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 75 (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.

Records showed the person and professionals involved in their care had been involved in initial assessments and information about their care needs as well as their wishes and life experiences were documented. Care plans were developed following an initial assessment and these were reviewed regularly.

There were systems in place to ensure people’s care was regularly reviewed, and the registered manager and field care supervisors visited the person and spoke with advocates and health and social care professionals to check if they felt the care provided met the person’s 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 medicines.

The provider understood and followed the principles of STOMP (stopping over medication of people with learning disability, autism or both) and ensured the person had regular reviews in relation to their prescribed medicines. Staff also monitored the use of medicines which were sometimes administered to reduce the person’s anxiety or distress. Records of incidents showed how the management team had reviewed the use of these medicines to ensure they were only given in the person’s best interests. Where people required support to manage distressed behaviours, staff recorded any interventions and their effectiveness. This enabled the management team to consider whether further training or de-escalation techniques were needed to support the person in the least restrictive way possible.

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.

The management team and staff worked in partnership with health and social care professionals to ensure the person’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 professionals to ensure people’s holistic needs were met. They shared examples with us of how field care supervisors had worked with the person’s healthcare professionals to improve the management of their health needs.

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.

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

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

The registered manager was proactive in working with external professionals to improve the person’s quality of life. They shared examples with us of working with a multi-disciplinary team to review the person’s health needs and anxiety related behaviours. This had resulted in the person’s quality of life improving, through a reduction in the administration of medicines relating to distressed behaviours and less restrictive interventions being used by staff to support them.

Systems were in place and used by staff to monitor how the person responded to various situations. Staff completed a calmness tracker, which enabled them to review how their actions, or those of others impacted the person.

A social care professional told us, “[Person] is more settled, we are seeing excellent outcomes. The number of incidents has reduced right down, [person] is living their best life, the best we have ever known.”

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

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 we observed staff asking the person for their consent before providing care. They also supported the person to make their own decisions about how they spent their time.