Argentum 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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (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 care plans clearly reflected their needs and preferences. They were written with a focus on people’s strengths and promoting people’s wellbeing.

Managers and nurses regularly reviewed care plans, risk assessments and clinical tools and any changes were clearly documented. Relatives were also contacted and asked for their feedback as part of the review.

Staff told us people’s care plans provided the information they needed to support people in their preferred ways, and they were updated if people’s assessed needs changed.

People were involved in their reviews where possible and relatives told us any changes to people’s care were discussed with them. One relative said, “Yes I attend with (person’s) permission, they lead it, we recently had a review of their equipment. There were some changes needed, but it is always decided through them, they are the boss.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The service ensured people’s nutrition and hydration needs were met. Care staff recorded and monitored people’s food and fluid intake. A recognised risk assessment tool was used to assess and review any concerns around malnutrition. People were referred to external healthcare professionals such as dieticians for advice and support.

The service worked with other professionals and followed their guidelines and directions. One health professional told us, “I discuss any new guidance with managers, I know it is cascaded down and gets done.”

Overall, people told us they were happy with the food and drink provided, they received a choice of options and had been asked for their feedback on the menus available. Comments included, ‘perfectly good’, ‘food suits me’ and “I enjoy the meals.” Our observations confirmed people were given choice and people’s dietary needs were being met.

However, where people required regular repositioning to reduce the risk of pressure damage, care plans did not always clearly record if people required support or repositioned themselves independently. Daily records reviewed did not always show people were repositioned in line with information in their care plans. This meant we could not be assured the risk of people experiencing pressure damage was always being managed effectively. We discussed this with the manager. They advised there may be reasons why people decline to be repositioned in line with their care plan, these are discussed with health professionals and relatives. We also saw evidence the manager had discussed the importance of supporting people to reposition in line with their care plans in daily flash meetings, and they monitored this area through internal audits and governance meetings.

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 told us they worked together well as a team. Regular handover discussions ensured information was passed between them. Handover notes were detailed and recorded information such as people’s medical history, notes about how people were and any concerns. Short daily meetings were held and provided an opportunity for information to be shared about residents’ health and wellbeing and any specific priorities.

Staff engaged well with other agencies to ensure people's treatment needs were met. Health professionals told us communication from the team around people’s needs was effective. One health professional commented, “Staff are able to provide information such as PRN use or incidents without having to go through documentation which reassures me that staff know their residents well and are aware of the important information.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

A health professional from the local surgery completed regular ward rounds. The service ensured any advice given or amendments to people’s prescribed medicines were implemented.

The service completed oral health assessment tools for people and care plans detailed any support required. People’s weight was monitored and advice sought from health professionals if concerns arose. Staff supported people to attend routine appointments with healthcare professionals such as dentists and opticians.

People and relatives told us they were supported to access health care from the on-site nursing team and could see a doctor when they wished to. One relative said, “There is a really good nursing team. This is a real plus for me, they link up with the local GP surgery. The same doctor is here every week.”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Managers regularly reviewed and updated care plans when things changed. Care plans included people’s desired outcomes and included detailed information on how the service could help the person to achieve this. For example, where people had positive behaviour support plans these detailed how recording charts should be used to monitor behaviours and develop proactive strategies.

The service sought and followed medical advice where people had experienced weight loss. People’s weight was continually monitored and discussed in weekly clinical meetings. We saw several people had been supported to successfully gain and maintain a stable weight.

The manager had created a holistic care and emotional wellbeing service improvement plan. A visiting beautician provided holistic massage to people in the service on a regular basis. Wellbeing activities evaluation forms were completed for people for the massages they received to assess the impact for people. We saw positive outcomes were recorded.

The manager showed us case studies of people who had improved outcomes since moving to the service. Relatives and professionals confirmed the positive impact moving to the service had for people. A professional told us, “Since moving to Argentum, (person’s) wellbeing has improved tremendously. They engage in activities, enjoy trips into the community, interact with other residents, and have regained their personality.” A relative told us, “We cannot speak highly enough of the staff. Every single member of the team has been exceptional in their role, making (person) feel truly valued, comfortable and well cared for.”

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

Staff conducted assessments around people’s mental capacity and care plans contained relevant information, including around decision making. They recorded who the person would like to be included in making decisions about their care. Where people lacked capacity to make their own decisions a best interests process had been followed. Relatives had been consulted and any decisions made were seen to be the least restrictive for the person.

Staff were observed to be asking for people’s consent before supporting them. People and relatives confirmed they were asked for consent before being supported. One relative said, “They do ask, they always knock on door and ask is it ok to come in. If they have supported them to the toilet and leave them for some privacy, they also knock before they come back in to help them.”

Staff had completed training in the Mental Capacity Act (MCA) and DoLS and were able to explain how they sought consent from people to make day to day decisions in their lives. One staff member told us, “We need to ask for consent in everything we do, we ask people, we communicate with them. For personal care we tell them at each step what we are doing, if they give consent then you can go ahead.”