Worsley 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 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 63 (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 prior to their admission to the service, ensuring that placement was appropriate and that personalised care plans were established.

The registered manager explained that a “Resident of the Day” system was in place, whereby staff from all departments engaged with the selected resident to check on their wellbeing. As part of this process, care staff would also contact the resident’s next of kin and offer the opportunity to review and update the individual’s care plan where necessary.

Religious needs were considered as part of the assessment process. The service accommodated these needs by arranging visits from church, enabling residents to take part in a service if they wished.

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

Care plans were found to be basic in content and did not consistently reflect individuals’ current health needs. Key information regarding people’s medical conditions, risks, preferences, and required interventions was either insufficiently detailed or not regularly reviewed and updated. This meant that there was a lack of clear, comprehensive guidance available to staff to support the delivery of safe, effective, and personalised care.

In several instances, care records did not demonstrate a clear understanding of individuals’ needs, including changes in physical health, mental wellbeing, or risk factors.

The service utilised an electronic care planning system, which staff reported as being highly effective. They also used evidence-based monitoring tools to support the ongoing assessment of people’s health and wellbeing. For example, the Malnutrition Universal Screening Tool (MUST) was used to assess nutritional risk. Individuals’ weights were routinely monitored monthly. In cases where there was a noticeable reduction in weight or an increased MUST score, monitoring frequency was escalated too weekly. This enabled earlier identification of concerns and supported prompt referrals to dietitians and other healthcare professionals.

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 attended handovers regularly, and effective communication between senior carers and care staff supported continuity of care. Referrals to specialist services, including the SALT team and mental health services, had been appropriately made.

One staff member told us, “Using so many agency staff is no good, it sets you back as it is like doing 2 jobs, as we need to check the agency person is doing things right.”

Despite this, overall, staff said they felt well supported by the management team and could approach them for support.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence,choice,and control

On this assessment weobservedbreakfast being served later than expected, this meant people were in the dining room until mid-morning.Due to the amount of people needing support to get to the dining room staff started moving people 30 minutes before a meal was due to be served.This meant that people had little time in between meals to do what they wanted. People told us that meals were warm not hot when served and there were mixed reviewsregardingthe quality with many saying it was “okay.” There were delays in starting to serve meals as staff were moving people into the dining area. Clothes protectors were not used during mealtimes, and we saw one person in the afternoon with shirt and trousers that were heavily soiled with food, they were still in the same clothing whenobservedagain an hour later.

We saw people taking part in armchair exercises with the wellbeing coordinator and staff during this inspection, most of the people in the lounge joined in and said they enjoyed doing them.

The provider did not always routinelymonitorpeople’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.For example, we looked at the care plans of people that were on 2 hourly turns, the recordsindicatedthat these actions were consistently late.

The manager completed daily walkarounds of the service and approximately 10% of care plan audits each month;they then delegatedthe actionsto care staff, with senior care staff expected to complete the review and make any necessary changes.Thiswaspart of their role andadditionaltimewasnotrequiredto complete this.

Where necessary, referrals to relevant healthcare professionals were made without delay, supporting a coordinated and responsive approach to care delivery.

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

Staff demonstrated a clear understanding of their responsibilities under the Mental Capacity Act. We observed that people’s consent was sought prior to any care interventions, and staff consistently respected individuals’ choices, including their right to refuse care.

Where individuals lacked the mental capacity to make certain decisions about their care or treatment, the provider worked collaboratively with relatives or appointed representatives to ensure that decisions were made in the person’s best interests. There were 2 advocates aligned to the service to assist people to understand information about their care