Harrier 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 requires improvement. At this assessment the rating has changed to good.

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

This service scored 71 (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 assessed people’s care and treatment including reviewing their health, care, wellbeing and communication needs with them.

A qualified member of staff completed assessments prior to people moving into the service to determine whether their needs could be met. A person told us, “One of the nurses came to assess what care I needed.” Relatives confirmed they were involved in the assessment process and were able to contribute relevant information about people’s preferences and needs.

Assessments covered a range of areas, including people’s physical health, mental health, social circumstances and communication needs. Staff told us that the assessment was an ongoing process that continued after the person had moved in. A staff member said, “Even though we do an assessment before they come in, we continue to observe and learn about the person’s needs when they are here, and we update our records.”

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 provider used nationally recognised tools to assess people’s needs, including the Waterlow assessment for skin integrity and the Malnutrition Universal Screening Tool (MUST) for nutritional risk. These assessments informed care planning and supported the identification and management of risks.

People’s nutritional needs and preferences were understood and supported. Information about dietary requirements was shared with the catering team, and the service followed recognised best practice for modified diets. Food was prepared in line with IDDSI (The International Dysphagia Diet Standardisation Initiative)guidance, and kitchen staff had received appropriate training. Meals requiring modified consistencies were clearly labelled with the person’s name to reduce the risk of error and support people with swallowing difficulties.

Feedback about food and care was positive. A person said, “The food is good and if you want something else, they will make it for you.” A relative told us, “Relative loves the food there and there is always plenty – there is a café downstairs, and they always have tea and coffee available.”

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The provider had systems in place to support transitions between services, including the use of transfer forms and ‘blue folders’ containing key information about people. These were used when people were transferred to hospitals or other services. People’s needs were reassessed when they were readmitted to the home, following admissions and discharge summaries and medication lists were obtained to support continuity of care.

However, concerns were raised regarding communication and information sharing within the service and with external partners. Professionals reported that staff were not always able to provide accurate information about people’s needs. Communication with the service was described as inconsistent and dependent on individual staff members and managers.

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.

People and their relatives gave positive feedback about how staff responded to health concerns and sought appropriate support. A person told us, “I see the GP when they come on their weekly round, but I can ask to see them earlier if I need to.” A relative said, “The nurses request for the GP or call an ambulance if it’s an emergency.”

Other relatives also described timely access to healthcare services. Comments included: “I do know that the GP goes in there, so that gives me confidence,”, “They would always phone the appropriate people and let me know,” and “They have always let me know when they call the mental health team… and any change in medication they keep me informed.”

People’s records showed people had been supported to access a range of healthcare services they needed to maintain good health.

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

Care plans outlined the outcomes to be achieved, and there was evidence that these were used to guide care delivery and support people’s health and wellbeing. Where people required monitoring, such as weight, fluid intake or repositioning, appropriate charts were in place and had been completed correctly. This supported effective oversight of people’s health and enabled timely intervention where required. Review meetings took place regularly to assess whether people’s needs were being met and whether outcomes were being achieved. A relative told us, “When (relatives name) first went in, they could not walk, and they did a massive U-turn and can mobilise with support now. The staff have done a mega job on them.”

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

The service was working in line with the principles of the Mental Capacity Act 2005 (MCA), which provides the legal framework for supporting people to make decisions and ensuring decisions made on their behalf are lawful and in their best interests.

Mental capacity assessments had been completed and were decision-specific, for example, in relation to the use of bed rails or decisions about moving into residential care. Where people were assessed as lacking capacity, best interest decisions were made in consultation with staff, relatives and relevant professionals, and these were clearly documented. Records demonstrated that appropriate processes were followed to support safe and lawful decision making, including ensuring decisions were made in the least restrictive way and in people’s best interests.

Staff demonstrated an understanding of the MCA principles, including supporting people to make their own decisions wherever possible and recognising when best interest processes were required.