Ridgegate Home

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.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to consent to care.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager did not robustly assess people to ensure that Ridgegate Home was a suitable place for them to live and a place in which staff could meet their needs.

Information gathered prior to a person moving into the service was limited, particularly for those admitted initially on a respite basis. The details focused mainly on whether a power of attorney was in place, the person’s resuscitation status and basic information about family, friends, and medical conditions. A thorough assessment should include a person’s full care and support needs as without this staff cannot develop a robust care plan or be assured that the person’s needs could be met, especially when someone may be moving in at short notice.

Other assessments were more detailed and contained enough information for staff to use as the basis of the person’s care plan.

The registered manager planned people’s care in line with legislation and national practice.

Staff used nationally recognised tools to assess and monitor people. This included skin integrity (Waterlow), MUST (nutrition) and falls risk assessments to help tailor people’s care plans. Where people were at risk of their skin breaking down, staff had introduced pressure mattresses, repositioning regimes and appropriate pressure relieving equipment, although we did identify one mattress was not set correctly.

Staff worked well across teams and services to support people

The was evidence of people receiving the support and input of various external health professional services, such as the GP, speech and language therapy team, tissue viability nurse, dieticians, district nurses and a chiropodist. Where one person had regular input from the district nurses, staff worked collaboratively with them to ensure that the person receiving the treatment had been provided with appropriate medicine prior to their visit.

Internally, we observed and heard good teamwork within the staffing team. Staff chatted with each other and liaised together to make sure everything that needed to be done was completed and that people were not waiting to receive their care.

Staff supported people to manage their health and wellbeing. Staff listened to and followed advice from external health professionals. Where one person was receiving treatment from the district nursing team we read that staff had contacted them when the person’s dressing had come undone. This helped ensure that the person’s treatment was safe and appropriate.

People were provided with a choice of two food options at lunch and dinner and where people were at risk of choking or they preferred their meals prepared in a certain way, this was provided for them. This helped people to maintain a healthy weight and reduced their risk of malnutrition or a need to take supplements.

Staff routinely monitored people’s care and treatment to assess whether or not external input was required. People were weighed on a monthly basis and their weight compared with the previous month to look for weight loss.

Relatives told us their family member had benefitted from living at the service as staff were good at responded to people’s changing needs and also keeping them informed should they need to contact a health professional. A relative told us, “When he gets acute (attack) they get the doctor very quickly” and another said, “He has had no falls since being in the home where he did have them when living alone. He was also not taking his medication properly and had problems with his legs.”

The registered manager was not always following the principles of the Mental Capacity Act 2005 (MCA) as we found capacity assessments had not been undertaken for individual decisions and best interests decisions were not detailed enough to demonstrate staff’s rationale behind some restrictive practices.

Individual capacity assessments had not been completed for some people. For example, we saw one person had ‘consent to care and treatment, consent to DNAR and consent to medication’ all in one assessment. It was not clear whether the person’s capacity had been determined. It was also unclear on how decisions had been made in their best interests. This person had a sensor mat in their room to alert staff should they get out of bed, but this was not included in any of the documentation.

Another person had a ‘statement’ in their care plan to say they had capacity, but this was not dated and as such it was not clear if it was current or not. Therefore, staff could not be certain that this person could make their own decisions, or whether a person who had the legal authority to do so should act as their representative.

A third person’s bed was set low to the ground and yet there was no evidence that this had been discussed and determined as the least restrictive option for them, as there was no evidence of a capacity assessment or best interests decision.

Other people did have appropriate documentation in place to demonstrate staff had considered their capacity and the least restrictive option had been discussed. And staff received training in the MCA and a staff member told us, “To be able to make the choices for themselves if they have the capacity.”