Filsham 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 consistently good, and people’s feedback confirmed this.

This service scored 62 (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's health and social needs were assessed before coming to live at Filsham Lodge; This had ensured the service could meet the identified needs of the person and that staff had the necessary training to keep them safe and well. There was evidence of family involvement within the documents. One family member told us, “The move in process was most efficient, they included our thoughts and wishes regarding care support and spoke with my relative and looked at all their history and needs.”

People’s communication needs were assessed regularly and reviewed so as to ensure people were offered opportunities to participate in their care decisions. Most people’s care records were reviewed regularly to ensure they remained an accurate reflection of people’s needs. We have previously identified some shortfalls with updating care plans under the safe question. People's assessments included sufficient detail about their individual care needs and preferences, which had ensured their needs were met effectively.

Whilst the provider planned and delivered people’s care and treatment with them, in line with legislation and current evidence-based good practice and standards, there were gaps in some people’s care plans. See our well led section for more on documentation.

Relatives told us that checks on their relatives did take place and concerns were shared with them and monitoring put in place to track improvements or concerns. One relative said, “They check their skin, make sure they eat enough. I trust them” and “Good nutrition, but not a lot of choice. I have seen the menus and when I’ve visited the food looks lovely, and she eats every bite and drinks plenty of fluids.”

Staff knew people well. Staff told us that they are given training which follows current good practice guidance, and that they get updates and refresher training. One staff said, “We get training refreshers and supervisions. We also have competency assessments for medicine giving.” However, there were gaps in the training matrix that meant that not all staff had the required training at this time to meet peoples’ needs. This is covered in the safe and well-led questions.

We saw evidence of multi-disciplinary team meetings to discuss people’s needs and wishes and this had ensured sharing of good practice. However, we have received some feedback that was not positive regarding sharing of information which is currently being addressed through safeguarding meetings. The provider used a computerised care record system for all their care services that used recognised assessments to assess people's support needs.

Recognised assessment and monitoring tools were used appropriately to track improvements or concerns, and the manager had oversight of these and planned action appropriately. The service had links with other organisations to access services, such as tissue viability services and speech and language therapists (SaLT). This had resulted in mostly positive outcomes for people as staff were able to detect changes in people’s presentation and needs.

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.

Staff, teams and services were all involved in assessing, planning and delivering people's care and treatment. Staff worked collaboratively to understand and meet people's needs. When they needed advice or support they sought it from the appropriate health professional and listened to their advice. Each person had a computerised ‘all about me’ and ‘hospital passport’ document that was updated regularly when changes occurred and was printed off before any transfer or hospital admission. This ensured people’s safety and well-being information was shared between teams and services to ensure continuity of care. When a person was due to be discharged from hospital, a member of the management team completed a new ‘admission’ pro-forma that informed staff of any changes to their well-being or safety so they could be assured that the person was safe to return. Information about people’s lives and backgrounds were recorded as well as pertinent information in relation to their health and support needs. The home worked with other health professionals to support people with specific health conditions, such as diabetes and Parkinson’s disease. Health professional feedback was mixed and included that people appeared well cared for and staff were empathetic towards people.

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 by staff to eat healthy meals and drink regularly to maintain their physical health. Healthy fruit and yogurts, bite size sandwiches were offered in between meals to ensure people had enough food and drink. People were encouraged and supported to walk and be active, and to take part in activities.

Care documents showed there was evidence of regular reviews and input from the GP, Optician and Chiropodist. Equality and diversity were embedded in the principles of the service and the provider had an equality and diversity policy in place to protect people and staff against discrimination. There were processes in place to guide staff about how to support people to lead healthier lives. People's care plans and risk assessments were reviewed regularly, for example people were weighed to ensure they maintained a healthy weight and a chiropodist ensured foot care to enable them to keep active. There were organisational policies and protocols in place to support staff to deliver effective care.

Whilst the service routinely monitored people’s care and treatment to continuously improve it, they had not ensured that these were recorded and care records updated. This had the potential to impact on consistent and effective care delivery. For example, changes to their skin condition, repeated falls or difficulty in eating safely.

Comments from relatives however were positive, and included, “They keep us updated and tell us what is said by doctors.” Another told us, “[Relative] has settled in well, they do monitor them, I have seen them record drinks.”

Staff told us they carry out care reviews every month or more regularly if there are concerns and discuss changes in care on each shift. One said, “We have daily flash meetings our residents can change quickly, we discuss any changes, like who is not eating or drinking well.”

The staff team worked alongside the GP, dieticians and speech and language therapists (SaLT). Care plans and assessment tools were in line with guidance from the national institute for health and care excellence (NICE).

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

We were told by people, “They do ask me first because helping me, they don’t just do it. They help me with appointments and always involve me.” One relative told us, “My relative can give consent for simple everyday things, like drinks and washing, but not for other things, we have had a best interest meeting with the doctor about their living here and I know they have forms for my relative with the social worker.” Another relative told us, “I have been involved in my relatives’ care, they have a sensor mat now as they are not safe walking about on their own were, I have signed on their behalf for somethings too and agreed to appointments.”

Staff we spoke with were able to tell us how they offered people choices in their daily care and demonstrated an understanding of people’s right to make their own decisions. Staff told us, “Everybody is treated with respect. Like asking them things even though they can’t make decisions, we never take anything for granted, we also know is someone is distressed so we would stop and go back later.”

Staff had received training in safeguarding but only 49 percent of staff had undertaken Mental Capacity training.