Lakeside Residential 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.

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 because they did not always check and discuss people’s health, care, wellbeing, and communication needs with them.

A review of records for 7 people showed on-going assessment and monitoring of people’s current and changing needs were not maintained. Monitoring charts, such as fluid intake and hygiene charts were not consistently completed to reflect the care and support people needed to maintain their health and well-being.

Staff told us information about new admissions was not always communicated to them. One person arrived the morning of our site visit for a period of respite. Staff had not been made aware they would be arriving. Arrangements were quickly made by care and housekeeping staff for the person’s stay. We spoke with the person, they told us; "I've only come in today, but I come for respite every year that I can get in. It’s the best home I've been in. The staff are lovely.”

The registered manager told us all new referrals were made through the local authority brokerage system. We were told there were issues in receiving contracts due to the bidding process and minimal information provided in relation to people’s health needs. To help ensure suitability of any placement the registered manager would carry out a pre-assessment, meet with the person and family prior to any decision being made. The relative of one person told us, “[Person] moved in 8 weeks ago and has settled well. We visited before [person] came, so we could have a look around and chat with staff. It’s important to get a feel of the place.”

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

People had access to the health care support they needed. Records showed appropriate referrals had been made to other agencies for advice and support such as, speech and language therapy and the community nursing team. Guidance provided was included within people’s support plans. However, we noted records to show areas of risk were being regularly monitored were not always accurately maintained. A review of training records showed only 50% of staff had completed training in nutrition and hydration.

We observed lunch time and found people were not always effectively supported with their meal. We saw suitable tables were not provided for those people wishing to have their meals in the lounge areas. This was raised with managers. It was later confirmed that adjustable small tables had been purchased for people to use.

People’s records lacked information about their food preferences. Kitchen staff said they were aware of people’s dietary needs, however, had requested information about people’s likes and dislikes to help with menu planning. This had not been provided.

Whilst people were offered choice we received a mixed response in relation to the meals provided. People told us, "It’s the same things all the time and it’s too bland", "The food is so-so, just okay really", "I can't fault the food. We get a choice each day and I get plenty of drinks" and "The food is okay; it’s not all my personal choice but a reasonable variety.” One person told us they would like Caribbean style meals. Staff said these had been tried, however the person asked for the food that other people were eating.

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 spoken with gave good examples of how they worked together with other services to ensure people’s needs were met. Staff said there was regular communication with GP’s and other agencies when making or following up on referrals for people.

As part of people’s care plans, hospital packs had been developed. This provided relevant health and personal information about people’s needs. This would be shared with nursing staff if people were transferred to hospital to ensure consistency in care.

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

Not everyone was able to engage in planning or managing their care. Records did evidence where healthcare support had been provided from relevant health care teams such as GP’s, dietician and speech and language therapy. To help monitor and maintain people’s health, additional monitoring records, such as repositioning, food and fluid, and weights charts were also in place. As reported on within this report, we found these were not always completed in full so that people’s changing needs could be easily identified and responded to.

People’s care records explored their individual social, emotional, and physical needs. However, from our observations and a review of records, we found there was a lack of people’s participation in any meaningful activities helping to promote and maintain their independence.

The provider did not always routinely monitor people’s care and treatment to continuously improve it.

Over the last 12 months there had been a change in management. Systems to monitor and improve the service had not been embedded. Improvement plans did not explore all areas of the service and consider areas of continuous improvement.

Staff spoken with did not feel changes within the service were effectively communicated to them or that opportunities were provided for people and staff to share their views or ideas, helping to inform where improvements could be made.

Whilst people’s care records were personalised with some information about their wishes and preferences, shortfalls were identified in relation to on-going monitoring so changing needs could be quickly identified and responded to.

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

Policy and procedures were in place covering the Mental Capacity Act. However, only 60% of care staff had completed training in this area.

A review of people’s records showed little evidence of their involvement and where able, consent to their care and support had not been sought. Records did show mental capacity assessments had been completed. However, the capacity and consent tracker showed care staff had consented on behalf of people, where they lack capacity to consent for themselves. This was raised with managers. Records were to be reviewed to better evidence where people had been involved and consulted about their care and that consent was only sought by those with lawful authority to do so. Records should clearly evidence those consulted with when decisions are made in people’s best interest.

Applications for new or to renew Deprivation of Liberty safeguards were submitted to the supervisory body in a timely way so people’s rights were protected.