Rayners Residential Care 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 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 prior to admission and determined if the service could safely meet their needs. Once people were admitted they were supported by staff who asked them about their life history, cultural or religious beliefs, protected characteristics, and preferences. Relatives were involved in this process too. The registered or deputy manager used this information to develop people’s care plans containing clear information about people’s physical and mental health, communication needs and day to day support requirements. This meant staff were enabled to provide people with effective care. The provider ensured each person’s care plan was reviewed monthly and gathered people’s views and those of their relatives.

People and relatives told us they were asked about their needs and wishes and felt staff knew them well and treated them with respect. Relatives said the provider maintained regular contact with them and sought their views about their relatives’ 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.

Care plans and related records showed consideration of current legislation and best practice guidance. Nationally recognised assessment tools were in use for monitoring skin integrity and the risk of malnutrition. People’s nutrition and hydration needs were respected, including details of any enhanced monitoring, likes and dislikes, and specific dietary requirements.

The service worked well with external professionals to ensure they were contacted for advice when needed. Medical interventions were promptly sought, and care planning and monitoring processes were updated following any advice received.

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 benefitted from a staff team that worked well together and with professionals external to the service. Professionals who supported people with their individual health and care needs stated communication with the staff was effective. Visiting professionals were positive about their working relationship with staff and reflected on their availability and skills.

New guidance provided by professionals was added to people’s care plans and shared with staff to ensure it was followed. One professional told us, “I have always been impressed with the professionalism of all thestaff,from themanagers, carers,domesticstaffand kitchen staff”. Another said, “the team are always pulling together and positive”. One professional told us how staff provide clear information regarding people’s needs.

This meant people benefited from coordinated, well‑connected care, supported by effective communication and joint working across teams and services.

Staff attended subject specific development meetings to ensure their understanding of how to meet people's needs and to keep them safe. Staff told us, “It’s like a family here, we communicate well during shifts and between shifts”.

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 worked effectively with a range of external professionals to protect and promote people’s health and wellbeing. The management team and staff were aware of how to access health and social care professionals should there be a need and both people and professionals confirmed this was done appropriately.

People and relatives confirmed they had access to GP services, specialist nurses, podiatry, dentists and opticians and hearing services where required. On review of people’s care records, we found evidence people received this additional support as needed.

Consideration had been given to menu planning to help ensure healthy nutritious meals and snacks were provided with produce that was in season and sourced locally. A person told us, “The food here is very good, I enjoy my meals” another informed us “they do seem to go over the top to get that right”.

People had access to drinks throughout the day with routine trolley rounds by the room service staff and filled jugs of water or juice in bedrooms. Monitoring fluid intake was clearly a priority for all staff, and an effective process was in place to achieve this. People told us “They (staff) are very active in giving me drinks all the time” and “I get more than enough to drink too”. People benefited from a self serve refreshment station that they could access throughout the day.

People were encouraged and supported to take part in a range of physical activities, such as, seated tai chi or carpet boules as well as activities to promote positive emotional and psychological wellbeing such as flower arranging and music therapy. Sessions were well attended and people were engaged throughout.

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 were regularly asked their views on the service and if there were any changes they required. People and their relatives had monthly reviews of their care plans with staff and discussed any changes to their health or support needs.

Care plans were detailed and contained information on diagnosis, specific health needs and past medical history. Risk assessments were detailed and explained actions staff should take if a person’s health deteriorated. Staff monitored people and raised concerns appropriately, where required. A staff member told us, “If I see risks developing outside a person’s care plan, I report back to senior colleagues”.

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

People said they were supported to have maximum choice and control of their lives,
Staff understood their responsibilities in relation to mental capacity and consent and that people had the right to refuse care and had received training in this area. Staff recognised the importance of people giving consent and supported people to make informed choices and respected these.

People’s capacity to make decisions was reviewed under the Mental Capacity Act 2005 (MCA) and where people lacked capacity, decisions were made in people’s best interests. Records did not detail all actions taken to support people’s decision making though, we found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.