Avondale Castlemount 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.

There were robust risk assessments in place which were clear, understood by staff and developed alongside people. These focused on how staff would identify, respond to and prevent risks to people posed by their physical and mental health. They were regularly reviewed after incidents or if people’s health needs deteriorated. For example, there had recently been a choking incident, with a referral to speech and language therapy made and that person’s care plan updated. Staff spoke with confidence that they had time to retain an up-to-date knowledge of people’s risk assessments to allow them to apply them in practice, and that information would be shared with them when these changed. One staff member explained “If people’s needs change, then care plans are updated. They are discussed at meetings or handover. I read care plans regularly to ensure I remain up to date. Communication is really good”.

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.

There was robust guidance in place to support people which reflected current best practice. As a mental health service, this was focused clearly on people’s recovery, rehabilitation and promoting purpose and positive mental wellbeing. Staff had access to guidance and information about triggers to distress, how people may respond if distressed and how to communicate with them in a sensitive way to acknowledge their emotions whilst reassuring them and protecting them from harm. One professional working with the service told us, “I feel there is very good balance of support offered and staff will always look at ways to encourage independence and growth, whilst maintaining appropriate safety and support”.

The service understood and reflected models such as STOMP and Right Support, Right Care, Right Culture and embedded these in their care which prioritised independence, choice and the least restrictive options of care.

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.

We received positive feedback about how the staff team worked seamlessly to support people in a consistent and positive way, including in interacting with other services. The staff team worked collaboratively to advocate for people, and to respond to people’s mental health needs in a sensitive and compassionate manner. One person told us, “The team we’ve got at the moment is the strongest I’ve had; I can’t thank them enough. They’re good at what they do and genuinely care. I get support with activities and help with the things that matter to me. They saved my life”.

Professionals who spoke to us also reflected positively on their interactions with the service including specific members of staff. One stakeholder shared with us a recent experience and stated, “It was evident how much (staff member) genuinely cares. Their quick decision to call for emergency assistance during a recent incident, combined with their professionalism, compassion, and passion for their role, was truly remarkable. The level of care they demonstrated was outstanding”

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.

Staff were currently working with multiple people to help them book, travel to and attend health appointments by themselves which gave them control over their own health. One person explained to us, “I’m doing lots of work around accessing the community and attending appointments with staff. If there are (appointments) I feel I can now attend by myself I will say so, but staff can come with me if I feel it’s needed. Recently staff attended one with me where I needed extra support”. For another person staff had worked with them to create a visual health timeline setting out all their appointments and sitting down with them beforehand to write down all the things they wanted to say to ensure that they could communicate what was important to them when accessing health services.

There was detailed and robust guidance in place for how staff should support people in managing their own health and wellbeing. One person received daily insulin injections for their diabetes and staff had recently received training from a specialist team to allow them to engage with the person around their diabetes and to explore helping them self-administer in the future.

Professionals working with the service were complimentary about how they worked with and referred to them with one saying, “I have observed the way staff advocate for those they support when needing and accessing external care. If, for example, we have identified an issue with a person’s physical health, the staff will support them to arrange seeing their GP and follow-up on any advice or care necessary, keeping us informed as well, so as to aid better holistic care and partnership working”.

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.

People met regularly with staff to discuss and agree the goals and outcomes they wanted to achieve through their care. From these discussions, specific “focus areas” were identified, with a designated staff member assigned to support them in working towards and achieving these goals. For example, we saw “focuses” around helping people attending appointments independently, cook for themselves, maintain healthy relationships and move to living independently. These were closely monitored through a structure of key worker meetings, analysis of any incidents, debriefs and regular consultation with people to monitor the progress being made and allow changes to be made if needed. For example, through these “focuses”, a person had been able to attend a hair appointment outside of the service for the first time which had brought them great pride at being able to be in control of their personal appearance.

There were robust systems and monitoring to review people’s physical and mental health. Instances of distress or anxiety were recorded, with detailed analysis to explore any contributory factors and make proactive referrals to mental health services for specialist advice and guidance if needed. If people were at risk of not eating or drinking regularly during times of low mood, this was closely monitored by staff who worked creatively to explore why this may be happening and put in place strategies such as a curated “Bistro Menu” which they had designed with one person to allow them to explore the importance of nutrition and hydration.

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

Staff ensured people’s consent was actively sought and respected at all times and demonstrated a strong knowledge of the Mental Health Act including people’s rights to make unwise choices. All people at the time of our visit had full capacity to make decisions for themselves. People living at the service placed themselves at risk due to their own choices, so the focus of staff was on empowering them with information on these risks to allow them to make informed choices. For example, the service had recently arranged a session hosted by Kent Fire and Rescue to provide people with information about the risks of smoking inside the building and people had agreed safety protocols around this. Other people placed themselves at risk through substance misuse. A staff member explained, “It’s important to emphasise (Person) has the right to make unwise choices. Instead, they enjoy regularly going out for a cup of tea and companionship, so I would go with them and use this as an opportunity to support and discuss their substance misuse with them to help them manage this safely”.