April 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

Although there was limited impact for people using the service, not all risks to people's safety and wellbeing were assessed, recorded or provided enough detail as to how identified risks should be managed and mitigated. This placed people at potential risk of not having risks to their safety met in an appropriate and safe way. The registered manager worked closely with health professionals to support peoples needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

This service scored 71 (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 their families participated in the planning of their care and support needs. A person told us, “I have been living here for a few years now and they know how to look after me. The staff all know me well enough and know when I am unhappy or anxious and know how best to support me”.

Staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff understood the need to gain consent from people for care and to encourage people to make decisions for themselves.

During the assessment, we did not receive any feedback from partners.

People's care plans and risk assessments were not always personalised, and support was not always in line with their care plan. For example, we observed a person using a Zimmer frame to mobilise around the home however, there was no risk assessment in place and their mobility had not been documented in their care plan. Following the assessment, the registered manager has updated the care plans and risk assessments to ensure people’s care is delivered safely and is person centred.

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.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.

Consent to care and treatment was sought in line with legislation and guidance. People had been assessed for their capacity to consent to specific aspects of their care. People told us they received a choice about their care and treatment. A person told us, “The staff here always ask me if I want to do something but, in the end, it is my choice, and they respect that. They always knock before coming into my bedroom and they give me space when I need it.” A relative told us, “The staff always respect [relative’s] decisions and also encourage [relative] when they need to. My [relative] can make the choices [relative] wants to and is also confident to do so."

Ensuring consent to care and treatment in line with law and guidance The Mental Capacity Act 2005 (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 take particular 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 MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. People had capacity to make day-to-day decisions. We found staff practice reflected the principles of the MCA. People were encouraged to make their own decisions, while still minimising risk. Staff understood their roles and responsibilities in relation to the MCA 2005 framework.

Staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff understood the need to gain consent from people for care and to encourage people to make decisions for themselves. Staff told us, “I have recently completed my training and I understand the importance of gaining consent from the people I support.”