The 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.

At the last inspection, risk assessments and care documentation were incomplete and placed people at risk. At this inspection, assessment processes were in place, and staff demonstrated a strong understanding of people’s needs. Staff adapted care based on changes in presentation. However, care plans did not always fully reflect this knowledge, showing a gap between practice and recorded information rather than a failure in care delivery.

Staff described adapting communication approaches depending on individual needs, stating, “Some days communication is good and some days bad. You just have to take your time and listen attentively.” This demonstrated a compassionate, person-centred approach to assessing and responding to people’s evolving needs.

However, while staff knowledge of individuals was strong, some care plans lacked consistent detail in parts. There were examples where information relating to areas such as communication, mobility and specific health conditions was not always fully captured or clearly recorded. This could make it more challenging for all staff, particularly new or unfamiliar staff, to have a complete understanding of people’s needs. Despite this, staff were able to describe people’s needs confidently and provided care that was responsive to those needs in practice.
 

Care was delivered in line with professional advice and best practice. Staff worked with external professionals and responded appropriately to changes in need. This represented an improvement from the last inspection where professional advice was not always recorded. Documentation required further strengthening to ensure guidance was consistently captured.

Staff demonstrated a good understanding of people’s needs and applied their training to deliver care that was safe and person-centred.

There was clear evidence of collaborative working with external health professionals to support the delivery of effective care and treatment. Staff described how they engaged with professionals such as district nurses, with one explaining, “We have to explain what has happened and can they have a look, then action is taken,” demonstrating how clinical advice informed care delivery. Health professionals confirmed improvements in practice, stating staff and management were, “Eager to know what the plan of action is” and had become, “More proactive in seeking guidance”, which supported safer and more effective treatment outcomes.

Training systems were in place and staff reported applying this learning in practice. Staff demonstrated good knowledge of individuals and were able to respond appropriately to their needs in practice. The provider had recognised the need to improve the consistency and detail of documentation and had plans in place to address this through the implementation of a new digital care system. This demonstrated a proactive approach to strengthening how evidence-based guidance is recorded and embedded to evidence positive outcomes for people.
 

The provider had improved working 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.

Partnership working had improved in some areas, such as work with district nurses, particularly in recent months. Feedback identified this required further embedding into practice, to ensure this was consistently effective in ensuring joined-up care.

Internal team working was generally described positively, and staff supported each other to deliver care. One staff member said, “We all help each other out on shift,” indicating a collaborative approach within the team.
 

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 were supported to access healthcare services, including regular input from the district nursing team. Referrals to external healthcare professionals were made, and staff responded to identified needs. The provider was working to ensure all follow-up actions and recommendations were consistently embedded into care planning.

Staff supported people with day-to-day health needs, including nutrition and monitoring. One person told us, “They’ll get the nurse if I need them,” indicating access to external professional support. The registered manager was transferring to a digital system to improve records and evidence people’s improved health outcomes or that these had been sustained over time.
 

Monitoring systems were in place and staff described observing and responding to changes in people’s health. This demonstrated improvement from previous failings where monitoring was not effective. However, records were not always consistently completed, limiting the provider’s ability to evidence outcomes fully.

Staff were actively involved in monitoring people’s wellbeing and responding to any changes in their needs. For example, staff described how they observed food and fluid intake and acted where concerns were identified. There were systems such as daily meetings and handovers in place to share this information, helping to ensure continuity of care.

Health professionals told us staff were, “On the ball with ringing us when they have any concerns,” and that, “Improvements have been made, particularly in the last six months.” This demonstrated that the service was proactively seeking input where needed to support people’s health and wellbeing.
 

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

Staff demonstrated understanding of consent and described seeking verbal consent before providing care. One staff member told us, “We always ask before we do anything,” indicating awareness of some aspects of person-centred approaches. We checked some people’s records to ensure where conditions were put on people’s liberty, that the service was meeting them. We found these conditions had been met.

We discussed with the registered manager, the need to regularly review restrictions on people’s liberty. For one person who had restrictions in place, the registered manager assured us they were in the process of reviewing these to ensure least restrictive options were always in place.