Rance Healthcare Services Ltd

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 newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People and relatives confirmed they had been involved in initial assessments and were given the opportunity to discuss their care needs as well as their wishes, views and life experiences. People told us their care plans were developed following the initial assessment and these were reviewed regularly.

There were systems in place to ensure people’s care was regularly reviewed and field care supervisors contacted people and their relatives on a frequent basis to check they were happy with their care and to ensure it met their current needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Care plans and risk assessments were developed based on best practice guidance. For example, where people had a learning disability the provider followed the principles of Right Support Right Care Right Culture. Assessment tools were used to plan for people’s needs around eating and drinking as well as falls management and the management of sore skin.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Relatives told us they felt staff and the management team worked in partnership with them to ensure people’s needs were met. Staff told us there were systems in place to support the sharing of essential information which they used to share updates with other staff members, or with the management team so action could be taken in relation to people’s care and support.

The registered manger shared how they worked in partnership with relevant health and social care professionals to ensure people’s holistic needs were met. They shared examples with us of how field care supervisors had worked with a person’s GP to better manage their pain, and this had impacted the person’s ability to spend time out of their home and take part in activities they enjoyed.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People and relatives spoke positively about the support their received in relation to their health. One relative told us, “They (staff) let me know about any marks or scratches they see [and] if his nails are too long, then I deal with it and forward it to the GP. His skin is being monitored, and he gets dressings and creams for it. The dentist, nurse and skin integrity nurse are all involved.”

One person shared how staff had responded quickly to a health emergency. They said, “Once with a carer I went all funny and was shaking. The carer found me like that and called an ambulance.”

The registered manager ensured information about people’s health was recorded as part of their initial assessment and updated when people’s needs changed. Staff told us guidance was available to them, and they used information in people’s care plans to provide support for people’s health and wellbeing. This included monitoring people’s food and fluid intake.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

There were systems in place to monitor people’s care and ensure it met their expectations. Members of the management team regularly sought feedback from people and their families, to ensure the care provided was effective.

Relatives shared examples with us of how the care provided had a positive impact on their family members. One relative said, “There is a rota of carers coming in who know [person’s] routines so that she has set times. She had an input on these [routines]. She has a preference for female carers and due to age and cultural issues she only has female carers. They are Punjabi speaking carers as she doesn’t speak English, although she has never specified ethnicity. The carers put Sikh prayers on in the background for her.”

The provider told people about their rights around consent but did not always fully comply with the requirements of the Mental Capacity Act 2005. Although people’s mental capacity had been assessed, more detail was required within these assessments to ensure they reflected the support people required to make specific decisions about their care. Following the inspection the nominated individual shared with us their plans to address and improve records of assessments and best interest’s decisions. We will check this at the next inspection.

Despite these concerns, people and relatives were confident staff sought their consent. A relative commented, “Yes, they always ask and record it as consent obtained. They noticed [person] only had 1200mls of fluid and asked her to have more. She didn’t at first. They said we can only encourage but not force, later she did have more.”