- Care home
Alpine Lodge
Report from 20 February 2024 assessment
Contents
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
Effective
People had a comprehensive assessment of their needs, which included consideration of clinical needs, mental health, physical health and wellbeing, and nutrition and hydration needs. However, we found they were not always followed and at times contradictory in particular in regard to moving and handling. Some people’s nutritional and hydration needs were not being met. Care plans were detailed and were reviewed. We saw input from health care professionals and care plans updated accordingly. However, we found these were not always followed and therefore people were not always supported to live healthier lives. We checked whether the service was working within the principles of the Mental Capacity Act 2005. We found some people were not given choices, or consulted and some support was very task orientated.
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.
Assessing needs
People and relatives told us they were involved in the assessment of their needs. A communication care plan was completed for each person. This helped to identify how to provide information to the person so it was accessible and tailored to meet their needs.
Managers told us they were working with staff to ensure there was effective monitoring of people’s care and treatment and their outcomes.
The peripatetic manager had been improving care plans and predominantly they were detailed and showed people were involved. However, we found they were not always followed and at times contradictory in particular in regard to moving and handling.
Delivering evidence-based care and treatment
Our observations showed people who needed support or encouragement to eat or drink did not always receive it.
We observed lunch being served on both floors. On the downstairs unit there was a calm atmosphere and people were offered a choice of meals. We saw staff kindly engaging with people encouraging them to eat or offering drinks. People made positive comments about the quality of food provided. However, on the upstairs unit people were not supported or encouraged to eat their food and food was left in front of people to go cold.
People’s nutrition and hydration needs were not always met. Hydration and snack stations were not stocked when we did a tour of the service, we found a brown banana and a dried-up orange in one bowl which had been there days. These were stocked up and drinks placed on units during our site visit. Clinical reviews were carried out and the GP visited regularly, they were in the service on the day of our visit and staff were ensuring they were following up where necessary.
How staff, teams and services work together
Relatives told us they were concerned about the number of agency staff at the service. They told us this impacted on the quality of care provided to their family member.
Management told us some staff were being performance managed as they had identified the need for further support and training to ensure they were consistent in their approach to ensure people’s needs were met. There was a high level of genuine sickness which was impacting on the staffing. This was particularly noticeable in the standard of cleanliness as domestics were off sick.
Partners told us the peripatetic manager was working with them to try to improve the service. They could see improvements being made by them, but staff were still not embedding them into practice.
In people’s records we found evidence of involvement from other professionals. However, our findings showed there was risk that guidance would not be followed. People’s risks were identified and mostly detailed in peoples plans of care. However, they were not always managed effectively.
Supporting people to live healthier lives
We received mixed feedback from people and relatives about the quality of care provided. Our findings showed some people had not received the support they required to enable them to live healthier lives. People made positive comments about the new activities co-ordinator. However, the service had not promoted people’s wellbeing by providing activities within the community.
Staff had completed an assessment of people’s risks to their health and wellbeing and on how to support people to prevent deterioration. However, we were not fully assured staff would recognise and report people’s deterioration.
People were referred to health care professionals when required and in people’s records we found evidence of involvement from other professionals such as doctors, optician, tissue viability nurses and speech and language practitioners. Care plans were detailed and were reviewed. However, we found these were not always followed and therefore people were not always supported to live healthier lives.
Monitoring and improving outcomes
Some people’s care was not routinely monitored to ensure they received the care and treatment they needed.
Managers told us they were working with staff to ensure there was effective monitoring of people’s care and treatment and their outcomes.
People’s care was not always monitored to ensure they received the care and treatment they needed. We saw input from health care professionals and care plans updated accordingly. However, staff did not always follow the guidance.
Consent to care and treatment
Our observations were mixed, some people were consulted and they, or a person lawfully acting on their behalf, were involved in planning, managing, and reviewing their care and treatment. Other people were not given choices, or consulted and some support was very task orientated.
Staff were aware of the need to and had submitted applications for people to assess and authorise that any restrictions in place were in the best interests of the person.
We checked whether the service was working within the principles of the MCA. The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The service was aware of the need to and had submitted applications for people to assess and authorise that any restrictions in place were in the best interests of the person.