Edgecumbe 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

This means we looked for evidence that people’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last inspection we rated this key question requires improvement. At this inspection, the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives gave mixed feedback around their involvement in creating and reviewing people’s care plans. A relative said, “There is a care plan. Every so often I go through it.” Another relative told us, “I haven’t seen the care plan for a while.”

Staff and the management team told us they reviewed care plans on a monthly basis and were in the process of transferring them onto the new electronic system. All staff had training in using the new electronic care planning system.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs. People’s care plans were detailed, and we were told staff fully understood people’s needs. However, risk assessments were not always detailed to provide staff with guidance on managing certain health conditions. Care plans had not always documented that staff had discussed individual health, care or well-being and communication needs with people or their relatives to ensure care was effective.

People received support to eat and drink enough to maintain a balanced diet. Relatives confirmed people’s nutrition and hydration needs were met. A relative said, “My relative has put on weight. Staff come round with a menu to choose from so my relative can make a selection.” We observed a positive mealtime experience. People told us they were offered choices, and we observed people receiving appropriate support to eat and drink where required.

The manager spoke about attending different forums to ensure they were following best practice guidance. The management team recognised that improvements were required. Staff told us they had access to policies and procedures; however, training had not been kept up to date. The provider acknowledged there were gaps in training.

Care and support to people was not always delivered in line with good practice standards. The provider’s systems did not ensure that staff were up to date with national legislation and evidence-based good practice. For example, in relation to medicines, staff had not always completed/refreshed training in key areas. People’s nutrition and hydration needs were not always well documented in care plans to guide staff. We found policies and procedures had not been updated and were not fully embedded within the service.

Staff told us information was shared amongst the team effectively via handovers and team meetings and partners fed back the service had positively engaged in addressing issues. The management team told us they had a good working relationship with the local authority and healthcare provider.

The service had been working closely with the local authority to make improvements to the quality of care being provided to people. We received feedback from a health care provider who had been working closely with the service. They told us the new manager and deputy were supportive to staff and were leading the service in a professional manner. They observed the care delivered at the service was safe. They told us, “Manager and deputy manager are keen to ensure all aspects of the care delivered to their residents is in a safe manner, and always considering resident’s choices and wishes.”

The provider had systems to communicate with staff and residents. These included daily handovers, and regular team meetings with staff. They also used digital technology for communication.

People and relatives told us that the staff supported them to live healthier lives. One person told us, “The chiropodist comes in. The doctor does checks if needed.” Another person told us, “She can stay in bed, but they support her to go down so she can get involved in activities, such as bowling, cooking and chair aerobics.”

The service promoted health and wellbeing by providing healthy meal choices and encouraging people with regular activities and exercise. Staff took steps to identify risks to people’s health and wellbeing and worked with other professionals as needed. The service supported people to manage their health and wellbeing to maximise their independence, choice, and control by employing a wellbeing coordinator who supported both staff and people. They provided group activities to people and also one to one activities for people who were bedbound.

People were supported to participate in immunisation and screening programmes as appropriate, and referrals to appropriate health care professionals had been made as needed. We found care plans needed to include more detail about the support people needed to improve or maintain their health. One person was on a low sugar diet; however, the care plan did not sufficiently provide detail about what foods this person should eat.

The service routinely monitored people’s care and treatment to continuously improve it. A wellbeing coordinator was employed by the service to improve outcomes for people. We observed the wellbeing coordinator encourage people to participate in chair yoga with their relatives. We also observed people do one to one activities and we saw people being encouraged to do ball play. The wellbeing co-ordinator had detailed knowledge of people’s different abilities and preferences.

Staff told us they looked at people’s care plans regularly. Staff were encouraged to understand and follow best practice when caring for people. Staff told us they felt people’s care plans and risk assessments were sufficiently detailed, however, we found gaps in people’s risk assessments.

Expected long term outcomes were not sufficiently detailed in people’s care plans. Staff improved outcomes for people, but these were not well documented. The manager told us they would take action to review risk assessments and improve the monitoring of people’s and outcomes.

We observed staff respecting people’s rights when delivering care. Consent was obtained and people’s wishes were met as far as possible. People were encouraged to make choices during our visit and staff listened to them and gave people time to respond.

Not all staff were able to demonstrate an understanding of the principles of the Mental Capacity Act or Deprivation of Liberty Safeguards. Training had not been refreshed in this area. We highlighted this to the management team, who said they would review staff training.

People’s capacity was considered and documented in line with the Mental Capacity Act 2005 (MCA). Consent to care and treatment forms had been completed for people and care plans included decision specific capacity assessments as per best practice guidance.