Lakeside Care Home

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.

The service was in breach of regulations relating to consent to care and treatment, safe care and treatment, and good governance.

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.

People’s needs were assessed with them or a family member on their behalf prior to them joining the service including their health, care, wellbeing and communication needs. This meant the provider could ensure they could meet people’s needs prior to them moving in.

Improvements were required in the documentation and recording of people’s assessed needs and care interventions. For example, where people had a urinary catheter fitted, their needs, care interventions and expected outcomes required further detail. We found gaps in staff records of care interventions in areas such as repositioning and the application of topical creams. This made it unclear whether planned care had been delivered and was effective.

This contributed to a breach of the safe care and treatment regulation.

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

We were not assured people were receiving their diet in a way that had been assessed by a professional. For example, one person had their food modified as choking or swallowing difficulty had been identified as a risk. We saw evidence this person had been assessed by a Speech and Language Therapist (SALT), however the advice and guidance from the SALT had not been reflected in the person’s care records or within the risk information held by the kitchen staff.

We saw evidence the diverse range of people’s needs had been assessed, including their communication needs, and this was documented in a person-centred way, with care planned accordingly.Nationally recognised tools were used to assess matters such as skin integrity.

This contributed to a breach of the safe care and treatment regulation.

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.

There was evidence of partnership working with external professionals such as GPs and the Older People’s Mental Health team. We contacted a number of healthcare professionals as part of this assessment but did not receive any feedback to support our assessment findings.

Staff we spoke with were positive about their working environment. They said they were supported by the service management and had good working relationships with their peers which resulted in good care outcomes for people using the service.

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 through accurate record-keeping or, where possible, to reduce their future needs for care and support.

There was not always clear, person-centred guidance for staff on how to monitor and respond to changes in people’s conditions or escalate concerns. Whilst we did not identify a significant impact on people, we identified 1 person had experienced poor outcomes on more than 1 occasion due to poor urinary catheter assessment and care planning. Staff had not used associated catheter equipment appropriately because of the lack of recorded guidance. Expected outcomes and escalation processes were not in place for areas such as poor fluid intake and infrequent bowel movements.

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 andconsistent, or that they met both clinical expectations and the expectations of people themselves.

Whilst monitoring systems and processes were in place, staff had not used them accurately or effectively. There was no provider-level or service management oversight of these systems. Improvements were needed to ensure people’s care and treatment were monitored effectively.

Records were in place to monitor areas such as repositioning, fluid intake, bowel movements, topical cream applications and malnutrition. However, the records relating to these aspects of care did not evidence people had been supported in line with their care plans or assessed needs. The lack of oversight at provider or management level meant evolving risks had not been identified or escalated.

This contributed to a breach of the good governance regulation.

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

Consent to care was not always recorded clearly within people’s care records or in line with legal requirements. Mental capacity assessments and best interest decisions had been completed for some people where required. However, this was not consistent, for example for the use of monitoring equipment such as pressure mats, decision specific capacity assessments or best interest decision processes. Where people had others lawfully acting on their behalf, the service had ensured the appropriate documentation had been obtained.

This contributed to a breach of the regulation in relation to consent to care and treatment.

We observed, and people and relatives told us, staff sought consent to care at the point of delivery. Staff had received training and had a good understanding of mental capacity; they were able to explain how they supported people to make informed choices about their day-to-day lives. We saw care was delivered in the least restrictive way possible.