Camberwell 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

People were supported to stay healthy and access healthcare services when needed. The provider assessed people's mental capacity and made decisions in their best interests. Staff worked well with most external professionals to provide care and support which reflected best practice. Staff said they worked with other health and social care professionals to help meet people’s health and social care needs. However, mixed feedback from professionals showed there was more work to do to ensure partnership working with all external professionals was effective.

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.

Most people told us they had been involved in the care planning process and their views were included. Comments from relatives included, “[Family member] does have a care plan and I was consulted and led on it. It was reviewed two weeks later about her pain management. I discuss her care with the manager every two to three weeks” and “The manager discussed with us about mums likes and dislikes, medication and interests.” Despite mainly positive feedback a minority of family members did not feel they had been consulted. One relative told us, “I’ve asked for the care plan many times and it’s never been presented to me.”

Staff told us people's needs were clearly recorded in care plans and this helped them understand people’s needs. Staff also told us they regularly reviewed people’s care with the involvement of the most appropriate family member and other care professionals.

Assessments of needs were carried out. Initial assessments and care plans covered people’s health and social care needs including oral care. Care plans reflected people’s individual needs and preferences and contained clear guidance for staff on how to meet these. We found the assessments and care plans were completed to a good standard and were easy to understand. Despite generally good principles, many people receiving care told us they had not seen a copy of the care plan, and this corresponded with feedback gathered by the provider during their satisfaction survey.

People were positive that nutrition and hydration needs were being met and people had food that was safe for them to eat and options to appeal to their personal preferences. Comments included, “There is always hot and cold drinks and snacks” and “Yes, so far [family member] has enjoyed the food and it is varied.” Family members were also satisfied that individual dietary restrictions and guidelines were being followed. Comments included, “[Family member] is having the speech and language team visit due to swallowing problems. The carers take time for her to eat and don’t rush her and “The nurses know [family member] has to drink a lot to avoid the risk of infections.”

Due to concerns raised by speech and language therapists about the skills and competency of staff there had been additional training put in place for staff to ensure they understood how to follow eating and drinking guidelines and ensure people were getting food that was safe for them to eat. During the assessment we found staff including kitchen staff showed a good understanding of people’s dietary needs and knew what guidelines were in place.

There were eating and drinking care plans in place which highlighted the risks associated with eating and drinking. The provider worked with the GP, speech and language and dietitians to mitigate the risks. In response to feedback from speech and language therapists the provider was working on improving the systems in place including introducing a residents’ diet board so all staff could see risks, guidelines and recommendations at a glance. Food and fluid charts we reviewed showed people had adequate nutrition and fluids.

Family members told us staff worked well together and had confidence that staff would contact health care professionals if required. Family members spoke positively about the knowledge and competence of care staff. The G.P visited this weekend and came straightaway. The home has been thorough in contacting medical people” and “I spoke to the dementia specialist nurses, manager and assistant manager on the care plan. They are very good on health issues.”

Staff told us they were supported in their work. They told us there was good communication between staff other agencies and they felt comfortable reaching out to their colleagues and management for support. A member of staff told us, “I'm extremely happy with my job role. I love and enjoy caring for the residents and meeting their needs together with my team members.” The registered manager told us there were regular multi-disciplinary meetings at the home which supported the oversight of clinical care people received.

Feedback from professionals who worked with the service was mixed. Most professionals told us the registered manager had made substantial improvements with the safety and quality of care and communication with the team was effective. Positive comments included, “In general, since working with the staff over the past 18 months and by providing training there has been some improvement in skills, staff are more engaged with advice” and “Yes, we have regular multidisciplinary team meetings, and the home will also email me if they are concerned and would like me to see a resident and their family.” Despite generally positive feedback some professionals had concerns with the competency of staff and did not think staff were always following eating and drinking guidelines and tissue viability care plans well. We did not identify any issues with eating and drinking or tissue viability during the assessment, but the mixed feedback indicated further improvements with partnership working was needed.

Appropriate systems were in place to help keep staff informed of changes in the home and with people’s needs. This was done through regular staff handovers, meetings and daily logs. Staff worked well as a team, sharing information with one another as necessary to help ensure people received continuity of care. The provider was being supported by the GP with twice weekly visits to the home. The provider also had good communication with the funding authorities, people they supported as well as family members.

Family members told us people were supported to stay healthy and see healthcare professionals when needed. People received pain relief whenever they needed it without delay. People also told us staff were quick to respond to healthcare emergencies and make sure people received medical attention promptly. One person told us, “When I had a fall they were instantly there to help me and to check that I wasn’t hurt” and “When health problems come they get the doctor or the hospital sorted.”

Staff had a good understanding of people’s physical and mental health needs. They knew what medical conditions people had and how these affected them.

Care plans contained a good level of detail about people’s health conditions. However, we found diabetes care plans lacked sufficient detail about all the risks associated with this condition. We discussed this with the registered manager, and they have updated and reviewed diabetes care plans to ensure they were sufficiently detailed.

Family members told us the service was responsive when people's needs changed. Comments included, “The staff are monitoring [family member] closely. If anything changes they act quickly” and “[family member] was unwell recently, the nurse on duty picked this up and [family member] was sent to hospital to get checked over.”

Staff told us there were monitoring and recording processes in place to ensure any changes to people’s health and wellbeing would be identified in good time. Routine monitoring included areas such as nutrition, hydration, activities, health concerns and appointments. This helped staff to respond to people’s changing needs promptly and make sure people receive the appropriate support in good time. One member of staff told us, “We monitor changes in behaviour to identify people’s needs, especially where people can’t tell us what’s wrong.”

At the last inspection in December 2022, we found the monitoring process in relation to tissue viability and food and fluid charts were not effective. The provider had made improvements. There were effective monitoring systems in place to record a range of health care needs such as food and fluid charts, repositioning charts and wound care. Staff completed daily notes to show how they had cared for people, and these were reviewed by the manager. There were daily meetings to ensure staff were kept up to date about changes to people’s health and wellbeing.

Most people told us either they or their family member had been consulted about their care needs. Despite generally positive feedback, a minority of relatives felt they had not been consulted. Many people receiving care told us they had not seen their care plan and this corresponded with feedback from people gathered by the provider during their satisfaction survey.

Staff had been given Mental Capacity Act (MCA) training and they understood their roles and responsibilities on how to present information to enable people to understand and make choices about their care. Staff we spoke with were aware of the importance of making decisions in people’s best interests and not imposing unnecessary restrictions on people. A member of staff told us, “If people can’t decide things for themselves we have best interests meetings and involve a family member or friend if possible.”

The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS) We found the provider had assessed people’s mental capacity to make decisions and made appropriate applications when restrictions were in place.