Valley Lodge Care 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

This service scored 50 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The provider had processes in place to assess and review people’s health, care, wellbeing and communication needs. However, these processes were not always consistently effective in ensuring care was planned and delivered in a proactive way that optimised outcomes.

Staff described responding to changes in people’s needs by increasing oversight and adapting support where risks became more apparent. These actions demonstrated that staff were able to recognise and respond to developing concerns. However, interventions were not always introduced at the earliest opportunity, which limited the provider’s ability to consistently reduce risk and prevent avoidable deterioration.

Relatives confirmed that care was adjusted as needs changed, including the introduction of additional support and monitoring. While this reflected a responsive approach, it also highlighted that care planning was not always sufficiently forward-looking to ensure consistently positive outcomes.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Records did not consistently demonstrate best practice guidance was followed. Care plans and risk assessments were not always updated promptly after incidents, such as falls or changes in health needs. Post-fall protocols and monitoring arrangements were not consistently documented, and there were gaps in repositioning records and skin integrity monitoring. This meant it could not always be assured that care was delivered in line with current guidance or that risks were being managed proactively. As many of these improvements were recent, further time is required to confirm they are fully embedded and sustained over time.

Despite these issues, staff described care that aimed to align with evidence-based practice, particularly in areas such as falls prevention, pressure care and the management of long-term conditions. They also reported improvements in how incidents were managed, including clearer actions taken following falls.

Relatives provided positive feedback about the care delivered, describing staff as responsive to healthcare needs. They noted appropriate catheter management and timely action when people became unwell, which offered reassurance about day-to-day care delivery.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Safeguarding concerns raised by community nursing teams highlighted previous breakdowns in shared accountability, particularly in relation to skin integrity and continence management. These issues indicated that communication and joint working with external professionals were not always effective or timely, limiting opportunities for coordinated care planning and early intervention. As a result, risks were not consistently managed in a collaborative way, leading to variable outcomes for people and reducing the effectiveness of joined-up care.

However, relatives described positive experiences of engagement with external professionals. They gave examples of regular GP involvement and specialist support from hospice services, particularly for end-of-life care. This demonstrated that, when effectively accessed, multi-disciplinary input contributed to safe and responsive care delivery.

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.

Previous concerns relating to nutrition, hydration and personal care indicated that support in these areas had not always been delivered consistently. Monitoring and follow-up were not always robust, meaning risks were not always identified early or managed proactively. This suggested that, while staff could recognise issues, responses were sometimes delayed or reactive rather than preventative.

However, staff described supporting people with their nutrition, hydration and mobility needs, and relatives confirmed that concerns were escalated when there were changes in intake. For example, some relatives said they would be contacted if their family member was not eating or drinking, demonstrating increased awareness and recognition of risk in these areas.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Daily care records were not consistently completed, and this lack of reliable documentation, combined with ongoing concerns relating to falls and skin integrity, reduced assurance that risks were being effectively monitored and managed. It was not always evident that appropriate action had been taken in a timely manner or that risks were being consistently mitigated.

Although governance audits and care record reviews indicated some improvement, inconsistencies in recording and recurring risk themes showed that these systems were not yet fully effective in driving sustained change. As a result, it could not be fully assured that people’s outcomes were being consistently or effectively monitored.

However, there were signs of progress. Care plan reviews were taking place more frequently and better reflected people’s individual needs, and relatives reported increased monitoring and oversight following incidents.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Staff demonstrated inconsistent understanding of the Mental Capacity Act (MCA), best interests decision-making and Deprivation of Liberty Safeguards (DoLS). Not all staff were confident in how to apply these principles in their day-to-day practice, which reduced assurance that people’s rights were consistently upheld.

Some staff were able to describe how they supported people to make decisions in their best interests and in the least restrictive way. However, this knowledge was not consistent across the staff team, indicating that further training and oversight were needed to ensure a shared understanding and consistent application in practice.