Rowan 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 were assessed face to face prior to moving to the service. This meant the management team were able to confirm the service could meet people’s needs. The registered manager told us “We invite people to come and have a look around first. We have a checklist we use; we then talk with them and find out what we need to know. It starts to populate the care plan as the weeks go on.” Care plans included a range of assessments covering people’s physical and mental health and well-being.

People’s communication methods were outlined within their care plans to enable them to receive care and treatment which worked for them. Care plans we looked at identified any difficulties with communication, such as hearing or speech and tools they used such as electronic devices. However, we did review the care plan for one person with a degenerative eye disease which meant their peripheral vision was very poor. There was nothing documented in the care plan to inform staff to speak to the person face to face to ensure they could be seen and understood. We fed this back to the head of care who told us they would address this.

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 current evidence-based good practice and standards. Nationally recognised assessment tools were used, including an escalation tool used to assess people’s clinical condition when people became unwell. Concerns were escalated quickly and acted on. Support from specialist teams was sought when required.

The provider worked well across teams and services to support people. Records we looked at showed the staff referred people to other health professional teams and sought support when needed. Staff told us they found other health professionals input invaluable. For example, one staff member said, “The older people’s mental health team write the care plans [for some people] and they are really useful.” Feedback from health professionals included “We feel that Rowan Lodge is very responsive about any patient concerns” and “When we visit Rowan Lodge we usually liaise with the senior nurse who accompanies us during the ward round but links in with other nurses on the wards as we go around to see patients.” We saw records of when the local GPs visited the service. Staff prepared a list of people they wanted to be reviewed and the reasons why. They told us they did this to streamline the process for when the GP arrived on site.

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 told us they received support to access healthcare, inside and outside of the service. A physiotherapist visited the service weekly, which people’s relatives told us was beneficial. People told us they were supported to attend healthcare appointments if needed. The registered manager told us they had recently recruited a nutrition and hydration specialist. They said, “We want to make sure people are getting their nutrition and hydration needs met, and to make sure people on modified diets are enjoying their food for example. We have one person who needs a modified diet but hates the texture, so we want to make sure they can still enjoy their food.” One person said, “I want to try and lose a bit of weight. I’ve seen the nutritionist and she’s going to help me."

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. Records showed staff liaised closely with other health professionals. We saw records that showed staff had followed up with other health professionals when issues had not been resolved. One staff member said, “We are able to refer direct to the tissue viability nurse (TVN) or to SALT (speech and language therapy). With the TVN for example, we send a referral and photos of any wounds; [they] are very accessible for support and advice.” The service had recently put in a place a more detailed falls risk assessment and the head of care told us there were plans to move to a more comprehensive risk assessment for choking and dysphagia.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Overall, people told us staff asked for their consent before supporting them and respected their choices. For example, one person said, “They ask if I’m ready for a wash and I can say if I’m ready or not. I can choose to stay in bed if I want to, they [staff] are very good like that.” One person’s relative said, “The staff do always ask for consent. I noticed [relative] hadn’t had a shave this morning but when I asked about it, [relative] told me he'd told the staff he didn’t want one, so the staff respected his wishes.” During the inspection we saw and heard staff asking people for their consent and offering choices. For example, we saw staff knock on bedroom doors and wait for a response before entering.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care services, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. All legal applications had been made in accordance with DoLS. This meant people’s rights were fully respected. The registered manager kept a record and tracker of DoLS applications and authorisations. When conditions were imposed as part of an authorisation, there was clear guidance in people’s care plans to inform staff how to endure conditions were met.