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 inadequate. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 always make sure people’s care and treatment were effective because they did not always update care plans in a timely manner.

Care plans lacked up to date information about people’s current care needs and often contained out of date, incorrect care guidance meaning that people were at risk of receiving unsafe care and support. For example, one care plan contained incorrect information on a person’s mobility needs, whist another person’s contained incorrect information regarding care and management of diabetes. This was raised with the provider who told us they had plans to review all care plans. They provided evidence following the on-site assessment of care plans that had been reviewed. Those that were reviewed were clear on people’s care and support needs. There was a risk that had this not been raised by CQC, care plans would continue to not be reflective of people’s needs.

Staff demonstrated that they knew people’s needs and families and relatives shared positive experiences about the care their loved ones received. Families told us they had confidence in the care planned for their relatives, had access as required to relevant documents and were kept informed of changes, such as changes to medicines.

Staff told us that any changes to a person’s care were communicated in handover, meaning they were better informed on how to support people and any changes in the support they require.

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.

We saw evidence where staff had reached out to other health professionals if they had concerns on an individual’s health and well-being for advice and support. There was also a weekly ward round where people’s care and treatment were reviewed by an external healthcare team to ensure that best practice and care was being offered. Staff told us that any changes were communicated to them at handover.

Best practice was being followed with hydration needs. People living at Radcliffe Manor House had personalised fluid targets set by relevant external professionals and staff encouraged people with fluids to ensure they were meeting this target. Processes that were in place to monitor hydration were effective, with staff escalating to relevant teams if they had concerns around fluid intake. This meant that people’s needs were appropriately monitored and reviewed when needed, minimising risk of dehydration.

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.

People had ‘hospital passports’. This meant, should they need to attend any appointments or visit the hospital, important information was recorded and send with the person, sharing necessary information with healthcare professionals.

The service had a positive relationship with the GP practice, who visited regularly to carry out reviews of people’s medicines or any changes in clinical conditions. We saw documentation in daily notes when professionals had visited, and any updates or changes were also recorded in the daily notes.

Handover documentation and daily notes were informative and offered staff the opportunity to effectively pass on information between them and with other professionals. Staff we spoke with told us they worked together well as a team and communicated well between themselves.

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 told is that they had good access to the local GP, hairdresser, visiting optician and a chiropody service. One relative told us, “[They] had the optician in to test [their] eyes. The chiropodist is very good and aware of [their] needs.”

The provider used an external food provider for the main meal served to people. Feedback on the current food provision was generally positive, with a choice offered at mealtimes, and alternative items available if preferred. Special diets and one-to-one support were also apparent during meal service. One person told us, “It’s very good and the choices are fair, or they’ll offer you another item. They did a packed lunch for me when I went to the theatre, and they’d saved my lunch to heat up for my supper in my room when I got back - it was lovely. Nothing is too much trouble.” A relative also told us, “The staff have worked at introducing new foods, so [relative is] changing [their] set habits. It’s very personalised to what [they] want. [They are] eating more variety than ever.” This meant that people were supported to have healthy balances diets whilst acknowledging their preferences.

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

Personal preferences were found within some care plans; however this was not consistent. Care plans lacked detail around individual needs, which meant that staff were unable to follow preferences. People told us that their care needs were being met and personalised to individual needs. The provider told us they were in the process of reviewing and updating all care plans and that they would include personal preferences. Following the assessment, the provider shared updated care plans which detailed people's wishes, preferences, likes and dislikes, meaning that they were person centered.

Activities were available 7 days a week, which meant people were able to engage in large group or smaller activities, depending on their preference. One relative told us, “[They have] never looked better...Here [they will] join in activities and staff are so supportive of [them]. Now [they’ll] choose to be in the lounge all day. [They] enjoy jokes and teasing with staff - they’re delightful and seeing [my relative relative] laugh means the world to me.”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

People told us they felt staff were polite and asked for consent before carrying out personal care or tasks. One person told us, “I must say I’ve never known them not ask me first if I need something doing. They’re so kind.”

We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA), whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found mental capacity assessments were not completed in all relevant areas, or they had not been reviewed for a long period of time. We did find the service had completed relevant paperwork in line with the MCA, to deprive a person of their liberty where necessary. This includes where people would not be free to leave the building due to not understanding risks which places them at risk of harm.