Radcliffe Manor House

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 changed to inadequate.

This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to safe care and treatment

This service scored 38 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

The care plans in place for diabetes were not person centred and lacked detail on how diabetes can impact people and how to best manage needs and symptoms. We addressed this with the provider who took action to update these. Care plan information had not always been updated and therefore did not accurately reflect people's needs and put them at risk of receiving unsafe care and treatment. For example, one persons’ care plan stated that they could walk with a walking frame, however they were to use a hoist for transfers only. This put people at risk of harm.

People we spoke with told us that they had not been involved in care planning or reviews of care plans. One relative told us that they were involved in paperwork when their loved one was admitted, however further discussions or reviews regarding care had not taken place.

Staff told us that changes in people’s needs were not communicated well, and care plans were not always updated in a timely manner. This put people at risk of receiving unsafe and care and treatment.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

People were not always supported to have good hydration. Where people required fluid monitoring. People did not have fluid targets within their care plans and fluid charts showed that fluids consumed was extremely low. We saw hydration stations within communal areas and jug of water in most rooms; however, we observed that the water levels in the jugs had not changed over the course of the day. A relative told us, “[Their] jug has been empty for the past few days. I have to go and fill [their] water bottle up.”

Whilst staff maintained records of what people had eaten and drank, the provider confirmed these were not always accurate. Therefore, we were not assured people were prompted to drink enough fluids.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. We found communication and collaboration between different job roles to be poor.

Staff worked together well when providing care. During the assessment, staff were clear on their roles for the day and who they were supporting. However, care staff, senior carers and kitchen staff did not seem to communicate throughout the assessment. Care staff were focused on respond to call bells for people allocated to them. However due to staffing, the communication and morale was low at the time of the assessment.

Staff told us that they were not kept up to date with changes that happened. Staff told us they reported concerns to management, but action was not always taken. One person told us, “Communication is exceptionally poor.” We were also told, “When someone has a fall we completed the form and don’t hear anything. We do not get asked how we can improve.”

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.

Staff explained that they worked hard to meet people’s needs. However, staffing levels in the care home meant they often felt rushed.

People’s care records showed there was access to healthcare professionals. However, known health related risks did not always have written guidance for staff to follow when supporting people in identifying concerns and the actions to take. This included information such as how to support people with diet controlled diabetes and details of recommended fluid levels. This meant that staff did not have the correct information to support people effectively or safely.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People explained that due to staff being rushed, they did not always feel staff monitored their needs well and one relative was concerned that staff were not suitably monitoring a person’s hydration. On reviewing the person’s care records, we found there was poor record keeping for how much the person was drinking.

People’s food and fluid intakes were not accurately recorded. Therefore, the provider would not be able to quickly identify changes and take any action to maintain their safety and well-being.

Although records were audited, these audits had not recognised this or made improvements. This meant people would continue to have poor outcomes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. We observed people being offered a choice of meals, as well as being offered medicines prior to administering this.

People told us that staff gained their consent prior to providing support. One person told us, “Whatever they do to help, I’ll get asked first.” Another person told us, “Mostly they’re polite enough and ask me before getting me ready.”

Staff had received training around the Mental Capacity Act (2005); however, care plans did not always reflect the principles of the Mental Capacity Act (2005). We found care plans lacked detail regarding people’s capacity, ability to consent or make decisions, and support needed to make decisions. Some people did not have capacity assessments completed for decisions around care and treatment. One care plan we reviewed told us a person had a cognitive impairment, but lacked detailed around capacity, choice and preferences.