The Lawns

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.

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.

Staff demonstrated a good understanding of people's individual needs, preferences and routines. Care plans reflected people's assessed needs, including risks, personal preferences and input from relevant healthcare professionals. This helped ensure care was delivered in a way that reflected people's circumstances and requirements.

Assessments were reviewed and updated when people's needs changed, supporting a responsive approach to care. Staff recognised changes in people's health and wellbeing and took appropriate action, including seeking advice from healthcare professionals and implementing recommendations when required.

People and their relatives told us staff understood their needs and involved them in discussions about their care. One relative told us, “They [staff] have been really good with my [loved ones]. [My relative] suffers with anxiety and they have supported [them] well through this. For example, when [my loved ones] first moved in, they didn’t have an ensuite and [my relative] was anxious because [they] had to share a toilet. The management recognised this and as soon as it was physically possible, they moved [my loved ones] so they had access to an ensuite, and they continually reassured [my relative] that this would happen and it did.”

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.

Care and support were planned and delivered in line with current evidence-based guidance, standards, best practice, legislation and best use of technology. Assessments of people’s needs were comprehensive, expected outcomes were identified, regularly reviewed and updated. Staff recognised and responded promptly to people’s changing needs. When people's health or wellbeing changed, staff took appropriate action and sought professional advice where required. Appropriate referrals to external services such as the dietitian or Speech and Language Therapy (SALT) team were made in a timely manner to make sure people’s needs were met. This helped ensure care remained evidence-based, person-centred and responsive to people’s changing needs.

People's care plans outlined their food and drink preferences. There was guidance in place to support people to eat safely when they were at risk of choking or needed their food to be a certain consistency. Staff demonstrated a good understanding of how to support people with this. Systems were in place to monitor people's nutritional intake and weight, and risks associated with dehydration and malnutrition. Care plans identified the level of support people needed from staff to prevent malnutrition and dehydration, and this information was available to the staff working in the kitchen.

We observed mealtimes and saw the food looked appetising. People were supported to choose their meals by staff showing them plates of the options. This was particularly helpful for people with dementia, enabling them to see what was available and smell the choices. There were snacks and drinks around the service in communal areas for people to help themselves. People’s feedback about the food was positive and they said they could eat where they wanted. Comments included,“The kitchen staff are amazing. The food is beautiful” and “[My loved one] used to refuse food when living at their own home. [They] seem to eat what [they are] offered now. Staff know what [my loved one] doesn’t like. The food is good and there are lots of choices for example at teatime they are offered, quiche, sandwiches, cheese and biscuits.”

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.

The provider operated effective systems and processes for referring people to external services and to maintain continuity of care. Plans for transition, referral and discharge considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. This meant people’s care was effectively coordinated, to ensure they received timely and consistent support and treatment.

Staff worked with external health and social care partners to prevent or reduce the need for admissions to hospital. Health passports and transition plans were developed, maintained and used consistently. For example, when people needed hospitalisation, they held hospital passports. This meant all relevant staff were able to access the information they needed to understand people’s needs and appropriately assess, plan and deliver their care, treatment and support. We received feedback from 2 health and care professionals about communication with the provider and collaborative working. Comments included,“They do tend to seek help for urgent concerns and prepare a list for the weekly call.They are usually able to give me the information I require when I speak to carers” and “I have a good working relationship with the senior carers and the deputy manager. [The deputy manager] has always been professional and endeavoured to assist the management of the residents. Any actions requested [they] have always ensured these are followed.”

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.

Supporting people to live healthy lives and maintain good health was a key value and aim for the management and staff team. They fully understood good health was fundamental to people to living their lives to the fullest and experiencing good outcomes. Two guinea pigs - therapy pets providing companionship – recently moved into the home on people’s request. The home offered an extensive wellbeing activities programme such as exercise and fitness classes, music and entertainment, memory enhancing reminiscence sessions, gardening alongside frequent outings such as visits to the beach, local shops, cafes and the boat trips. We received positive feedback from people and relatives about the support people received to manage their health and wellbeing and enhance independence. One relative told us, “Staff and management have been very welcoming about the dog going into the home to visit every day. They recognise how important it is to [my loved one] and what a calming influence it has for [them]. They understand the importance of supporting [my loved one] to see [their] dog regularly and so they facilitate this.” Another relative commented, “It feels like being at home. There is nothing I would change. There is a relaxed and comfortable atmosphere[SG3][MF4]. [My loved one] feels more comfortable now in joining in events and [their] anxiety has lessened. [They] particularly like the music events.”

Staff effectively empowered and supported people to be involved in or manage their own health, care and wellbeing needs as much as possible. The registered manager told us they recently held an educational session for people where staff explained the importance of hydration and the effects of caffeine on human wellbeing, highlighting the benefits of drinking caffeine-free drinks. Caffeinated drinks were available to people alongside caffeine-free options, and a variety of flavour enhanced smoothies to ensure good hydration.

Staff actively empowered and supported people to be involved in or manage their own health, care and wellbeing needs as much as possible. A member of staff told us, “People are being supported to make their own choices and maintain their independence wherever possible. A particularly positive example is a couple who live at The Lawns. They have been provided with their own area where they can make drinks, prepare snacks, and spend time together independently. This has been very important to them in maintaining their relationship and sense of normality. It has been rewarding to be part of a team that has supported and enabled them to continue living in a way that reflects their wishes and promotes their independence.”

Monitoring and improving outcomes

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.

People and their relatives told us they felt confident staff monitored people’s health and worked with healthcare professionals and partners to achieve positive outcomes. One relative told us, “They have a specialist nurse practitioner for frailty who visits the home weekly. If there are any concerns staff will get in touch with the doctor. For example, [my loved one] felt dizzy 1 day, and staff did checks and got in touch with the GP surgery to ask for a visit.” Another relative said, “[My loved one] was quite thin when [they] first came but [they] have gained weight since coming to the home. Initially [they] were on a high calorific diet plus supplements but now [they] are on a normal diet because [they] have done so well.”
Staff used a variety of methods and tools to monitor and improve people’s outcomes. If people had agreed plans of care to improve areas such as skin integrity, staff took actions such as re-positioning people. We found monitoring records reflected staff were consistently moving people as per the agreed plan. There was monitoring taking place for other health outcomes such as weight monitoring and food and fluid intake. Any concerns about people’s outcomes were identified and shared with people’s GP in a timely manner. The frailty practitioner reviewed all concerns during weekly visits to the home.
Healthcare professionals confirmed staff worked with them, followed their advice and monitored people appropriately which resulted in positive outcomes for people. However, some professionals told us they experienced difficulties with having a senior staff member to accompany them during their visits, especially around medicines administration times. Comments included, “The district nurses often arrive and are not being afforded a member of staff to escort to the resident they are there to see despite this being asked for by the clinical director and District Nurses lead.”

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

The provider had established effective systems and processes to ensure people’s human and legal rights were always respected and they had maximum choice and control over their lives. Staff demonstrated good understanding and working knowledge of the key requirements of the Mental Capacity Act (MCA) including Deprivation of Liberty Safeguards (DoLS). People were involved in decisions about their care and treatment as much as possible and staff ensured all practicable steps were taken to help people make their own decisions.

People’s mental capacity to make decisions was assessed whenever this was necessary. Where people did not have the capacity to make a particular decision, they were given the information they needed in an accessible format of their choice, and where appropriate, their family, friends, legal representatives or advocates were involved. All decisions were taken in people’s best interests ensuring staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.