Joseph 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 newly registered 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, wellbeing and communication needs with them. Before people came to the service a full assessment of their needs was completed. Care plans and risk assessments were detailed and person centred, providing staff with the information they needed to support people safely. People and their relatives told us they were involved in planning and reviewing their care needs. Communication needs were assessed to ensure people received information in the best way for them. The manager told us they provided information to people that is adapted to their needs and preferences. Where people had specific communication needs staff were trained to support them with this.

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. Clinical assessments tools were in place where needed such as food and fluid monitoring tools, body positioning charts and weight charts. However, we found episodes where body positioning charts were not always updated correctly. The manager told us they were addressing this issue with staff to educate them in the importance of keeping all records accurate and up to date.

Referrals were made to other healthcare professionals for their expertise, such as speech and language therapists and GPs for advice on swallowing difficulties and diet. People told us they were happy with the food at the service. The manager had recently employed a new chef who was making homemade biscuits and cakes as people had requested this. One person said, “There is plenty to eat and drink. What they do in the kitchen makes me very happy.”

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 worked with other health professionals to ensure they had all the information they needed to ensure people’s support continued when they were admitted to the service. When people were moving on from the service this was also carefully planned to ensure continuity care.

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 have access to dentist, opticians, GPs, chiropodists and other health professionals when needed to ensure all their healthcare and well-being needs were being supported. The manager sourced a private physiotherapist to work with people where needed and to provide group activities to help support people’s mobility. A health professional told us, “I give instructions to staff, and they really take it on board to support people with exercises. I have seen people improve with the support they are receiving.”

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 manager had a tool in place to monitor clinical outcomes for people. They kept this tool up to date so that staff always had the most relevant information available to them. Care that was planned was person centred and individual to people’s needs. The activity person supported people’s well-being doing activities that were led by them and what they wanted to do including accessing the community. The manager had systems in place to gain feedback on how care being provided impacted people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff had received the appropriate training in obtaining consent from people. Care plans detailed people’s capacity and their ability to consent and make decisions.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The 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 Act 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 so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The authorisation procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. The registered manager understood their responsibilities and the key principles of the MCA and DoLS, and we saw any conditions were being met. DoLS were being applied for appropriately and the manager tracked the progress of these. Where appropriate, relatives and advocates views and wishes were taken into account when care was planned.