Nutley 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

Effective - this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life. At our last inspection we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of legal regulations in relation to safe care and treatment and consent.

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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care, well-being and communication. The registered manager told us how they assessed a person prior to them moving to the service. They told us they visited the person to gain information around the person’s care and treatment. The registered manager considered if additional staff training was needed, and if the person was going to be a good fit with the other people in the service they would recommend for the person to visit. Staff were able to tell us people’s needs, including people’s communication preferences. A staff member told us, “It depends on the individual response and their stage of dementia, so if they can communicate verbally, we hear their choices – you give them options and questions with yes and no answers. And for people who can’t speak we make eye contact with them and speak clearly to them and they will nod their head or shake it. And if they don’t respond we will come back and try later or try a different member of staff so it is about giving people options and ensuring you take that time to understand what they want.”

The service did not always deliver people’s care and treatment in line with their assessed needs. Food monitoring analysis showed most main meals were recorded for individuals. However, there were some gaps within records. The registered manager told us they would expect all meals to be documented, including if the person had refused. They confirmed records did not show this. The registered manager told us they would take action to address these gaps.

People and their relatives enjoyed the food at the service. Comments included, “Very good home-cooked food” and “Dietary matters are attended to without fault.”

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing the needs of the person when moving between different services. The service worked with professionals when people moved into the service, such as ward staff and GPs. Relatives told us staff listened to them and worked with them to improve the quality of life for the person.

The service supported people to manage their health and wellbeing to promote a healthier life. People were supported in understanding healthy eating choices and provided with information about the risks if they wished to make an unwise health decision.

The service did not always effectively monitor people’s care and treatment where this was required. We saw examples where the service was not following their procedure following a person falling. People were required to be monitored every 30 minutes after falling, records showed gaps of between 2 to 4 hours. This could put people at risk of an injury following the fall, and a delay in treatment if the person was not being referred promptly to medical professionals. Whilst we did not identify anyone who had come to harm, poor monitoring of people’s health after a fall contributed to the continued breach of regulation in relation to safe care and treatment.

The service had improved its monitoring of unplanned weight loss and sourcing medical advice to address the concern. We saw from records people’s care was regularly reviewed.

The service did not always effectively record where people’s consent had been obtained. The registered manager was aware of the principles of the Mental Capacity Act 2005. However, some mental capacity assessments were missing. For example, where the service stored money for 18 people who we were told lacked capacity to make decisions about their money, this decision to have their money stored had not been recorded in line with the principles of the Mental Capacity Act 2005. Whilst we did not identify anyone who had come to harm, lack of records of consent contributed to the continued breach of the regulation in relation to consent. The service had made improvements to records, for example, recording best interest decisions. Staff were aware of gaining consent from a person before supporting them with care tasks. A staff member told us, “We always ensure we get their consent.”