The Evergreens 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

We reviewed 6 Quality Statements in this key question. We found the service had met the requirements in most areas however there was no formal procedure for updating peoples care plans with healthcare instructions which had left people at risk of harm. Also, some people were concerned at medical decisions being made by inexperienced staff members. However, people told us they could access healthcare professionals when needed and had been involved in care planning.

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 had been involved in assessments and care planning. They recalled being asked questions and staff writing down their answers. One person had no recollection of a care plan, but most people were aware of their plans.

Staff were not involved in assessing needs and care planning but told us they would read care plans on file and work to them. A member of senior staff met with people and completed pre-admission assessments prior to them moving to the Evergreens Lodge.

Pre-admission assessments were completed, and this information was shared amongst the staff team so they could provide appropriate care when people were admitted to the service. Reviews took place regularly and risks were assessed concerning identified needs.

We did not receive feedback specific to this area.

Staff completed regular training courses and were able to maintain current knowledge of health and social care practice. The registered manager had completed extensive training and planned to extend their learning further. Staff were knowledgeable about areas such as safe swallow plans and told us how they would ensure people received appropriate meal textures.

Staff meetings showed areas of good practice were discussed and adopted. The provider was working to become accredited with an end-of-life care pathway.

People told us they accessed healthcare professionals including GP’s, community nurses, audiology and chiropody services. They said the GP visited every other week and nurses visited to dress wounds frequently.

Staff and leaders knew which health and social care professionals were involved with the service and would not hesitate to contact someone should a person need them. The registered manager confirmed they had worked hard with external health and social care professionals and had developed positive relationships, much improved on those previously held. There were 2 GP surgeries providing ward rounds to the service.

We spoke with a healthcare professional who described some difficulties with the provider in that there were people using the service who needed a higher level of care than residential, due to the change from nursing to residential provision. They told us they were concerned; however, this had improved over the past 6 months.

We did not see a formal process for recording new health guidance into people’s care plans. For example, a healthcare professional told the provider a person needed to reduce their fluid intake due to a serious health condition. This information was not added to the persons care record in a timely way and the person continued to receive more fluids than instructed by healthcare professionals. This was confirmed by the deputy manager, the care plan we saw had been updated on 19 February 2024 and was set to be reviewed on 31 March 2024. The deputy manager had noted the change needed to fluid intake and would make the change at the next review. This meant for 26 days, this person’s care plan instructed staff to give a third more fluids than advised by their healthcare professional.

People were enabled to administer their own medicines and take responsibility for their storage. People could contact healthcare professionals or have staff do this for them. One person told us they felt staff who were not experienced and young had made health decisions about them at the weekend. They believed these decisions should come from a more experienced and senior member of staff as the outcome for the person was hospital admission. A person expressed their concerns at their incontinence pad not being changed frequently enough. They understood this could cause them to be sore and, while cream was applied, they preferred more frequent changes. This may be due to funded pads being just 3 per day.

Staff knew people well and were familiar with individual health conditions.

Weights were completed regularly, and analysis done of malnutrition universal screening tool (MUST) scores. MUST scores are calculated using body mass index (BMI) and unplanned weight loss to identify when people are at risk of malnutrition. People with scores were referred for support, had fortified meals, additional snacks and encouraged to eat in the dining room. At management level processes, were good and ensured appropriate training happened and actions taken to support people.

Without exception relatives believed peoples care was person-centred and met their needs appropriately. People told us the provider had worked to ensure their needs had been met.

We did not receive specific feedback in this area.

Monitoring took place of air mattress settings. Staff checked these to ensure they were at the correct setting. However, of 6 checked, 4 were incorrect meaning 4 people were at unnecessary risk of harm. These mattresses had been checked by staff members who had stated they were correct even though they were not. the management team also monitored Weights and MUST scores, and these were recorded and acted upon.

Relatives were happy with how staff treated people. They told us people were treated respectfully and were asked for consent before care was delivered.

Staff told us they sought consent before providing care to people and took care to maintain people’s privacy by closing doors and curtains when supporting them.

Consents were sought for areas such as care planning, use of photographs, support with money and administrations. These had been sought either from the person or from their legal representative who held a relevant lasting power of attorney.