Risby Park Nursing 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 outstanding. At this assessment the rating has remained outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 83 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Managers and staff made sure people’s care and treatment was effective by assessing and reviewing their health, care, well-being and communication needs with them.

Care plans were extremely person centred and included people's wishes, goals and aspirations and individualised needs.Care plans reflected people’s communication needs and staff were knowledgeable in how to support people to communicate. This included pain management plans in place to guide staff where people were unable to express verbally when in need of intervention and support.

The service 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.

Assessment of peoples care and risks were supported by use of best practice tools. For example, evidence-based guidance such as the Malnutrition universal screening tool (MUST) was used to help identify those at risk of malnutrition or those above health weight range. Other evidence-based tools were used to assess risk and need associated with falls, staffing levels and pressure area support. People who were identified as being at risk of skin integrity breakdown were monitored with repositioning charts so that staff could reduce the risk of skin breakdown.

The provider had a proactive approach to risk management, which balanced risk and opportunity. Incidents were discussed in team meetings and daily handovers. Where people had incidents of distress, care plans contained in depth detail to guide staff in de-escalating and providing reassurance.

The environment was thoughtfully designed to make the service suitable and appealing to meet the needs of people, including those living with dementia. Best practice had been followed in creating homely, welcoming and suitable environment. The layout of the building had been thoughtfully designed with communal areas which promoted engagement opportunities for people to meet with their friends and relatives when they visited. There were aids for people to be able to navigate and recognise different areas of the service. Corridors contained a number of items colouring books, puzzles, reminiscence articles as well as wall touch and feel items. Snack stations were located around the building to enable people to access fruit, biscuits and chocolate. Bedrooms had been personalised to reflect people’s personalities.

Thought had been given to avoid people who were cared for in bed from becoming socially isolated in their rooms. Technology had been used to provide visual laser light images projected onto the ceiling. People had easy access to appealing, well maintained gardens.

Activities staff also provided one to one activities providing stimulation. This included reading newspapers, poems, hand massages and nail care. People expressed their gratitude for the company of staff as a result of these activities. One person who chose to stay in their room told us, “I like to stay in my room, in my bed. I have never been a sociable person and the staff respect my choice. They come and chat and I never feel lonely.”

The staff and management team always worked well across teams and services to support people. Staff told us morale was high. One staff member told us, “I love working here. We all pull together and the focus is on the residents and their families we care for them also.”
Care plans were very person centred and focussed on people’s needs, wishes and aspirations as well as their clinical and communication needs.

The staff team worked in effective partnership with external partners, to ensure people had a positive admission to their new home. If people required assessment from an external health or social care team, the service had made prompt referrals and followed up on the prescribed actions. One relative told us, “They always keep you informed if there is any change in [person’s relative’s] health and we have seen improvement since coming here, now eating well and much happier and we could not be more pleased. When equipment was needed it was provided. The staff told us when they [staff] needed to get some outside help when [person’s relative] was losing weight. They [staff] know what to do and get things sorted. We struck gold with this place.”

Partnerships with external stakeholders were positive and this was reflected in feedback we received. The management team worked extremely well with people, healthcare partners and stakeholders in understanding the best way of keeping people safe, whilst not restricting people in how they lived their lives.

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

Staff worked closely with the local GP practice ensuring people received consistent, preventative healthcare tailored to their needs. People at risk of choking or malnutrition were supported to maintain safe and consistent diets. Referrals to speech and language therapists were made for those needing assistance with swallowing, and meals were fortified to improve nutritional intake. The chef was knowledgeable about individuals' specific dietary requirements, including allergies and preferences.

Positive comments were received about the variety of nutritious food provided. Kitchen staff were fully aware of people’s dietary needs and meal preferences, all of which were regularly updated in communications to the catering staff.

Mealtimes were an extremely positive experience; people were supported in a calm environment, warm, friendly environment. We observed staff to be patient, kneeling at eye level when talking with people and reassuring when assisting people with their meals.

Tables were laid out attractively with tablecloths, condiments and flowers. An extensive variety of drinks were offered including people’s personal choice of alcohol.

We observed one person tell staff their jacket potato was “too hard”. Staff asked what the person would like instead? “Mashed potato with salad cream,” was the response. This was provided without any hesitation just as the person had requested.

Comments from people included, “You get a good choice of food, it is all very nice, I like water in my room and they change my jug twice a day, I’ve got no complaints. If you don’t like something they change it without quibbling.” And, “I like the roast and the soups, it is all lovely and I can’t grumble about any of it. I get a satsuma sometimes, a pear, I like fruit and get enough of what I like. The quality of the food is superb, cannot fault it – everything about this place is good.”

Regular themed events included food relevant to the occasion being celebrated.

The provider had a comprehensive system of audits and surveys to monitor the quality of people’s care and treatment such as analysis of the mealtime experience for people with regular recorded observations completed. Records showed the management team had listened to the feedback from these and used this to look at what was working well, and where changes needed to be made to enhance people’s experience even further.

We observed seating arrangements to facilitate socialisation and support families visiting. One person told us, “I visit every day. I am made to feel most welcome, not in the way of staff but encouraged to enjoy time with my [person’s partner]. I am offered meals and drinks and can stay as long as I like. It is important for me and [person’s partner] to be together.”

There were small kitchenettes where people and their visitors could access drinks and snacks. This added to the welcoming atmosphere.

People told us how they enjoyed easy access to outdoor spaces with well maintained, appealing gardens with appropriate garden furniture, a large enclosed pond for safety where they enjoyed watching the wildlife.

The management team consistently monitored 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.

Regular care plan reviews enabled the management team to have full oversight of the health and social care needs of all people. People and their relatives were involved as partners in their care and supported to maintain their independence around decision making. One person said, “They ask us for our opinions such as what we think of the food and what activities we would like to join in with.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

People had mental capacity assessments, Deprivation of Liberty Safeguards (DOLS) applications and authorisations, and best interest decisions in place for all necessary decisions. DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) documents in place to ensure staff had all the relevant information.

Care planning records evidenced people were consistently involved in making decisions about their care and treatment.