Amber 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. 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, well-being and communication needs with them.

The registered manager told us people were fully assessed before they started using the serviceand stated, “[Deputy manager] does a lot of these [assessments]. She is our clinical lead. We do them face to face.” People’s needs were discussed with them and where appropriate their relatives before they started using the service. Person-centred care plans were developed and reviewed regularly, as confirmed by records. Staff told us they knew people well and had access to up to date care plans that clearly reflected people’s needs and preferences. One person told us, “The staff often will come in and have a chat to me. Yes, the staff do know my care needs.” A relative told us, “The staff know [relative’s] care needs, and are very kind and caring to [relative].”

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. Staff knew people well and how they wished to be supported with food and drink. People were given options at mealtimes and were able to choose what they wanted to eat which is something we observed during the assessment. One person told us, “Yes the food here is very nice, they cut mine up small because I have swallowing issues. If I don’t like what they bring in I can always ask for a different meal.” The chef told us, “Always options for people. If somebody doesn’t like my options, I asked what they want to eat and I cook for them whatever they want.”

Assessments were in place to identify the support people needed, and staff were trained to recognise choking risks and respond appropriately. Where required, the service worked with speech and language therapists to ensure people received the right support with eating and drinking.

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 had access to the information they needed to support people effectively and, where required, to support safe transitions between healthcare services. The registered manager and deputy manager had established strong links with health professionals, and staff supported people to attend appointments when appropriate. For example, the deputy manager previously worked as a senior urology nurse and used her skills and experience to support people with catheter care. She ensured catheters were managed appropriately and made timely referrals to relevant professionals when needed and records confirmed this.

Regular staff meetings, handovers and supervision ensured information was shared and staff worked together to meet people’s needs.

The provider supported people to manage their health and well-being 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 professionals and services to reduce the risk of health deterioration and promote their independence.

Staff attended regular meetings to ensure they had up to date information to support people and involve them in decisions about their health. Referrals were made to relevant health professionals, including GP’s, dieticians, speech and language therapists (SALT) and district nurses. People’s records clearly documented health conditions and required any any referrals made for advice and support. Staff had received training to recognise and respond to early signs of deteriorating health. One member of staff told us, “Every change we are updated, and the documents are also updated. If something changes we update peoples records immediately, for example if their swallowing has changed, we won’t wait. We will update the care plan and do a referral to the SALT team immediately.”

A relative told us they were always updated on any changes in their relative’s health and needs. One relative explained, “If anything is not right, we always get a telephone call, or updated as soon as we come in.” Another relative said, “I can visit any time, and always made to feel welcome, I am always updated on any concerns.”

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. The registered manager had systems in place to monitor outcomes for people. This included gathering feedback through meetings, telephone calls and surveys. Feedback was analysed to identify themes and areas for improvement.

The registered manager told us, “We are a very proactive home. We have very positive feedback from families.” We saw a variety of thank you cards and letters from families during our assessment. One person told us, “Yes, I would know how to complain if I had to.I am happy here though.”

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

People’s consent for care was sought, and staff understood the requirement to seek consent for care from people which was reflected in their care plans. Staff supported people to make decisions for themselves and offered them choice during all interactions.

The Mental Capacity Act 2005 (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 MCA 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 to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The registered manager was working within the principles of MCA and had applied for assessments and renewals of DoLS when required.