Devon 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 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.

People's needs were assessed and reviewed regularly to ensure care remained effective and personalised. Care plans, risk assessments and associated records were detailed, individualised and reflected people's health, communication, behavioural and support needs. Care plans also provided staff with clear guidance on how to support people in line with their preferences and daily routines. People contributed to assessments using communication methods appropriate to individual needs. This meant people received care that reflected their assessed needs and personal choices.

The provider maintained clear and accessible information about people's support requirements. Each person had a 1 page profile containing key information about their communication needs, risks, behaviours, preferences and required support. Care plan audits were completed quarterly and actions identified were shared with staff teams. This supported consistent care and helped staff understand people's needs at a glance.

Staff used assessed information to provide responsive support. We observed staff adapting the environment to meet a person's sensory needs by pausing maintenance work involving drilling until the person was ready to leave the area. Staff also told us they regularly read and updated care plans to ensure information remained person centred and relevant. This demonstrated information gathered through assessment informed day-to-day support and reduced the likelihood of distress.

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 received care and treatment that reflected their assessed needs, preferences and best practice guidance. Care records contained detailed and personalised information about people's nutrition, hydration and health needs, alongside guidance for staff on how to provide support. This helped ensure people received care that was tailored to their needs and delivered consistently by staff who knew them well.

Staff supported people in line with recognised clinical guidance and individual risk assessments. Where required, people were referred to speech and language therapists to assess swallowing and communication needs. Staff demonstrated a good understanding of the International Dysphagia Diet Standardisation Initiative (IDDSI) framework, and we observed people receiving support with meals that reflected their prescribed diets. This reduced the risk of harm and supported people's health and wellbeing.

Staff promoted people's independence while ensuring care remained safe and person centred. We observed 1 person being supported to eat independently using specialist equipment and encouragement from staff. Staff also used personalised strategies to reduce choking risks, including supporting a person to eat smaller amounts at a pace that was safe for them. Easy-read menus, flexible mealtimes and access to preferred foods and snacks further supported people's individual needs and choices. This demonstrated care was delivered in a way that balanced safety, independence and personal preference.

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 and partner organisations worked together to provide coordinated care. Records showed staff discussed changes in people's needs during monthly team meetings and used this information to update care plans. Regular multidisciplinary meetings were also held with healthcare professionals, including occupational therapists, psychiatrists and speech and language therapists. This supported coordinated care that reflected people's changing needs and helped ensure support remained consistent across services.

The service shared information effectively to support continuity of care. We observed a detailed handover where staff discussed people's wellbeing, activities, behavioural presentation and planned support. Hospital passports were detailed, personalised and available in an easy-read format, ensuring important information about people's communication, health and support needs could be shared when they accessed other services.

Staff used information shared across teams to provide consistent support. We observed staff and contractors adapting their approach to meet an individual's sensory needs after staff communicated that loud noises could cause distress. Relatives also described positive experiences of joined-up working, including support from speech and language therapists and healthcare services to address health concerns and improve outcomes. A healthcare partner told us, "The staff are all very helpful and I always get the information I need as well as the answers for any questions I may have." This demonstrated effective partnership working that helped people receive coordinated and responsive care.

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 supported to access healthcare services and maintain their health and wellbeing. Annual health action plans clearly identified people's healthcare needs, the support they required, and the healthcare professionals involved in their care. Records also showed routine monitoring of appointments with healthcare services such as GPs, dentists and opticians. This helped ensure people's health needs were identified, monitored and responded to in a timely way.

The service promoted healthier lifestyles through physical activity, nutrition and community involvement. During the inspection, we observed people walking, scootering, participating in movement activities and spending time outdoors. People were encouraged to make choices about activities, exercise and healthy eating in ways that reflected their preferences and goals. Relatives also described people accessing swimming, walks and other activities that supported physical wellbeing. This encouraged people to remain active and supported their physical and emotional health.

Staff worked proactively with people and healthcare professionals to improve health outcomes. Relatives described how staff supported people with weight management, seizure protocols and healthcare interventions when needs changed. A relative told us staff had successfully supported improvements to a person's diet and weight, while another described how staff worked with healthcare services to find effective treatment which resulted in positive changes in the person's wellbeing. Leaders also described encouraging healthier eating and physical activity tailored to individual needs. This demonstrated people received support to maintain and improve their health while maximising their independence and quality of life.

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

The service monitored outcomes where risks or health needs had been identified. Records showed monitoring charts were used when required and informed planned interventions. For example, 1 person who had experienced weight loss was regularly monitored and supported with their nutritional needs, resulting in their weight returning to its baseline. Support plans and reviews considered outcomes that were important to people, including increasing social engagement, independence and participation in activities. This demonstrated monitoring was used to identify concerns and achieve positive outcomes for people.

Staff worked proactively with healthcare professionals to review and improve people's wellbeing. Records showed staff had worked closely with healthcare professionals over several months to support investigations and diagnosis for 1 person. This led to treatment being introduced in a way that minimised distress while improving pain management and mobility. This meant the person experienced improved health outcomes and quality of life.

The provider reviewed people's progress and adapted support approaches where monitoring identified opportunities to improve outcomes. Relatives described improvements in people's nutrition, weight and wellbeing, while staff gave examples of changing support approaches to reduce isolation and improve mood. One staff member explained how regular evening walks had helped a person become more active and engaged. This demonstrated the provider used information gathered through monitoring and review to improve people's experiences and outcomes.

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

Staff used easy-read information, pictorial tools and individual communication methods to support people to express preferences and participate in decisions. Mental capacity assessment tools were provided in easy-read formats and included pictorial aids to help people communicate their understanding and preferences. This supported people to be actively involved in decisions wherever possible.

Mental Capacity Act assessments were decision-specific and carried out in line with legislation and best practice. Records showed assessments considered individual circumstances, involved relatives and healthcare professionals where appropriate, and explored the least restrictive options available. Best interest decision-making processes were detailed and personalised. This demonstrated people's rights were respected when decisions about their care were made.

Staff promoted choice and sought consent as part of everyday support. We observed staff offering people options, encouraging decision making and respecting choices about activities and daily living. During activities, staff used verbal prompts and visual choices to support people to express preferences. One staff member told us, "I try to always give them options so they can make their own choices." This meant people were supported to exercise choice and control over their lives.