Byron Lodge Care Home Ltd

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

People were unable to recall being involved in their assessments and care planning processes. Before people moved into the service their needs were assessed. The provider had systems and processes in place to meet people’s nutrition and hydration needs. People told us the service worked with GP’s and health professionals to meet their health needs. The provider had a clear process in place to escalate health concerns within a timely manner. Staff had a good understanding of meeting people’s changing needs. Staff told us they had training and support to meet people’s care and health needs. Care plans were in place which detailed people’s care and support needs as well as their clinical needs in relation to health conditions. People's choice and consent was valued, and the staff continually consulted people about their wellbeing and wishes.

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 were unable to recall being involved in their assessments and care planning processes.

Staff told us how they supported people to be as independent as possible in meeting their assessed needs. A staff member said, “Lots of people like to wash their own face and hands and we get the bowl and flannel ready, check the temperature is the way they like.”

Before people moved into the service their needs were assessed. These assessments were used to develop the person’s care plans and make the decisions about the staffing hours and skills needed to support the person. However, the assessments were usually completed on the telephone as most new people were admitted from hospital, which meant that the assessor was not able to get a full picture of people's needs. The service received details about the person on a hospital discharge form, sometimes the information was limited. For all new people moving to the service, there was a checklist that staff followed to ensure key information was recorded and essential assessments were completed. For example, medicines, moving and handling, and a set of baseline observations. The check list also included assessments and care planning that needed to be completed during the first 7 days. However, the process to ensure that assessments had been completed within the 7 days was not fully robust; this is evidenced by a person with no catheter care risk assessment in place after 7 weeks of admission. The assessment process included making sure that support was planned for people’s diversity needs, such as their religion, gender, marital status, culture and their abilities. People were reassessed as their needs changed to ensure the care they received met their needs. Some assessments included information about what people could do for themselves. For example, one person’s assessment described the person enjoying brushing their own teeth with an electric toothbrush, detailing that they needed assistance to put toothpaste on the brush.

We received positive feedback about the food. Comments included, “It is ok I don’t eat much”; “I enjoy my food”; “I don’t have a special diet, but I do enjoy ice cream”; “The food is ok” and “We have lovely food.” We observed that people received food and hydration which met their assessed needs. People had their meals in the dining room, lounge and in their bedrooms. The menu board in the dining area listed the choices available.

Kitchen staff and those responsible for supporting people with their food had a good understanding of people’s assessed needs in relation to type and texture of food. Staff told us they helped people to make their meal choices if they needed it.

The provider had systems and processes in place to meet people’s nutrition and hydration needs. Care plans and risk assessments clearly described what modified diet people were prescribed and the care plans followed The International Dysphagia Diet Standardisation Initiative (IDDSI) framework. The IDDSI guidance was also available in the kitchen to staff responsible for preparing, cooking and serving meals. The provider bought in fresh meals for people on a modified diet.

People told us the service worked with GP’s and health professionals to meet their health needs. A person said, “The doctor will come if I need him”. A person’s visitor told us, “I believe that [people] see health professionals when needed.” A relative confirmed they were kept informed about changes in their loved one’s health needs. They said, “We were told immediately when mum was prescribed antibiotics.”

Staff worked with health professionals such as dementia nurse specialists to ensure people got the care and support they needed. The management team told us, “We also have good links with our health colleagues in SaLT (Speech and Language Therapy), the advanced nurse Practitioner, the GP, TVN (Tissue Viability nurse), Parkinson’s service, diabetes team and the hospice. For example, if we need a syringe driver.’ Trained nurses within the serviced reviewed and updated people’s clinical records daily.

A healthcare professional told us, ‘Staff use external services appropriately. The refer appropriately to community services. Staff raise concerns with the surgery via email and if required in urgent situations via telephone contact. We have a dedicated phone line and email that the care home can use to get quick response and action from.’

The provider had a clear process in place to escalate health concerns within a timely manner. They had reviewed and amended the process to learn lessons from where things had not worked quite as well.

People told us they were supported with their healthcare. People said, “I would ask staff to arrange for me to see the doctor (if I was unwell)” and “The chiropodist comes every 6 weeks.”

Staff had a good understanding of meeting people’s changing needs. A staff member told us, “If someone suddenly becomes unwell, for example if they are sick, I press the emergency buzzer and the nurse comes straight away. There is no delay, and if I need to find someone, I always use the stairs, not the lift, in case it gets stuck.”

People living in the service had access to other health care professionals, such as GPs, dietician’s and specialist nurses. The care planning systems had direct access to the person’s health records via the GP connect service. This enabled the manager and nurses to fully review the person’s medical records and it gave the service access to notes written following GP or nurse visits.

People received support from staff when health clinicians assessed their health needs. A healthcare professional said, ‘Ward rounds are conducted appropriately. A senior member of staff or deputy manager is always available to conduct ward rounds and are well informed on their patients care.’

Staff told us they had training and support to meet people’s care and health needs. A staff member said, “We have had training in epilepsy and diabetes and the care plan is updated if there is ever a change or concern like a seizure.”

Care plans were in place which detailed people’s care and support needs as well as their clinical needs in relation to health conditions. For example, where a person was prescribed emergency as and when required medicines if they had a seizure. The care plan provided clear information about when to administer the medicine, why and how. Training had been provided for staff in this area and staff told us they knew what to do.

People's choice and consent was valued, and the staff continually consulted people about their wellbeing and wishes. People told us, “The staff will let me know what is going on and I can then choose what I want to do, go to the lounge or stay in my room”; “I can choose if I want to get up” and “The staff will ask what I want to do.”

Staff completed Mental Capacity Act (MCA) training and had a good understanding of the importance of consent and upholding people's rights to have choice and control over their lives. A staff member said, “We start by assuming the person has capacity and want to be as independent as possible.” The management team told us, “A couple of our residents have advocacy support, and we promote this service, leaflets are in reception and by the activities board.”

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. The service worked within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. When people were assessed as lacking capacity to make decisions appropriate procedures were followed to ensure principles within the MCA were followed. DoLS applications and authorisations were in place for people around any restrictions within their lives that they did not have capacity to consent to. Systems to review these were also in place. People's ability to consent to care and support had been assessed. Where people could not give informed consent, a best interest decision had been taken.