Cleeve 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 outstanding. At this assessment the rating has remained outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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.

Care plans were clearly written and mostly comprehensively completed, containing full details of mobility aids. Guidance was available for staff to follow about how to support people and their needs. The manager had a good understanding of what caused people incidents of distress and had put plans in place to reduce this incidents.

There were good examples of assisting people to take part in day-to-day activities such as caring for the resident animals. Communication plans were well documented including people’s ability understand and express themselves to others.

Care plans and risk assessments clearly identified people's needs and risks. They showed the action staff should take to minimise any risk of avoidable harm. Staff told us how information was reviewed and regularly updated. One staff member told us, “If there was any risk it will be quickly reported to management so an assessment could be made and risk assessment put in place.”

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 who required support with eating, were seen to be supported, there was clear guidance within their care plans, coloured crockery was used, and plates had a high rim which supported people living with dementia.

Care plans contained guidance for people who required profiling beds, specialist tilt chairs and catheter management. Staff monitored fluid intake and weight loss. However records completed for fluids required further improvement as fluids were not always documented. The provider had not identified this prior to our visit. People were not placed at risk as we observed they had access to fluids throughout the day.

Staff were aware of how to identify infections and changes to people’s clinical needs. Staff told us, “I support people with regular weight checks, repeated screening, and the use of food and fluid charts, to help to monitor progress” and “Some residents have difficulty swallowing, their meals are adapted to soft, mashed, or pureed textures, we will spend extra time with them to make sure they swallow the meal properly.”

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 felt they were kept informed about changes and worked well as a team “We are not rushed, its good teamwork, I feel very comfortable, everything is shared between staff if its busy, we work well together, everything is too good here.”

Care plans contained information about people’s needs and could be shared with professionals. Staff told us “We have a meeting almost every day where we exchange information and opinions, if one of the residents is not feeling well, we inform the manager. At the same time, we can call the GP and 111.”

Professionals told us, “The team work well together and there is always a positive atmosphere there when I visit. The care team involve the relatives in all aspects of a resident’s care, which helps with the family atmosphere in the care home.” We heard the staffing team joined professionals in information sharing sessions, working together to develop an intervention plan to support people with expressed needs in dementia.

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

The provider had many initiatives in place to promote and support people with their health and wellbeing. People were supported to access healthcare in line with their individual needs and preference. For example, people had support to access other health services, such as GP, physiotherapist, dentist, podiatrist and optician, as needed.

Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. The provider offered a wide variety of activities to support people to be engaged, entertained and to stay as mobile as possible, activities included, film nights, music, professional music players, pet therapy, exercise, Zumba, creative arts and crafts, theatre trips, and regular community visits. People could take part in weekly flower arranging, so there were fresh flowers in the home, painting, including painting small figurines, visits from a therapy dog, baking, a regular church service, visits from musicians and exercise sessions, from an external provider. In summer people who were interested grew vegetables and flowers in the raised beds in the garden. Visits were arranged for people who were able to go out, boat trips, visits to local garden centres and to shops in the village. There was a summer party and parties on other occasions. Birthdays were celebrated, or if the person wanted a quiet celebration with family, the home enabled this.

People spoke positively about these activities, “Lots of things going on. I go to the musical things, very good singer and somebody comes in to play the accordion. We have a dog that comes in.”

The provider routinely monitored people’s care and treatment. They ensured that outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

Staff continuously monitored people’s health conditions where appropriate, understood people’s individual needs and what action to take. Evidence based tools were used to support this practice. Staff took part in daily handover meetings, followed by meetings in the day where any changes in people's health and wellbeing were discussed.

Relatives confirmed staff identified and responded promptly to changes in their family members health “[Family member] was not eating very well before [person] came to Cleeve lodge, but is starting to eat regular meals now, the food always smells amazing when I visit, and I think they cater very well for the residents.”

The provider had received correspondence from relatives which recognised the positive outcomes staff had supported people to achieve. People’s achievements were recognized and celebrated by the service by sending out a newsletter to highlight people’s successes and ongoing activities and initiatives at the service.

The provider always carefully explained to people what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment.

People told us, “I go to whatever I want to go to”, “I don’t feel restricted I can do what I can” and “Indeed I can be independent. When I am going to do something, I talk to the carers and ask if it’s alright. I do this out of courtesy.”

People had mental capacity assessments, Deprivation of Liberty Safeguards (DOLS) applications and authorisations, and best interest decisions in place for all necessary decisions. DNACPR(Do Not Attempt Cardiopulmonary Resuscitation) and other important documents such as hospital letters were scanned into care plans to ensure staff had all the relevant information. The manager reviewed people’s DOLS to ensure information was correct and kept up to date. Documentation was completed in line with best practice, this maximised people’s opportunities to make decisions about their care themselves.

Staff received mental capacity act training and were knowledgeable on how to support people. Staff told us, “I encourage and support the person with dementia to take part in making the decision and to share their views, where possible. A dementia diagnosis doesn't necessarily mean you're unable to make decisions. Some people can choose their own clothing, food, drinks and daily activities” and “Sometimes people forget things, or may be confused as to why they are there, I reassure them about their care.”

Staff told us the importance of empowering people to make decisions, “Offering simple and clear choices, using visual aids, providing time and space.”