Archived: Rodney House Care 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 inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to meeting people’s nutrition and hydration needs and consent.

This service scored 29 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. Some risk assessments and care plans had not been reviewed for a significant period. This meant we could not establish the care plans staff followed were in line with people’s current assessed needs. When people’s needs had changed, for example, following a discharge from hospital, risk assessments and care plans had not always been updated. This meant prescribed equipment had not been appropriately assessed and put in place for one person. A partner agency had recently supplied emergency medicine for potential opiate overdose based on people’s assessed need. Risk assessment and care plans for people had not been updated to reflect this.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards. For example, staff did not have access to accurate information to follow regarding people’s nutrition and hydration needs. One person had specific guidance as instructed by a speech and language therapist to reduce the risk of choking on food and drinks. The guidance had not been correctly translated into the person’s care plan. This placed them at risk of choking due to receiving their meals and drinks at an incorrect consistency.

The provider did not always work well across teams and services to support people. The management team participated in weekly meetings with other partners where the needs of people were discussed, however, records were not always maintained. This meant important information was not known by all staff. Feedback from partners was mixed. One professional told us they had good working relationships with the staff team however other professionals told us staff were not always prepared or organised when discussing aspects of people’s care. This meant they could not always get a full picture of the persons presenting needs, and how best to support them. People did confirm they received input from partner agencies regarding specific medical conditions. One person told us, “The district nurses come in every day to give me insulin.” We observed several professionals visiting throughout our assessment.

The provider did not support people to manage their health and wellbeing, so people could not maximise their independence, choice and control. Staff did not support people to live healthier lives, or where possible, reduce their future needs for care and support. Several people who smoked lived at Rodney House Care Home and there was no evidence staff were proactive in encouraging people to reduce their smoking or engage in smoking cessation schemes. People frequently ignored the providers permitted smoking policy which placed non-smokers at the risks of passive smoking. Staff did attempt to intervene and challenge people who were smoking in unauthorised areas, however, this had limited success. Whilst a person would extinguish a cigarette or move to an authorised smoking area, the intervention did not prevent them from repeating this behaviour at other times. Some people received specific support from a partner agency around drug and/or alcohol addictions. There was no evidence of joined up care planning within records to reduce further needs for care or support. There was no outside garden area for people to enjoy and get fresh air and people were dependent upon staff assistance to leave the building. This created limited opportunities for some people to be supported with a healthier lifestyle. One person told us, “I have not been out in about a year as staff do not take me out.”

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure outcomes were positive and consistent, or they met both clinical expectations and the expectations of people themselves. Records failed to demonstrate people received regular and adequate nutrition and hydration to reduce the risks of ill health resulting from medical conditions or the risks of malnutrition and dehydration. The provider lacked systems to monitor the completion of care records and address when care had not been delivered. This meant we could not be assured people’s health outcomes were being adequately monitored.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. Several people had restrictions in place to limit the number of cigarettes or units of alcohol they accessed throughout the day. Some people had agreed to this, however, other people lacked the capacity to consent to this decision. Some people were not agreeable to restrictions in place at Rodney House Care Home. One person described the services as, “Institutional and restrictive.” Where people were unable to consent, there was no evidence the person’s capacity had been assessed, or a decision had been made in their best interests. Care plans did not always reflect accurate arrangements with regards to this.

Where there were applications or authorisations in place under DoLS, there was no reference to any of the restrictive practices regarding cigarettes and alcohol within the documentation. There was no reference to restrictive interventions such as bed rails or modifications made to a person’s diet.