Chapel 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 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 54 (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. Care plans were reviewed but did not evidence people had been involved in reviews about their care. One staff member said, “Night staff complete the reviews as we don’t get chance.” People and relatives told us they had not been involved in discussions about their care plans. We asked the registered manager to address these concerns and we were sent an action plan detailing how they would improve.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. There was evidence that recognised guidance, and tools were used to support people’s care and treatment such as multi-universal screening tool (MUST) for monitoring nutrition and weight, and tools to monitor people at risk of developing pressure areas. However, care planning documentation did not always reflect care had been delivered in line with people’s needs or current best practice. For example, some people had been identified as being at risk of developing pressure areas, but documentation did not always reflect basic care had been followed to minimise pressure areas developing. People were not always repositioned in line with their assessed needs, which put them at risk of developing pressure areas. The management team had recently identified some concerns in staff recording accurately and were in the process of improving systems. People who required modified diets were supported to access them.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. Information in care plans was not always accurate and could therefore be misleading. Staff handovers gave staff the opportunity to pass on information to their colleagues. Staff did not always work well together and were not always effectively deployed. One external professional said, “Permanent staff are easy to interact with, I have good rapport with them, find them helpful, feel they know residents well and appear to know about and understand residents' eating and drinking recommendations.” External professionals told us agency staff did not always understand people’s needs.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. People had access to healthcare professionals. However, care plans were not always reflective of people’s health needs and did not always guide staff in delivering appropriate care and support. Where care plans explained how people’s needs should be met, there was a lack of evidence to show appropriate checks had been carried out. For example, where people required safety checks, documents did not always record they had been completed in line with people’s assessed needs. One external professional said, “I feel they [staff] consistently follow diet and fluid recommendations (e.g. Level 4 Puree) but are not always consistent with eating and drinking strategies i.e. fluids from an open cup rather than spouted beaker, and diet from a teaspoon.”

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. Care plans identified the care plan aim, goal and outcome. However, they did not always meet people's currently assessed needs, and they were not always monitored to ensure positive outcomes were achieved. There was no evidence to show people had been involved in decisions about their care or been given an opportunity to share their desired goals.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We saw staff involved people when carrying out tasks, asking their permission and explaining what they were doing. One staff member said, “I offer people choices, treating them with dignity and respect, providing information and maintaining their independence.”