Park 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.

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.

Records showed care plans were reviewed regularly; however, there was no information available to confirm who was involved in those reviews.

We found some care plans contained handwritten notes, which meant it was not always clear when changes had been made, by whom, or whether the care plan had been formally updated following a review.

The content and level of detail within care plans were inconsistent, meaning the same areas of need were not always assessed for each person.

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

People’s nutrition and hydration needs were not always met. A relative told us their family member was not always supported to have their food cut up or given the support they needed to eat their meals. We observed people were provided with drinks; however, they were not always supported to drink them. The provider did not have effective oversight of people’s nutrition and hydration needs, as their food and fluid intake was not always accurately recorded.

Records showed some people were at risk of dehydration; however, staff did not record how much fluid they were offered or consumed. This placed people at risk, as staff could not effectively monitor their fluid intake or identify when they were not drinking enough and take appropriate action.

Care staff were often required to prepare and cook meals for people, which reduced their availability to provide people with the support they required at mealtimes. The provider had started to recruit a permanent chef.

A person told us, “Food is adequate.” People confirmed they were offered choices.

The provider generally worked well across teams and services to support people.

People confirmed they were seen by healthcare professionals when they needed to. Relatives confirmed they were informed if their family member was feeling unwell or had to be admitted to hospital.

A health and social care professional told us, “The [professional] has observed that staff identify concerns relating to residents’ health and raise these with the appropriate medical professionals. Staff also escalate concerns raised by residents and their families to the medical team. This communication and escalation enables the medical team to assess residents when concerns arise and to consider any appropriate interventions or changes to their care.”

Records confirmed that the provider communicated with external professionals, such as the pharmacy. However, records did not always contain enough information to evidence the advice provided or how this had been acted upon.

The service did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. The service did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

The provider did not effectively monitor people’s health needs. For example, 1 person experienced recurrent infections that required treatment with antibiotics. When asked, staff did not know whether the person was currently receiving antibiotics. Person’s medicine chart confirmed they were on antibiotics.

Records of healthcare professionals’ involvement were unclear in the person’s documentation. This meant staff did not have clear and up-to-date information about the person’s treatment, increasing the risk that changes in their health needs would not be consistently monitored or acted upon.

Health and social care professionals regularly visited the service. Relatives told us they were happy with how their loved ones’ health was being managed by staff at the service.

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.

We observed 2 airflow mattresses, used to help prevent pressure damage to the skin, were beeping, indicating they were not working correctly. This issue had previously been identified during the provider’s checks; however, no action had been taken. This meant the provider could not be assured people were being adequately protected from the risk of pressure damage. Records showed 1 person had redness to their skin; however, we could not establish whether there was any connection between the skin redness and the issue identified with the mattress.

Records showed skin concerns were documented; however, the documentation was not consistently clear or effectively monitored. Body maps were paper-based, and records would often state that an area was "healing", with limited information to demonstrate it was in progress or the outcome. There was no clear oversight of these records to demonstrate concerns had been reviewed and appropriate action taken. This meant the provider could not be assured concerns requiring further assessment or escalation to healthcare professionals or safeguarding teams were identified and acted upon promptly.

We found people’s emotional support and mental wellbeing needs were not always documented in their daily notes, even when these had been identified as needs within their care plans. This meant the provider could not be assured people received the support they required.

The provider lacked effective systems to monitor the quality and accuracy of care records, identify concerns and ensure appropriate action was taken.

The service told people about their rights around consent.

Staff told us they understood the Mental Capacity Act (MCA) and the importance of consent. One staff member said, “I have completed my Mental Capacity Act training and understand how important it is in my role. I understand that we should always give people the opportunity to make their own decisions and not assume that someone lacks capacity just because they need help. I try to give residents time to understand what is being asked and support them to make their own choices wherever possible.” Another staff member told us, “If someone lacks capacity to make a particular decision, we follow the appropriate best-interest process.”

Records showed mental capacity assessments and best interest decisions had been completed for individual decisions.