The Lakes Care Centre

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

We identified 1 breach of regulation in regard to how the service assesses people's needs to ensure they can meet needs and mitigate any risk at the point of admission. Partner agencies told us the assessment process needed improving. We found an instance where care plans and risk assessments had not been implemented in a timely way to ensure staff knew people's needs and how to meet them. Staff were committed to learning about people and their needs and preference. Staff spoke positively about the recent changes and improvement to how the service works with other professionals and the management was keen to develop good working relationships to ensure people's needs were met. Overall people living at the service, and their relatives felt confident that that the service could effectively meet people's needs.

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.

People’s needs had been assessed prior to admission and relatives told us they had been involved in this process.

Staff told us that they had information about people’s needs and how to support them and this information was readily accessible. The manager acknowledged that there had been some shortfalls in the assessment process, particularly for those requiring nursing care and that these had not always been updated or involved family. However, they assured us that a suitable process to involve relevant people would be followed moving forward.

Processes were in place to ensure people’s needs were assessed prior to admission to the service and risk assessments and care plans were reviewed regularly. However, the assessment process was not always as robust as possible, risk assessments, care plans and summary of needs were not always detailed or updated when a person’s needs had changed. Partners told us that the changes in management had caused some challenges on how peoples’ needs were assessed and how people were supported. One professional told us that the assessment process needed to be more robust and staff needed to be more curious when assessing whether the service could meet a persons’ needs. Another professional told us that information was not always escalated appropriately when there had been concerns. Overall partner agencies felt things were improving and were complimentary about the staff working for the service who it was felt generally knew people’s needs and were kind and caring.

People and relatives felt good quality care was being delivered. Relatives commented that people were supported to eat well, were gaining weight, and drinks were available. One relative commented, “[Family member is] on a liquid diet now and is putting some weight back on.” Another relative told us, “We can support [family member] with [their] food and [they] always gets good portions.”

Staff in the kitchen were given clear information about people’s dietary needs and this was reveiwed regualrly. Staff understood people’s needs and to provide care in line with these needs.

Processes were in place to ensure people had a choice of food to eat and drink and snacks were available throughout the day. Care plans contained accurate information of people’s dietary needs, food and fluid intake charts were maintained for those at risk and where people had modified diets records of this were maintained. However, the consistency of food and fluid was not always accurately being recorded. Feedback from professionals about recent safeguarding concerns indicated work was ongoing in this area to ensure staff had the knowledge, training and understanding of evidence based good practice.

People and relatives spoke positively about how people had been supported into the service. One relative told us, “They came to speak to [family member] and me at the hospital. Staff were aware of [their] needs when [they] moved in.” However, another relative told us that hospital services had not passed key information about an incident which meant the service had not implemented measures to mitigate the risk when a similar incident occurred within the service.

Staff told us that there were some challenges with how effectively the service and other organisations worked together. Staff noted that information provided from hospital services was not always accurate and it was difficult to get people reassessed and ensure they had the support needed when initial information was found not to be correct. Staff were not always confident to challenge other services when information was not made available.

Feedback from partner agencies was mixed. Professionals told us that generally staff were responsive to feedback and keen to learn and ensure people received the care they needed. However, some professionals felt that staff did not always have the knowledge and concerns were not always escalated in a timely way. Improvements to working relationships between the service and other health care agencies were needed. Action was ongoing

The service worked with people, families and other services to assess needs and used information obtained to develop initial risk assessments and care plans. We identified one case where care plans had not been implemented in a timely way and areas of key risk had not always been assessed in line with the providers policies. We raised this issue with staff and this matter was addressed following the first day on site.

People were supported to access health care services and medical interventions were sought when needed. One relative told us, “I was informed the GP was going and what time so I was able to visit at that time.” We observed people were supported to remains as independent as possible.

Staff told us there had been some challenges with working with some health care services and, at the time of our visit, not all people using the service were receiving regular ward rounds from their assigned Doctor. The manager told us this had improved following our site visit.

There were processes in place to ensure referrals to partner agencies were made as needed. This included contacting the dietitian and speech and language therapy for advice. Feedback from partner agencies indicated that concerns were not always escalated in a timely way and the processes within the local authority to do this were not always being followed.

People looked well cared for and relatives spoke positively about the service and felt their family member was well treated by kind and caring staff. Relatives commented that people were gaining weight and one relative said, “When [they] came in [they] couldn’t feed [themselves] and now [they] can.”

Staff understood the importance of promoting independence and told us the promoted and encouraged people. We observed people to do as much as they could for themselves.

There were suitable processes in place to monitor people’s safety and wellbeing. Care plans identified where staff needed to complete regular checks of people’s wellbeing. There had been shortfalls in how people's needs were monitored and improvements were apparent but needed to be embedded further.

People told us, and we observed staff requested consent before providing support. Staff were seen to take time explaining what they were doing and provided reassurance.

Staff understood the importance of obtaining consent and supporting and encouraging people to make decisions for themselves. One member of staff told us, “I have a conversation with people as well as explaining what I’m doing so people can make a choice, for example what to wear, style of hair.”

Care plans contained infomraiton about consent and how people communicated consent. People who lacked capacity had a mental capacity assessment and best interest decisions in place. Deprivation of liberties safeguards (DoLS) were being made. However, no statutory notification had be sent to CQC about DoLS which had been granted. This indicated processes for oversight and management in this area were not effective.