Redcote House Residential 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 requires improvement. At this assessment the rating has remained 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 50 (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 treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Care plans were not always created or reviewed collaboratively with people or their relatives, which meant there was a risk care plans did not fully reflect people’s needs and preferences. Most relatives we spoke with told us they had not seen their family member’s care plan. A relative told us, “I didn’t know they had a care plan, never seen one.” Another relative told us, “Yes there is a care plan, but I haven’t seen it for a while.” When changes had been made to people’s support needs, care plans were not reviewed to ensure they were up to date and relevant. Regular reviews help maintain the accuracy of the care plan ensuring they reflect changes in people's circumstances so staff can provide effective care and support. Clinical assessment tools were used such as the Malnutrition Universal Screening Tool (MUST); however, the provider had not used these effectively to assess nutritional risk and ensure appropriate care plans were implemented.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Care plans did not always reflect people’s current support needs, so it was not possible to establish whether people were always receiving the support they required. Clinical assessment tools were used, however, care plans did not always have guidance for staff to support them in identifying concerns and the actions to take such as when people were frequently refusing meals or choosing to eat very little.

The provider worked across teams and services to support people. However, the provider did not always ensure accountability when supporting people with their clinical needs. For example, professionals told us it would have been more beneficial to people if staff were more involved in reviewing peoples’ health needs to ensure they received appropriate and coordinated care.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Care plans did not always give enough detail on how to support people to change positions in bed to alleviate pressure on specific body areas to achieve good physical health and reduce the risk of any skin damage. A person’s daily notes showed staff were not regularly supporting them to change position in bed in line with their assessed needs. This put them at risk of pressure sores which could impact on their health, wellbeing and independence. Some people were on numerous medicines to encourage bowel movements; however, records of follow ups after taking these medicines were not made to see whether medicines had been effective. PRN records showed some people were going long periods of time without bowel movements which put people at risk of serious health concerns.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Records of PRN medicine administration had minimal information to evidence rationale or outcomes of administration. Pain killers and medicines used to promote bowel movements were used regularly with no evidence of how treatments were monitored to ensure effectiveness and positive outcomes for people. Although the provider completed monthly reviews of PRN medicines, records were not detailed enough to provide enough information to ensure they remained effective and were having the intended effect. Some people’s records showed they were taking multiple and frequent doses of pain killers and laxatives with only short periods of effectiveness.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. The service did not fully support people in line with the Mental Capacity Act 2005 (MCA). Mental capacity assessments or best interest decisions were not always carried out in line with best practice. For example, there was no record of what decisions had been discounted so it could not be determined whether decisions made were the least restrictive option. There were no records of how much involvement people had in decisions made for them and limited evidence of other people being involved including relatives or advocates where people did not have a representative. This meant information about the person was not always verified so that all decisions reflected, as much as possible, what the person would have decided. Observations of staff engagement with people showed staff offering people choices and how consent was sought before care and treatment was provided.