a strong awareness of how people might present when unwell, particularly those who were unable to communicate pain or discomfort verbally. Staff described looking for non-verbal indicators of illness or distress in behaviour as potential signs. One staff member told us, “They [person] might stop walking or continually scratching, which might indicate they are in pain.” Staff spoke about knowing people’s baselines so any changes could be recognised and acted upon promptly. This was particularly important for people living with dementia or those with limited verbal communication, and demonstrated staff took a personalised and observant approach to monitoring health, ensuring people who could not speak up for themselves were not overlooked.

The provider held regular multi-agency meetings, which included a nurse practitioner, providing a structured forum where concerns about people’s health could be raised and discussed. Following these meetings, people were seen promptly by the nurse practitioner, where needed, ensuring any identified concerns were acted upon without delay. Where further input was required, referrals and actions were followed up directly with GPs, creating a clear pathway. This demonstrated a proactive and coordinated approach to managing people’s health needs, with a strong professional oversight embedded into the routine running of the service.

The provider had systems in place to regularly monitor people’s care and treatment to support ongoing improvement. However, these systems were not always fully effective, as not all aspects of care and treatment were consistently recorded to inform and drive improvements.

Whilst staff were aware of people’s needs, it was not always clear what monitoring was in place for some people. During the inspection, ABC charts were not consistently completed. Whilst the effectiveness of PRN medication was being recorded, entries often lacked sufficient detail, contained inappropriate language and did not clearly document the de-escalation strategies had been used or their effectiveness of intervention. This meant insufficient information was available to evidence where interventions were working, whether behavioural patterns were being identified, or whether care and support were being adjusted in response. This limited the provider’s ability to demonstrate monitoring was driving meaningful improvement for people's outcomes. This was raised with the registered manager during inspection, who acted immediately.

Care plans were regularly reviewed, which indicated some oversight was in place. However, improvements were needed to ensure records were complete and consistently maintained. Some information found in care plans was conflicting. This had the potential to impact staff understanding and the consistency of care delivered.

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

Staff had received training in the Mental Capacity Act and demonstrated a good understanding of its principles. The provider actively supported people to make their own decisions wherever possible, and consent was sought before care and support were provided. Staff demonstrated a good understanding of gaining consent from people who may not always communicate verbally, using appropriate methods to interpret and respect individual preferences.

Throughout the inspection, people were observed being offered meaningful choices in line with their individual needs, preferences, and abilities, including choices about daily routines and care. Staff took the time to explain options in a way people could understand, supporting empowerment and decision-making practices.

Where people were assessed to lack the capacity to make decisions, Mental Capacity assessments had been completed and recorded in a decision-specific way. There was evidence of best interest meetings taking place in accordance with MCA principles, with records of meetings that involved people, their relatives and representatives, ensuring decisions reflected people’s wishes, feelings and preferences as far as possible.