Richard House 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 requires improvement. 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 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 and how they wished to be supported were assessed by the provider prior to them accessing the service. One relative told us, “The manager asked questions and made a note of things my loved one liked.” People’s needs were periodically assessed, and their care plans reviewed as a result.

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.

People and their relatives were involved in decisions about their care and support. For example, we saw evidence where staff worked with one person and their advocate to ensure their complex needs were met, and the person was supported to stay safe. One professional told us, “Anything I ask for gets done for this person, I don’t have to chase things up.” One relative told us, “I’m not sure about the care plan but I always get informed about things.”

During our assessment we saw several pre-arranged care reviews taking place involving people, their loved ones, and professionals.

People’s care and support was recorded using electronical care notes. However, some of the completed care records were task based and lacked person-centred detail. We told the provider about this, and the provider implemented an action plan to address this. The provider reminded staff about completing good and adequate records during staff meetings.

People had access to adequate food and drink, and staff had a good understanding of meeting people’s hydration and dietary needs. For example, during the lunch time we observed a staff member providing a person with glass of milk instead of a hot drink as this was their preferred choice. One person told us, “Food here is adequate and there is always enough.” One relative

told us, “Food here is varied, there is a choice.” People had access to drinks during the day, and staff offered snacks, including fruit to people between mealtimes.

People received support from relevant professionals when needed such as physiotherapist, dieticians, or a GP. One relative told us, “My loved one has a very poor appetite, but they have seen the dietician.” One professional told us, “Staff know residents well and they always reach out if they need to ask for advice or to escalate things.”

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.

The provider worked with several stakeholders and partners to support positive outcomes for people. We received positive feedback from partners and stakeholders about the collaborative work they did with the provider. One stakeholder told us, “The provider is open and transparent, we have a very good working relationship. I know the person who lives here is safe.” Another professional told us, “I communicate with the manager via e-mails. Staff know people well.” One relative told us, “Staff get along well together, and they seem to work together well as a team.” One staff member told us, “We are all like a family here, we all work together.”

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 ensured people had access to appropriate support and advice from relevant professionals when needed such as GP, District Nurses or physio. One staff member told us, “There is one person we support, and I would always ask the District Nurse if I wasn’t sure about things.” One stakeholder told us, “Staff advocate well for people. They get in touch with the GP straight away when needed.”

People had access to the outside space. We saw one person spending time in the garden as this was a part of their daily routine and supported their mental-well-being.

Staff had a very good knowledge and understanding of people’s individual preferences. However, this was not always captured in people’s care plans. People’s care plans were not always person-centred and detailed. We told the provider about this, and this was included as an action in their ongoing improvement plan.

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.

The provider reviewed people’s needs during regular reviews and meetings. One relative told us, “I get e-mails with invitations to take part in the meetings.” We saw evidence, people were included in the service reviews supported by relevant people such as social workers or family members. People’s risk assessments were reviewed when required. However, not all the changes were captured in people’s care plans, and we told the provider about this. The provider implemented an ongoing improvement plan regarding updating people’s care plans.

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

People’s consent to care was obtained and staff had a good understanding of the importance of this. During our visit we saw staff seeking people’s permission before providing support, for example if they needed help with eating or drinking. Staff received training in the Mental Capacity Act 2015 (MCA) and overall had a good understanding of the MCA principles.

The provider worked within the MCA. However, we did not always see how people who lacked capacity were supported to understand their rights around the care and treatment they were offered. For example, we saw best interest decisions completed by the Local Authority but not the provider. We told the provider about this, and they intended to review this as a part of their improvement plan.