The 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 58 (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 person-centred, but they did not always contain enough detail to ensure people received effective care and treatment. Important information was missing, meaning staff did not always have clear guidance on how to meet people’s needs safely and consistently.

Care plans required further detail to support staff to respond appropriately to people’s needs. For example, one person’s care plan identified their triggers and early signs of distress but did not outline how staff should support or reassure them during these moments. There were no proactive or reactive strategies documented in their care plan. People did have other care plans in place however, the information documented was different in different care plans. Leaving staff without clear direction on how to provide effective support when the person became distressed.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People did not always receive care in line with health professionals’ recommendations, placing them at risk. One person had speech and language therapy (SALT) guidance in place, including clear instructions on food preparation, foods to avoid, and the level of support required at mealtimes. Staff were able to describe which foods this person should not eat.

However, daily records showed that the person had been given food that did not meet the requirements or show that it was prepared in the way set out in the SALT plan. This meant the individual was exposed to avoidable risk. We discussed this with the registered manager, who told us they would review the information.

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.

The provider had effective systems in place to support communication and information sharing among staff. Staff received a handover at the start of each shift, ensuring they were informed about any concerns, appointments, or changes in people’s care needs.

Staff told us that updates were shared promptly and could be accessed in multiple ways. One staff member said, “If something does change, we can change it quickly online. We also have a communication book; it is added in there so staff can review this when they are on shift for recent updates.”

The provider did not always support people to manage their health and wellbeing. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were not always supported to meet their individual health needs, including ensuring they accessed required healthcare appointments. One person needed regular dental check‑ups, but there was no evidence they had attended a dentist. Their care plan clearly outlined the oral hygiene support they required and the actions staff should take. However, staff did not consistently record that this recommended support had been provided, meaning the person’s oral health needs were not always met.

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.

The provider did not have effective processes to monitor people’s health outcomes. "One person required weekly monitoring of their weight and blood pressure; however this was not clearly documented in their daily records, and there was not always evidence the checks had been completed. Without proper monitoring this person may have had health needs that were missed or not dealt with in time."

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

Staff understood the principles of the Mental Capacity Act (MCA) and respected people’s rights when supporting them with decisions about their care. We observed staff seeking consent before providing support and responding to people in a considerate and respectful manner, which people reacted positively to. Staff understood their role in gaining consent and said, “I ask them politely, I would also explain the reason why we are supporting them at that time.”