The Lodge 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

People’s needs were assessed before they started to use the service. This was done with the involvement of the person and their relatives and covered areas such as people’s care needs, wishes, and past histories as well as their religious and cultural needs. The management team and staff understood the importance of people having the right to make their own decisions. People were able to make day to day decisions about their lives such as how they were supported or how they want to spend their time. The staff team worked well with other health and social care professionals to ensure the needs of people using the service were fully met. Staff monitored people’s health care needs and made referrals to the appropriate health care professionals when needed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Before people started using the service, an initial assessment of their needs was undertaken. This was done with the involvement of the person and their relatives and covered a number of areas such as people’s care needs, wishes, and past histories. This helped to ensure if the service would be able to meet people's needs.

The provider told us that referrals would come from a number of sources when a person required residential care support. They told us that they responded and either the director or an individual nominated by them would carry out an assessment promptly to ensure that care provisions worked in a seamless way.

We noted people’s needs were assessed continually and updated when change occurred. We saw evidence of how care records were reviewed on a monthly basis, allowing staff to assess changes in the care needs of the people living in the home. These reviews were carried out by senior leaders in the home and countersigned by the manager on completion. We noted some people were assessed using a dependency tool but that not all people had a copy of this in their files. This was discussed with the management team, and they acknowledged the issue.

During our visits to the home, we saw many examples of where the home had adopted care practices which enhanced the quality of life of the people they supported. This ranged from equipment required to relieve potential pressure sores as well as a range of monitoring tools that met other needs associated with an ageing population. However, we felt that the home needed to deliver better support to people who had dementia living in the home. Whist we saw some information about each person on their door and some items in boxes on the walls by bedroom doors we felt that the provider could do more to support people with this condition. This was discussed with the managers who told us about their plans to expand staff knowledge of dementia which included both materials and training.

Staff and the management team had a good understanding of the care needs for people they supported. The managers showed us monitoring systems in place to ensure people received food and drink regularly to maintain their health. These intakes were being measured against people’s weights which were regularly monitored to ensure weights were within healthy ranges.

We noted systems and practices that supported good care for this particular group of people who used the service. We saw that the provider used approaches to support that resulted in good outcomes for people. This was particularly evident in care practices that countered conditions associated with an ageing group of people. The provider told us that in the 12 months since they had been involved in the care home their priority had been to provide good care for people. They shared with us their plans to further develop their expertise in dementia care.

We saw the home working with partner agencies. We were told by the GP when visiting the home how they meet with the staff to talk about anyone who had health concerns and how sharing of such information could result in positive interventions for people.

The manager told us how they worked with health professionals and had paid for additional support services from the local GP practice. For example, the provider has worked with the GP and arrangement that staff were able to contact them directly 24 hours a day which included weekend and bank holidays. This meant staff would be able to speak with a doctor that knew the person who lived at the home, and they would have their health history.

As part of our assessment, we aimed to seek the views of a range of people involved with a service. As well as those directly running the care home, we sought the views of other professionals involved in the care of people. We spoke with a person who delivered specialist training to prevent unnecessary hospital admissions. The person informed us that staff had received this training in April 2023, but it had not been carried out since despite attempts to do so. We discussed this with the provider, and they later arranged for the training to be delivered to their team. They went on to add that since the new provider took over the staff were always happy to call or e-mail the nursing team for advice and support.

In describing the setup of the service, the provider told us how the small staff teams operated across each unit within the home. To provide consistency and knowledge of the people they generally stayed working within the same unit but could work across the whole home if required.

During our time spent in the home we saw good quality food being served. The food was freshly cooked with healthy portions. We were shown a menu for people to choose from which was different each day. Staff told us that the menu rotated and that the home had developed a seasonal menu to offer greater choice.

Staff told us how they ensured people ate healthily. They offered people a choice of 2 vegetables with their cooked meals. They told us how fresh fruit was put out on the breakfast tables every day which included satsuma’s, bananas and pears. Staff could access the kitchen in the evening to make sandwiches for people if they were hungry. There was also yoghurts, jelly and cold puddings available if people wanted it. Currently, people could have toast as the only hot alternative between meals though the provider told us they were looking into providing soup as another alternative in the future.

At our last inspection, we found people's needs in relation to eating and drinking were not being sufficiently assessed to meet their needs. At this inspection, we noted people were supported to eat and drink enough to help keep them healthy. Staff were aware of people’s food preferences and acted in accordance with people’s wishes. Care plans included people’s preferences and the support they may require with meals. The provider told us about how they worked alongside the GP to review people’s health on a weekly basis. They mentioned how staff prepare a list of anyone with a health concern then discussed with the GP. The GP told us how this responsive approach allowed minor health concerns to be addressed before they could become more serious. The GP said, “The team are very familiar with the needs of people here and working in such a way prevents unnecessary hospital admissions and is a way of treating people before their conditions worsen.”

As a result of the partnership working between the home and other agencies, people were able to stay healthy and avoided unnecessary admissions into hospitals. Staff were able to get advice 7 days a week to ensure people could remain in the home and receive treatment where possible.

The manager informed us that from carrying out audits and spot checks they reviewed any actions that need improving. This helped to improve the service. For example, feedback from relatives and people mentioned that at times the lounge could get very loud and crowded. The provider told us they were planning to make another lounge which would help with this concern.

We saw the provider had a number of processes to monitor and identify positive outcomes. We noted the minutes of regular meetings within the home, both management and staff, sharing information discussing best outcomes for people’s care.

We saw consent forms in all of the care files we looked at. These were aimed at getting people’s permission for staff to support them in a way in which best suited the person.

Staff told us that they would always ask people for their consent before any care or support was given. For example, one staff member said, “I always explain to the person what I’m going to help them with and ask them for their permission before I carry out the task.”

As part of the review of care folders we noted that the home had sought the consent of people around access to information about them. We saw, where possible people signed to state that they had understood the information. We did not see this in every case and would recommend the home considers how to obtain this from people who find it difficult to consent. We saw other information detailing care which was in the best interest of each person. This covered a range of important decisions and provided clear information on how the person was involved in the best course of action for them.