Dawson Lodge

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• 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

We assessed two quality statements within the effective key question. People’s needs were assessed prior to admission to the home and regularly reviewed. Needs assessments were holistic and person-centred. Staff we spoke with showed good knowledge of people’s needs and how to meet them, considering their likes/dislikes and preferences. People were supported with their healthcare needs. The systems in place supported prompt access to healthcare support and these included staff observations of indicators to deteriorating health. There were daily GP calls and daily and weekly meetings to share information about people’s health needs and progress. People had ready access to food and fluids including snacks. People and relatives spoke positively about the quality of food available. People’s dietary preferences and needs were catered for, and people were involved in the development of the menu.

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.

People were involved in an assessment of their needs prior to their admission to the service. This information was used to develop a care plan, and these showed people’s needs were regularly reviewed. A person’s relative said, “We discussed [person’s] risk of falls before they came here, they [staff] are very aware of this.” Another relative said “My relative has lived here for more than 12 months. We are very happy with [person’s] care here.

The acting home manager explained how, following an initial needs assessment, information was uploaded onto the electronic care planning system to generate guidance for staff, including risk assessment within 48 hours. Staff told us the guidance and information on the care planning system and updates shared at daily handovers enabled them to understand people’s current needs. Their comments included, “I have the information [needs assessment] on my phone. If I need to know anything I will access it on my phone, care plans are very detailed” Staff told us and records confirmed people’s needs were regularly reviewed. A staff member said, “We do monthly care plan reviews and make sure all applicable changes are made and that the current plan is accurate and up to date. We will speak to the resident or will chat to the family to see if any changes are needed” We saw examples of how people's assessments had been updated between reviews following an incident or changed need. The acting home manager had recently written to people and relatives encouraging their involvement in care reviews.

Nationally recognised tools were used to assess people’s needs. People’s communication needs and preferences were described in their care plans. Needs assessments included people’s likes and dislikes and activities and interests to support their wellbeing. People’s care records showed their care plan was developed using a person-centred approach. People’s assessed needs included their communication, wellbeing, sexuality, emotional, care and health needs. Records were kept enabling staff to monitor people’s assessed needs were met. For example, for one person their care plan detailed how activities assisted them when they experienced distress. A staff member told us about the activities they enjoyed, and records confirmed their involvement in these.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us they were supported to manage their health needs. For example, a person said, “Yes they do consult with Doctors here if it’s an emergency, but I haven’t needed to see one lately.” People were also supported to exercise with sessions available every day. At the time of the inspection a garden party was planned to celebrate the garden ‘revamp’ carried out by volunteers. We saw people could access the garden independently and enjoyed the outside space.

The acting home manager told us how staff had recently completed training to enable them to carry out physical observations to see if a person’s health has or is at risk of deteriorating. They said, “As we know the residents well, we notice any small changes which would trigger a concern, we can now just check their stats and give that information over the phone straight away, this could mean people receive quicker medical treatment.” The acting home manager told us people could access an ‘at home’ dentist, who would visit people at the service. The community nursing team and GPs also visited people in the service. The acting home manager reported communication with healthcare teams was good. We spoke with a visiting healthcare professional who told us referrals were made appropriately and information was shared to support people’s health outcomes. Staff told us they reported health concerns to the team leaders who acted on these. A staff member said, “We will tell the team leader who will then get any medical professional that they think should attend to come in.”

People’s care records were summarised into a ‘hospital pack’ that could be shared with other healthcare professionals. This information helped to support continuity of care. Staff handovers and meetings to review and monitor people’s health needs enabled staff to provide appropriate support. For example, we saw a person’s needs had been reviewed by staff and other healthcare professionals. This had resulted in improved outcomes for this person. A daily call was in place with the GP surgery to ensure healthcare concerns were addressed promptly. Records showed people received the support they needed to live healthier lives. People’s records showed they were referred to and received treatment from a range of healthcare professionals including Speech and Language Therapists (SaLT), GPs, community nurses, physio and occupational therapists, older people’s mental health team and emergency services. People’s weights were monitored, and their nutritional needs and preferences recorded to provide guidance for staff. Other monitoring such as fluid intake, nutrition watch and wound care progress/treatment meant people’s health and wellbeing was promoted.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.