Millreed 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 58 (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.

At the time of the assessment care documentation including risk assessments and care plans were being transferred from one electronic system to another. We looked at documentation from both systems.

Although staff had received some training in the new electronic system, there had clearly been issues with the transfer and in some cases care plans were not in place as needed.

Care plans varied in quality with some providing good detail about people’s needs and others lacking in the information staff would need to make sure they supported people in line with their needs and preferences. This was being addressed, and we saw examples of much more detailed and person-centred care plans being developed.

There was no evidence of people, or where appropriate, their relatives having been involved in planning and reviewing their care. The management team told us they planned to address this in the new system.

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

Information about delivering evidence-based care and treatment was not always available in care plans. For example, information about the management of 1 person’s epilepsy was confusing and although the specialist nurse had been involved, their input was not recorded. One person required a special diet, but this was not consistently recorded across their documentation, and we saw records of this person having been served food which could have affected them adversely. Whilst this had been identified and addressed, care records had not been appropriately updated.

Most people were happy with the food they received and told us they were given choices. One person said even though they were a ‘fussy eater’ staff always found them something they liked. One person was not happy that they were consistently served food they had told staff they didn’t like, and another felt the tea-time meal was insufficient. Another person said how nice it was to be able to get a drink whenever they wanted one.

A relative told us how pleased they were that their family member had gained weight since moving into the service.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.

Effective processes were not always in place to monitor people’s care and treatment.There was insufficient oversight of records in relation to food and fluid intake and repositioning to maintain healthy skin. Care plans were not always fully reflective of people’s current needs. Reviews of care plans did not evidence a review of the effectiveness of the care plan.

At the time of the assessment people’s care records were being transferred to a new electronic system which we understood was causing some difficulties. The management team told us they would use the introduction of the new system to better involve people or, where appropriate, their relatives, in the review of their care plans.

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

Where people lacked capacity to make their own decisions about their care and support, the principles of the Mental Capacity Act (MCA) needed to be followed in making best interest decisions for people. This process had not always been followed correctly in relation to, for example, equipment to monitor people’s movement such as sensor mats. This was addressed during the assessment following the correct process.

CCTV was used throughout the communal areas in the service with television screens in the office showing all activity. The regional manager was confident the previous manager had discussed this with people living at the service and their consent sought. However, we found this process had not been completed for all people. This was addressed immediately using the best interest process where needed. The regional manager also turned the screens off to protect people’s privacy from visitors to the office.