Maple 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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.Staff training had been improved to give them the necessary skills to keep people safe. People’s consent to their care and support was obtained in the least restrictive way.

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.

Initial assessments were carried out when a new person started using the service. This was used to form a detailed care and support plans. People were assigned ‘key workers’, staff members with specific responsibility for the person. Staff therefore quickly got to know people well and were able to provide them with the support they needed.

Some people had lived at the service for many years, and their assessed needs were reviewed and support plans updated at regular intervals or when their needs changed. People’s communication needs and preferences were well documented providing staff with the knowledge of how best to understand and converse with them. People had communication passports which provided an overview of their preferred ways of communicating. This included the use of pictures, objects of reference, 'now and next' boards, emotion boards and social stories. We saw evidence that families and professionals such as occupational therapy and speech and language teams had been involved. This ensured the care and support provided to people met their assessed health, wellbeing and ways of communicating.

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 were supported by staff in regular key worker meetings using their preferred communication methods to identify their likes and dislikes related to their everyday care and support.

People were settled living at Maple Lodge and staff had created ways to work with people positively. We saw examples of good evidence-based care being provided. Where people’s needs and circumstances changed, the registered manager was proactive in researching information advice and services to best support people. For example, we saw people had been advised about checking for testicular cancer. Easy read information had been used to discuss how to do this, alongside the staff who would support people with this task. This was done in a collaborative and sensitive way, to act quickly if anything was needed to be followed up.

People’s nutritional and hydration needs were consistently met. They participated in food menu meetings to choose their preferred meals ahead of food shopping. Some people liked to do the food shopping with staff. Staff closely monitored individuals’ wellbeing and actively promoted healthy lifestyle choices. People’s weight was regularly monitored. Where there were concerns with weight loss or weight gain, a plan was in place, for example, guidance for staff on adding calories such as full fat milk, snack and drinks with high calories.

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.

The registered manager had effective processes in place to escalate health concerns, and records confirmed that health professionals were actively involved in people’s care. Guidance on the actions staff should take when there were changes in people's behaviour or physical needs were in place. Staff worked closely with health care professionals for the benefit of people in the service and liaised with them where needed.

We saw some good practice in relation to advice and information obtained from professionals such as with the GP and occupational therapy to work with people effectively. Family members were complimentary about the staff team and the support provided to their relatives. A family member said, “[Name of relative] has regular health checks and there’s nothing at the moment for either of us worry about.” Another family member told us, “Any changes in health, they [staff] do pick up.”

People were given accessible information about their health in formats they could understand. The registered manager reported working closely with health and social care professionals to ensure individuals’ needs were consistently met.We observed staff working closely together to support each other. A staff member told us, “We are a really strong team at the moment; everyone does a lot here and we are all quite dedicated.”

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 and supported to make healthier choices to help promote and maintain their health and wellbeing. Staff told us they understood the importance of supporting people to live healthier lives and to engage in decision making about their care. Staff responded to changes in people’s acute care needs by contacting medical services and acting as advocates to get the best care for them. A staff member said, “As it is hard for people to tell us if they feel unwell, it is vital we are aware of changes in their behaviour which could indicate there is something not right and do something about it.”

The registered manager supported people to manage their health and wellbeing in discussion with them. Oral health plans were in place, providing clear and detailed guidance for staff to follow. People were supported to attend medical and other appointments such as GP, opticians and dentist appointments. Staff reported back any actions needed and communicated any outcomes with people’s relatives. A family member said, “They take [name of relative] to appointments, and let us know where they are, and how it went.”

People were supported to understand and make choices about their diet, lifestyle and physical activity which were in their support plans. We saw activities and decisions made in their daily notes. A family member told us, “There are very regular appointments for [name of relative], and we usually know about any issues or concerns.” Another family member said, “[Name of family member] had a procedure recently and the staff rang us as soon as they got back to tell us that they coped really well.” Staff also supported people to engage in community activities that promoted good health. Individuals took part in swimming, gym sessions, and dance classes to encourage physical wellbeing.

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

There was a robust approach to monitoring the effectiveness of people’s care, treatment and support and action taken to continuously improve it. People were engaged in planning their life ahead to ensure it was a life they chose or needed. We saw positive examples of this in people’s care and support plans. People were encouraged to maintain independence in areas such as personal care, following hobbies and interests and social engagement.

Staff worked collaboratively to understand and meet people's needs. This included, daily handovers, staff meetings, and supervisions to ensure staff had up to date information to support and promote people’s wellbeing. Staff discussed people’s goals and aspirations in key worker meetings which were working very effectively and recorded people’s response. One record clearly recorded the person was not interested in attending a dance class and staff researched and discussed other opportunities they might like to join.

There was good evidence of how staff worked together to understand triggers, warning signs and support people with their discomfort, distress and behaviour. This had had a positive effect on people’s wellbeing. A family member said, “They pick up on changes, any little thing, if it’s to do with health or not.”People’s skills, life experience and strengths were discussed with them and those involved in their care, to understand how people’s short, mid and long-term life choices, goals, ambitions and outcomes could be planned and achieved. The triggers causing people distress, how this affected their behaviour and how staff supported them with positive outcomes were recorded.

There were some positive outcomes for people using the service. The registered manager gave us examples of how they had worked with people who were due medical procedures where they needed to be awake. They had used the individuals’ style of communication to explain the procedure, took them through the expectations using visual reinforcement to explain step by step what would happen. People were able to successfully have the procedures completed, with minimal distress and anxiety.

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

People’s capacity to make decisions were clearly documented within their support plans. Some people had representatives such as the Court of Protection (COP) which looked after their best interests in relation to their finances. The registered manager liaised with the COP regarding people’s financial arrangements and decisions. Family members were aware of these arrangements. Deprivation of Liberty Safeguards (DoLS) authorisations were in place for people. These had been authorised and reviewed as required. DoLS set out the legal authority for people to be deprived of their liberty, in their best interests.

Staff received training in the Mental Capacity Act (MCA) and understood the importance of gaining consent when supporting individuals. Where people lacked capacity to make specific decisions, the management team completed assessments and made decisions in their best interests. We saw these had been recorded, who was involved and the decision made. The registered manager was proactive in identifying when people required support to for example carry out self-examination checks to promote good health. Staff followed professional guidance in supporting these checks with best interest and mental capacity assessments being carried out. People or their representatives were involved in any decision-making as and when needed.

Family members felt staff obtained people’s consent and choices when supporting them with their everyday needs. We observed this during our assessment. They felt staff knew people’s ways of communicating their needs and ability to make choices and decisions. “Although [name of relative] has limited communication, staff really understand them. When a professional visited and asked them questions, they just wandered off, as the professional was not asking them in the right way. That’s why the staff are so important in helping [name of relative] make decisions and choices.”