Sagecare (Chesil 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 inspection this key question was rated good. At this assessment the rating remains 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.

The manager had a very clear understanding of the range and scope of needs that the service could accommodate. They told us that due to considerations around the physical environment and ethos of the service, admissions were best suited for people who were able to manage risks and assess danger independently of support. The manager attended panel meetings with stakeholders, such as social workers and representatives from the housing provider. These meetings helped to assess whether the service could meet prospective tenants needs, ensuring referrals were suitable.

People told us they were involved in initial care assessments and care plans were reflective of agreed outcomes of support. The provider also reviewed previous assessments from external stakeholders to help determine people’s care requirements. There were systems to regularly review people’s needs, with care being adjusted as appropriate. This helped ensure people’s current needs were being met.

The provider planned and delivered people’s care and treatment with them. They did this in line with legislation and current evidence-based good practice and standards.

People told us they received the support they needed to eat well and keep hydrated. Their care plans detailed the support they needed in cooking, eating and drinking, including preferences and preferred routines. Care plans detailed any cultural, religious or medical considerations around eating and drinking. Staff had a good awareness of the importance of promoting nutrition and hydration. They told us how the encouraged people to eat and drink well and reported any concerns to senior staff around nutrition and hydration.

Many people used the onsite restaurant facilities, which the provider was not responsible for overseeing. However, there were examples where staff encouraged or helped people to access these facilities. One person told us, “The carers will take me down for my lunch into the dining room.”

There was an internal team, who developed the provider’s policies and procedures. Policies were regularly reviewed and updated to help ensure they were in line with best practice. Staff told us policies were available for them to review electronically, which helped to ensure they were able to refer to guidance and advice when needed. One staff member told us, “We have all the information we need on our phones. If in doubt, you can refer to a policy or call the management for help.”

The provider worked well across teams and services to support people.

When external stakeholders had input into people’s care, the provider clearly defined and documented each organisation’s role. There was evidence of positive collaboration with external stakeholders, such as working with the housing provider to address housing or tenancy issues. The provider maintained effective partnerships and information-sharing agreements with people and external professionals. This promoted a consistent, coordinated approach that supported positive health outcomes. Referrals were made to district nurses for skin integrity concerns, and updates were shared after professional’s visits. This promoted a consistent, positive health outcomes, as people received timely and appropriate support from professionals.

There were effective communication systems between the provider’s staff team. Senior staff used the electronic care planning system to promptly identify changes or concerns about people’s care. Care plans were uploaded to the electronic system in ‘real time’, with changes to care required highlighted for staff to review. This helped to ensure staff working across different shifts, at different times were supporting people in a consistent way using the most current information about their needs.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

People told us staff supported them to access healthcare services as required. One person said, “The carers would ring the doctor if I needed one.”

Peoples’ care plans detailed how their medical conditions affected their everyday lives and how staff should support them to meet their healthcare needs. There was evidence of good quality care and input from staff, resulting in positive health outcomes for people. For example, staff worked with one person to understand how their medical condition affected their confidence and motivation. They ensured the person received the right professional support and equipment to help improve their everyday life. This helped the person live well with their ongoing condition.

People were supported to follow exercise and fitness plans set out by external health professionals. For example, staff supported people with exercises recommended by health professionals, which aided their recovery after injury or periods of ill health. Staff facilitated regular group exercise classes in communal areas of the service which enabled people to participate in suitably tailored light physical activity. This helped to improve people’s health and promoted their wellbeing.

The provider ensured staff received specific training relevant to the needs of the people they supported. This included training in people’s medical conditions and the use of specific care equipment. The provider had significant training resources available, which meant they responsively provided staff training in line with people’s changing needs or the needs of new referrals.

The provider routinely monitored people’s care and treatment to continuously improve it.

People told us that their care promoted positive outcomes in relation to their health and wellbeing. They told us that staff worked with them to set out what they would like to achieve from care and how this was best accomplished.

Staff monitored changes in people’s needs and identified when they required extra support. Senior staff ensured this support was provided. For example, staff noticed a person was struggling to apply transdermal patches as prescribed, which affected their pain relief. They reported this to senior staff, who arranged additional care calls to assist with applying the patches. This ensured the person received the pain relief they needed.

In another example, one person arrived at the service being cared for in bed. They were declining care and had stopped eating while in hospital. Staff encouraged them to engage with personal care and external health services. As a result, the person was supported out of bed using appropriate equipment, began eating and drinking regularly, and was even supported to visit the restaurant in the communal area. These actions led to significant improvements in their physical health, nutrition, hydration, and overall wellbeing.

Senior staff monitored the electronic care planning system to check key care tasks had been completed. This was monitored both during and outside office hours to maintain effective oversight. People and, where appropriate, relatives had access to the electronic system, allowing them to review care notes and monitor outcomes. Staff said they always had the information needed to meet people’s care needs and were clear about what people wished to achieve through their care.

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

People told us their views and wishes were considered when their care was planned. Comments included, “The care is pretty much what I asked for, if I need it to change, I will let the manager know.”

The provider had robust systems to obtain people’s consent to care. People told us they received copies of their care plans to review and confirm their agreement with the care provided. Where individuals had legally appointed representatives, the provider verified documentation to ensure these powers were valid. This safeguarded people’s rights by confirming that appointed individuals could legally act on their behalf.

Staff demonstrated strong knowledge of the Mental Capacity Act (2005). They explained that regular training helped them understand the importance of promoting choice and respecting decisions. Staff recognised that people have the right to make unwise choices if they had capacity. Staff said they always encouraged individuals to consider the risks, but ultimately, if people understand those risks, their decisions must be respected. Where choices could compromise safety, staff reported concerns to leaders to address. One staff member told us: “I always assume people have capacity. I give them time, explanations, and options so they can make their own decisions.”