Archived: Tollington Lodge Rest 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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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.

People had care plans which were stored on an electronic system. The plans provided an assessment of people’s needs and gave information about people’s health and communication preferences. Some people’s health and wellbeing care plans required further detail to be added. The deputy manager told us they were in the process of being updated and we saw this was in progress.

People and their families were not regularly involved in formal care plan reviews, but said they could talk to the manager when they wanted to. One person said of staff, “They know what they are doing and what I like.” A relative told us of their loved one, “They have a support plan, if there are changes, they discuss, it’s not a sit-down meeting but ongoing as and when needed."

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.

Monitoring tools for people at risk in areas such as malnutrition or pressure damage were completed. Oral health assessment tools detailed the support people required in this area.

People’s food and fluid intake was recorded. Where people had been assessed as being at risk of choking or had specific dietary requirements, clear information was recorded in their care plans and where meals were prepared. Staff knew the importance of following dietary guidance for people. A staff member told us, “It’s very well documented and training is given to make sure it’s done correctly."

The provider worked well across teams and services to support people. People had hospital passports which shared information with health professionals if a person required a hospital admission. Where people were supported with their health by professionals, the provider worked alongside them and followed a multi-disciplinary approach. New guidance or protocols were added to people’s care plans and risk assessments.

Handovers between staff and managers were completed regularly and recorded information such as any recent health issues people had. Staff felt they were effective. One staff member told us about handovers, “They let us know what’s been going on, how the residents have been and any changes."

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 encouraged to be independent and have control in their own lives, for example personal care routines detailed what people could do independently and where they required support.

An advanced nurse practitioner from the local doctor’s surgery visited the home regularly. This meant people could discuss any concerns about their health. The service ensured any advice given or amendments to people’s prescribed medicines were implemented.

People told us they had access to health professionals. One person said, “The GP comes round, I saw them this morning. They keep an eye on me.”

People were encouraged to maintain their independence around their mobility. An exercise activity was available to people weekly, to either complete in a group or individual session.

Staff received specific training to support people with their health conditions, this included epilepsy and diabetes training.

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.

Care plans included outcomes for people and detailed information on how to support people to achieve these. The registered manager told us how they had provided music and films for a person in their preferred language which had a positive impact on them. A professional told us how the registered manager had identified when a person was more able to participate in their personal care routines than had been thought when they moved into the service. They said the registered manager had ‘instructed their team to support the person in a manner that encouraged their independence promoted their dignity’.

People’s rights around consent were promoted and respected which enhanced person-centred care and treatment. Staff were able to explain how they sought consent from people to make day to day decisions in their lives. One staff member told us, “I ask them and make sure they are happy, I respect people choices and do not take over.”

However, where people may lack capacity, the provider had not always completed their own decision specific mental capacity assessments and best interest decisions for people. This included for any restrictions for people in accordance with the Mental Capacity Act (MCA) and where DoLs applications had been made for people.

The registered manager was in the process of completing MCAs for people, starting with medicines. An example was shown and was well completed.

One care plan detailed a person lacked capacity; we were told this was no longer the case however, a mental capacity assessment had not been completed to confirm this as is required.

A professional told us the registered manager had been receptive to their feedback around completing mental capacity assessments and best interest decision documentation, and had prioritised their learning in this area, which they found ‘reassuring’.