Britannia 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.

This is the first assessment for this service registered under a new provider. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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. Before people came to the service a full assessment of their needs was completed. Care plans and risk assessments were detailed and person centred, providing staff with the information they needed to support people safely. Assessments were regularly reviewed, and any changes were updated. Communication needs were assessed to ensure people received information in the best way for them.

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. Clinical assessments tools were in place where needed such as food and fluid monitoring and weight charts. Referrals were made to other healthcare professionals for their expertise, such as speech and language therapists for advice on swallowing difficulties and diet. Any support or advice was recorded in people’s care plans for staff to follow. People told us they enjoyed the food at the service and that they had plenty of choice. Menus were discussed with people daily so that they can choose what they felt like eating each day. One person told us, “Food is nice, have drinks when you want.” Another person said, “The food is spot on, I like the chilli con carne or curry.”

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 worked with other health professionals to ensure they had all the information they needed to ensure people’s support continued. This included follow up with specialist hospital visits and working with the multidisciplinary healthcare team to provide continued support to people. The registered manager told us they worked closely with mental health and dementia teams who provided support to people at the service.

The registered manager 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 told us they were supported to access dentist and foot health support. One person said, “I have an electric toothbrush and mouth guards for my teeth. A lady comes in and does my feet.” People told us they had access to the GP when they needed to see them.

Staff told us they liaised with community mental health nurses and supported people to go for regular monitoring such as blood tests. When specialist referrals were needed to the tissue viability team for advice, these were made promptly. Staff monitored people for signs of skin breakdown or infections and sought advice from the appropriate healthcare professionals. The GP practice provided support from specialist health professionals who carried out weekly checks with the service to see if they needed any reviews of people’s health.

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. Staff monitored people’s physical and mental wellbeing for signs of changes that may need intervention. Each morning staff had a community meeting with people to help them plan what they would like to achieve that day. If they did not attend the meeting staff met with them individually, this helped people structure how they wanted to spend their time and what meals they would like to eat. This approach of engaging with people also helped to set out goals for the day and plan community outings to improve social opportunities.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff had received the appropriate training in obtaining consent from people. Care plans detailed people’s capacity and their ability to consent and make decisions. Staff understood people had the choice to make their own decisions even if they may be unwise unless they lacked capacity.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The authorisation procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. The registered manager understood their responsibilities and the key principles of the MCA and DoLS, and we saw any conditions were being met. Where appropriate, relatives and advocates views and wishes were taken into account when care was planned.