Devonshire House and 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 Good. At this assessment the rating has remained Good. This meant people’s outcomes were now 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 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.

Peoples’ care plans and risk assessments were managed on an electronic computer system. The care plan format contained all the necessary information to deliver a person’s care and support. The Summary sheet was important as it gave a single page of information that could be easily accessed quickly. For example, by agency staff working in the service occasionally. There were some inconsistencies between the information in the summary page and the rest of people’s care planning. This was being addressed by the service management and senior staff.

Families of the people that used the service were involved in their relative’s care planning, with consent, so they knew how their relative was, and the support they were receiving.

The new service management said they wanted to make people’s care plans and risk assessments more person centred, individual and simpler, so they more positively reflected how to care for people.

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.

All care tasks were recorded by the care staff on handheld devices which they carried with them, and the information on tasks being delivered was uploaded directly onto the electronic system.

Many people had nursing care needs and significant personal care needs. These people’s care planning was thorough, reflecting how each care need was to be met by the care staff.

The new management of the service was actively reviewing people’s care and making changes that improved peoples’ outcomes. For example, one person was experiencing frequent falls. The new service management recognised the person’s medication might have contributed to these falls taking place and contacted the GP to test removing this medication. The person was now having less falls.

A new call bell system had been installed in the home, and we heard calls being answered quickly. This system could audit the time taken for people to be responded to.

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 care and domestic staff worked well together as one effective team to deliver active and fulfilling lives for people, as well as meeting their personal care needs. One care staff member said, “Everything is a learning curve and we are all working together to do everything we can to meet peoples’ needs.”

Devonshire House and Lodge worked closely with health and social care services in Plymouth and Devon. There was constructive communication between the home’s management team and staff, with health and social care professionals working in the community. For example, the service had worked closely with 2 GP surgeries that supported the home to address outstanding issues with people’s medication.

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.

The service took pride in the quality of the food provided to people, and to staff. The chef had won an award for the quality of their cooking. We saw the quality and choice of food provided. Each unit had their own dining area which was furnished so everyone on the unit could eat together. Presentation plates had been introduced so people could see and smell the food on offer when making choices of which food option they would like to have. Menus were also on each table so people could read about the food there was to choose from. One person said, “The food is to die for – the meals are terrific. One of the chefs makes delicious home cooked soups. We have a choice of meals and recently they’ve had sample plated meals in the dining room as well as the menus on the tables, so you know what you’re having. I have two water bottles I carry with me on my trolley (walking frame) and (the staff) fill them up for me from the water station.”

Many people were supported by staff to eat. We saw people being supported with care, patience and compassion. Where people were at risk of dehydration or weight loss their food and fluid intake was recorded and their care, planned and delivered with skill.

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

Most people using the service had a high level of care need including nursing, personal care and dementia care needs. Though their personal care needs were complex, the service monitored the wellbeing of the whole person and not only how their basic care needs were being met.

To support people’s wellbeing, the service continued to record the many and varied stimulating activities taking place for people in the service. For example, on our second visit to the home the monthly Holy Communion church service was taking place. This was well attended by 30 people, their relatives, supporting staff, and church volunteers. People said they had plenty of activities to enjoy. One person said, “Today’s communion was nice and I like the entertainment. The hairdresser has done my hair today and I have the chiropodist.” Supporting people to be engaged in a way that was meaningful for them helped improve outcomes and people’s general sense of wellbeing.

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

People’s dementia care needs were being met by trained staff. For example, dementia care training was delivered in person rather than only as an online training package. This improved staff skills in dementia care, who then supported people with dementia more effectively.

The service had a Mental Capacity Act (MCA) Policy that covered all aspects of the MCA. All those who needed to have a Deprivation of Liberty Safeguard (DoLS) in place for their own safety had one applied for by the service to the Local Authority.The service had used best interests processes under the MCA for the recording of necessary safety restrictions where people lacked capacity to make their own choices. For example, pressure mat sensors to inform staff when a person had got up from a chair or from their bed to help prevent risk of falling.