ResCare

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 – 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.

This is the first assessment for this service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and support needs were they did not always check and discuss people’s health, care, wellbeing and communication needs with them. The provider assessed people’s needs when they first used the service for respite stay and took account of the Equality Act.

Relatives told us they discussed with the provider any changes in their family member’s needs and medicines. There was some evidence that people and their relative discussed their care and wellbeing, but we could not be assured people’s needs and risks had been consistently assessed prior to each respite stay. Any changes in care needs and the support required was not always reflected the care plan to enable staff to provide appropriate care and support. The provider assured us this would be addressed.

When we returned to complete the inspection visit we found people’s needs had been assessed prior to their respite stay. Care plans had been reviewed and updated. Record showed people were supported with positive risk taking and in the review of their care and support.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People were supported to receive care and support that enabled them to live in line with their individual needs, preferences and choices. Records showed risk screening tools and best practice guidance were in place to support safe and effective care delivery. However, the provider had not sought guidance and direction or confirmed the information received from relatives had been checked with external healthcare professionals to help them understand how best to support people. This issue was raised with the provider and actions were taken to address this.

Staff demonstrated an understanding of people’s dietary preferences and, where appropriate, encouraged individuals to develop and maintain life skills, including involvement in meal planning and preparation. Staff were aware of people’s preferred diets including modified diets and cultural meals. People’s care plans included the risk of choking and their food and choice preferences and food to be avoided due to risk of choking and swallowing difficulties. We observed a person eating their meal whilst sitting at the dining table with a member staff. They told us they enjoyed the meal whilst their finished a fizzy drink.

The provider did not always work well across teams and services to support people. Staff did not always communicate with external professionals to ensure people receive safe and coordinated care. There was no formal process to share assessments of people’s needs when they moved between services, and existing systems did not adequately support the sharing of essential care information. As a result, people’s assessed needs and care plans were not always reviewed prior to each respite stay, and hospital grab sheets were not consistently updated to reflect current needs, risks, and medicines.

The provider and staff told us they discussed people’s needs prior to admission; however, this was not always documented. The provider gave assurances that systems would be strengthened to ensure communication between management and staff is properly recorded and to improve collaboration with external professionals.

The provider promoted people to live healthier lives. Although information about individuals’ health needs and the health professionals involved in their care had been documented, staff told us they sought confirmation from relatives before accessing the necessary healthcare support for people using the service on a respite basis. While we found no evidence of delays in accessing medical attention, this practice had the potential to place people at risk to their health and wellbeing. The provider assured us they this process would be strengthened to improve people’s quality of life and promote positive outcomes.

The provider supported people to maximise their independence, choice and control. Relatives told us staff supported their family member respectfully and whilst promoting their rights and personal choices. Staff encouraged to make healthy lifestyle choices as part of their everyday support, for example, people to have a healthy and varied diet, and reminded people to drink plenty of water for good hydration. Activities people enjoyed were included in their care plan and staff used this information to support a person to stay active and engaged in meaningful routines that contributed positively to their physical and emotional health. Staff understood people’s needs well and supported them in a way that was proactive aligned with what mattered to them.

The provider had not consistently review people’s assessed needs prior to each respite admission, which meant care plans were not always updated at the point people moved into the service. However, staff effectively monitored people’s care needs during their stay and provided support that ensured outcomes were positive and consistent.

Relatives told us staff monitored their family member’s care and health and kept them informed of any changes. Care records showed staff escalated concerns to the provider and followed instructions when people’s health was of concern.

Staff monitored people’s nutritional intake to promote and maintain good health. They were aware of people’s health conditions and were able to recognise changes or symptoms. One staff member explained how they followed care plan guidance to manage a person’s health condition safely. Daily records showed staff documented the care provided, including information about people’s wellbeing and outcomes, which supported continuity of care during their stay.

The provider did not always ensure people were informed about their rights in relation to consent, and people’s rights were not consistently respected when care and treatment were delivered. The service was not always working in line with Mental Capacity Act 2005 principles.

There was limited evidence to demonstrate that people had been involved in decisions about their care including decision specific assessments for example administering medicines. Where people lacked capacity to consent, decisions were not always made in their best interests. For example, best interest decisions did not consistently evidence consideration of the least restrictive options when access to the kitchen area was restricted. In addition, there was no evidence the provider had sought the appropriate legal authorisation to deprive a person’s liberty. The provider responded promptly by ensuring areas were accessible in a safe and least restrictive way and confirmed that an application for legal authorisation had been submitted.