Healey Lodge Residential Home

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 requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to safe care and treatment.

This service scored 54 (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 prior to their admission to the service. People and relatives told us they were involved in the admission process. One relative said, “I am involved in [person’s] care plan. The transition went so well when [person] moved there. Social services were involved.” Initial assessments were taking place prior to a person’s admission to the service to ensure the service could meet people’s needs.

Staff told us they were kept up to date of people’s needs through daily handovers. One staff member said, “Handovers are twice a day. I read care plans when I have a spare minute. They’re kept in the office.” There were no service user guides or welcome packs available to people. We raised this with the nominated individual who said they would look into implementing 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. People were positive about the food on offer. One person said, “The food is decent, traditional British meals, portion sizes are good. I can always ask for something different if I don’t like what’s on the menu.” Relatives praised staff for ensuing their loved ones ate and drank well. One relative said, “Anytime [person] presses the buzzer they can have a drink or a snack. They (person) used to be so frail but they are much healthier now. I’ve never seen [person] healthier than they are now.”

Staff had good knowledge of people’s specialised diets. One staff member said, “Some people need modified diets such as thickener (thickening powder for fluids) and blended meals. Some people are diabetic and information is in the kitchen and in people’s care plans. We assist people with their meals.” The kitchen held information on people’s dietary requirements including any modified diets, preferences and even which cup people liked to use. A range of options were available to people including varied menus and alternative options. A range of snacks were available throughout the day including milkshakes and cakes to encourage people to consume more calories. Not everyone was on a fortified diet and some people were encouraged to eat healthier.

The provider did not always work well across teams and services to support people. People who were living with a learning disability did not have their goals and ambitions for the future outlined in their care plan. This meant it was not clear what people wanted to achieve to live a more fulfilling life. Some relatives told us they weren’t always kept informed when people’s needs changed.

Handovers took place twice daily where important information was communicated to staff. Staff told us they worked well together as a team and communicated with each other. Allocation sheets were completed daily and we saw evidence of referrals being made to other healthcare professionals including SALT (Speech and Language Team) and dieticians as required.

Professionals told us referrals to their service would be made as required and the nominated individual spoke of staff being allocated key workers who oversaw care and acted as the main point of contact for relatives and professionals.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Distressed behaviours were not always well managed which was evidenced through our observations and through behaviour logs. Staff told us, “There is no rush, we can spend time with people. People are encouraged to live a healthy lifestyle with chair exercises, mindfulness colouring and walking in the garden.” However, when we reviewed the activity logs there was no evidence of chair exercises taking place or any activity that would promote healthy lifestyles. Relatives told us people were encouraged to live healthy lifestyles through diet and supervision.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Tools for monitoring people were in place but were not up to date and accurate. Behaviour charts were not detailed enough to advise of how a person’s behaviour had impacted them and what the outcome was for the person to help reduce future risks. Oral health plans and risk assessments were not detailed enough and it was not clear whether people were registered with a dentist or when they were last seen. For people that required a dentist, this decision was not always being made in the person’s best interests.

Moving and handling risk assessments were not accurate and one document was contradictory. This could lead to confusion and potentially inappropriate care being provided. Records relating to pressure relief monitoring were not consistently completed and no action had been taken for some people when weight loss occurred.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, records relating to DoLS were not robust enough. Information on whether people had a DoLS in place was confusing and some records contradicted each other. Staff were not aware of who had a DoLS or if any restrictions were in place. This meant we could not be assured people were being deprived of their liberty safely.

Staff told us the importance of obtaining consent. They said, “We always ask for consent, we ask, ‘Am I OK to do this?” A range of care plans and best interest decisions were in place and people had their capacity assessed, where appropriate. Consent forms were signed by the person or relative. The nominated individual told us all decisions were made in line with the Mental Capacity Act and people were encouraged to make their own decisions.