Royal Garden Hotel

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 remained 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. People’s needs were assessed before admission to ensure staff could meet them. Admission criteria required people to be independently mobile and have capacity to make decisions about their care. People were able to have a trial stay before committing to move in permanently. A person told us, “I came in here for a week to see what I thought of the place. I thought once my sight started to go it would be time to get some help and when I came here, I found it was ideal. I wanted to choose whilst I could make my own decisions.” Relatives told us staff took time to understand people's requirements and preferences to ensure the service could meet their needs. A relative said, “They were very thorough in asking questions from family to find out [person’s] needs.” Preadmission assessments covered physical health, nutrition, communication and risks associated with people's care.

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. Staff used recognised assessment tools to establish risks to people, for example, the Waterlow tool to identify and mitigate the risk of possible skin breakdown and deterioration. When staff noticed a change in people’s health needs, they used the Situation, Background, Assessment and Recommendation (SBAR) tool to share with professionals to enable timely intervention. Records showed work was needed to consistently demonstrate actions taken following changes in weight and nutritional monitoring. However, this had not impacted on people receiving appropriate healthcare support as staff understood people’s needs.

The provider mostly 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. We identified an instance where timely involvement had not been sought by specialist services to promote good outcomes for a person whose needs had increased; however, staff had remained in continual contact with the person’s GP. Staff worked alongside GPs, district nurses and other professionals to support people's health needs. People and their relatives spoke positively about communication between the service and external professionals. One person said, “I am getting all of the treatment I can get; I have been to all sorts of appointments.” A relative told us, “They work well with other professionals and listen to their advice.” A healthcare professional commented, “Staff follow treatment plans and are very good with follow up and letting me know. I have confidence if I leave anything with staff they will come back to me.”

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. Staff monitored people's nutritional needs and adapted their approach when health conditions changed. A person who lived with diabetes was enabled to independently monitor their blood sugar levels. Staff were provided with a detailed care plan including signs to watch out for if levels fluctuated and how to minimise complications in diabetes. Relatives described positive outcomes for people living at the service. A relative commented, “[Person] has put on weight, so they are doing well. [Person] has got to a point they need specific dietary needs; staff have met their needs well. They give [person] a good choice. I know they are providing foods just for [person], what they get is not on the menu.” People were encouraged to remain well by participating in meaningful activities that promoted their physical and emotional wellbeing.

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. People’s health and wellbeing needs were monitored by staff; we saw examples of changes in medicines which benefitted people. The registered manager told us about a person who appeared over sedated as a side effect of their medicine, they contacted the prescriber for a review. They told us, “I said to the surgery, I think it's the [medication name] making [person] like that. They took [person] off it, and they went back to normal." People and relatives were encouraged to provide feedback to improve the service. Relatives described improvements made following feedback, including increased activity provision and changes to menus. One relative said, “They have really improved the activities now; there is so much on offer for the residents.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. At the time of our assessment all people living at the Royal Garden Hotel were able to make decisions. Processes were embedded within care planning and reflected people's individual choices. Consent was consistently considered and recorded. Relatives told us people were able to make decisions, a relative said, “[Person] can make all their own choices. They get up at the time they want, wears what they want and choose their own food.” A person told us, “When they help me, they always ask if I am happy with them doing this or that. They would stop if I said no.” We observed people being asked for permission and consent throughout our visit. Staff had been trained to gain an understanding of the principles of the Mental Capacity Act 2005 and the need to involve people and those important to them in care decisions.