Aspen Lodge Residential 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. The service was in breach of legal regulation in relation to consent to care.

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 was effective because they did not always check and discuss people’s health, care, wellbeing, and communication needs with them. People told us they did not feel involved in their assessment and care plan and would like to be more involved. Relatives however felt they were always kept informed and up to date. There was limited information to show how people had been engaged in their care plans and subsequent reviews. The electronic assessment and care planning system in place sometimes lacked detail about people’s individual needs and preferences. We found inconsistent information in some risk assessments and care plans and not all monitoring charts had been completed effectively and reviews had not been completed monthly in all cases. This meant we could not be assured the system was effective in keeping people’s needs up to date. Despite these issues the assessment and care planning system in place was used by staff to inform how they supported people, and staff told us they were confident people had their needs met.

The provider did not consistently consider evidence-based practice in the support people received. The provider told us about half of those living at the home were people living with dementia. Despite this, there had been little progress on developing a dementia friendly environment. Some work had taken place but there was more to do. The provider’s vision for the service described aspirations for the service such as simplifying navigation, enhancing lighting, changes to flooring, enhancing bedrooms with contrasting furnishing and displaying familiar items to improve the care environment for people with dementia. There was no detailed action plan or timeframe for when this would be achieved, therefore we could not identify if the provider was making the improvements required in a timely manner. However, in other areas the provider had introduced tools which were evidence-based, for example, they used a variety of evidence-based risk assessment tools to identify risks to people’s skin and to identify and manage risks associated with nutrition and these were effective in managing risks to people’s safety.

The provider worked well across teams and services to support people. The provider information return described regular contacts with health professionals to share information about people. For example, doctors reviewed people’s health needs during a weekly visit and there were regular interventions and assessments from a range of health providers. Records showed staff worked closely with district nurses, speech and language therapists and community psychiatric nurses to manage people’s needs and develop plans to support them. There were regular daily meetings in place for staff to share information about people and their needs. The staff told us these were an effective way of staying up to date about people’s care.

The provider supported people to manage their health and wellbeing. People and their relatives felt staff supported them to maintain their health. A person told us, “The doctor comes in every Monday if you need to see them.” A relative told us, “They arranged for an optician to come in and she got new glasses as a result. The dentist and doctor also visit regularly.” Staff told us they had information about people’s health needs in their care plans. We saw care plans included information about people’s health needs and where advice had been given by a health professional this was followed. The registered manager told us they had good relationships with local health providers and could make referrals as required. We saw referrals had been made to occupational therapists, falls services and there was regular contact with people’s doctors and community nurses.

The providers systems for reviewing and monitoring peoples care were not consistently effective and did not always involve people. People told us they were not involved in reviewing their care plans. A person told us, “They don’t talk to me about my care. If I wanted to, I think they would if I asked.” The registered manager told us all care plans in the system were reviewed monthly and reviews were documented in the electronic care planning system. However, care plans had not consistently been reviewed as required. For example, we found 1 person’s mobility care plan had not been reviewed and another person had not had their continence care plan reviewed. This meant we could not be assured that peoples care outcomes were consistently being assessed and monitored.

The provider did not always ensure effective practices were in place to seek consent. The requirements of the Metal Capacity Act 2005 were not always followed when people were unable to consent or make decisions about their care. The registered manager told us and we saw that some decision specific mental capacity assessments and best interest decisions were documented in the electronic care records where people lacked capacity to consent. For example, we saw this was in place for the use of photography and the sharing of information and care plans. However, some aspects of people’s care had not been considered under the Act. The provider had CCTV in place, and we found mental capacity assessments and best interest decisions were not in place relating to consent to this system being used. This meant we could not be assured people’s rights were always protected. However, People who could consent to their care told us they were able to make their own decisions and staff asked their consent. Staff were observed seeking consent and records and conversations with staff showed they had received training in the mental capacity act.