Ormsby 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.

The service did not have robust systems in place to ensure people’s needs were consistently assessed and reviewed. Key documents, including support plans and risk assessments, were out of date and did not always reflect people’s current needs, preferences or circumstances. There was no clear referral process in place for identifying needs, and hospital passports lacked sufficient detail to support safe transitions into healthcare settings. This presented a risk to people's safety, especially during emergencies or periods of transition.

Relatives told us they were not routinely involved in care planning or key decisions. One family member said, "No I’m not. She plans her holidays with a key worker and anything else... I don’t really get involved," while others stated, "Not involved," and "They arrange what they do, and they tell us what they do."

The manager told us that since she has started that people were now being involved in their annual reviews alongside professionals such as advocates and social workers. They said individuals were supported to contribute in meaningful ways, including choosing photos for review documents and using non-verbal communication to express preferences. This indicates some positive steps towards inclusion and person-centred planning.

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

Some restrictive practices were in place within the service. However, these practices had not been assessed or reviewed to ensure they were appropriate. This did not reflect best practice to support people with learning disabilities and autistic people, including guidance around right care, right support, right culture. Reviewing and minimising such practices is an important part of delivering evidence-based care that is tailored to individual’s needs.

The service worked proactively with external professionals, including the Intensive Support Team (IST) and Speech and Language Therapy (SALT), to ensure care was tailored to people’s individual needs. The manager described how IST were initially involved due to concerns about a person's behaviour and reluctance to leave the house. By focusing on language, building self-esteem, and exploring the person’s preferences, the team developed a trusting relationship, and the person was able to engage in activities outside the home. IST continued to support others in the service through behavioural assessments, while SALT were triaged to explore alternative methods of communication for another person. This aimed to reduce repetitive speech that had been identified as a potential trigger for others. These interventions supported people to engage more positively with their environment, reduced distress, and improved quality of life.

The provider worked well across teams and services to support people.

Staff, managers and professionals worked well together to coordinate care. One staff member told us, "Communication is good with management, my colleagues, and with residents. We also communicate with professionals."Professionals confirmed this, highlighting clear communication channels and an effective management structure. Professionals said this had a positive impact on people’s everyday living skills and quality of life.

The provider supported people to manage their health and wellbeing.

Staff supported people to live healthier lives through regular health monitoring, access to healthcare professionals, and promotion of healthy choices. People had a Health Action Plan that recorded medical appointments, follow-up dates, annual health checks and vaccination details. Healthy eating was promoted through discussions at regular resident’s meetings, where people were encouraged to contribute to menu planning. Staff adapted approaches where needed to ensure people received the care they needed. For example, one person, who found it distressing to visit the GP surgery, was supported to have their doctor visit them at the service.

These approaches ensured people received routine and preventative healthcare in a way that respected their preferences. Individuals maintained good physical health, and staff were able to identify and respond to emerging health concerns promptly. The person who received GP visits was able to access healthcare in a way that reduced anxiety and prevented health needs being missed.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were recorded.

Support plans and risk assessments had not been reviewed consistently, which meant important changes in people’s needs may not have been identified or acted upon. Although staff had discussions with people about setting and achieving personal goals, there was little written evidence to show how these goals were agreed or how progress would be supported or measured. The manager confirmed that people’s goals had not been formally reviewed or incorporated into their care plans. As a result, people were at risk of receiving care that did not reflect their current needs or aspirations.

There was limited evidence that people were encouraged or enabled to learn new skills or increase their autonomy. As a result, there was a risk that people could become over reliant on staff support, which may lead to institutionalised care practices and missed opportunities for individuals to achieve greater independence and improved quality of life.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Staff did not always follow the correct procedures for seeking and recording informed consent in line with the Mental Capacity Act 2005 (MCA) and the provider’s consent policy. Records did not consistently show how people had been supported to understand and agree to their care. Mental capacity assessments had been completed for people, but not for all decisions, including restrictive practices in place, such as limited access to food and toiletries. This meant that not all decisions had been assessed, and decisions made on behalf of people lacking capacity did not evidence they were in their best interests.

This inconsistency meant people were at risk of receiving care or being subject to restrictions without appropriate legal safeguards in place. Consent had not been sought from people when there were changes in their needs and care provision, which meant care may no longer reflect the person’s current wishes. People with communication or cognitive needs were particularly at risk should they not have been supported to understand their options and communicate their choices.

The provider’s consent policy sets clear expectations around gaining informed, ongoing consent, including the need to provide accessible information and involve others lawfully where capacity is lacking. The manager had identified gaps in practice and had begun to address these, including starting to complete capacity assessments and reviewing consent procedures. However, these improvements were not yet fully embedded or consistently applied across the service.