Richmoe Healthcare

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. This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Assessments were carried out prior to care commencing. This included work to identify people’s preferences and routines around their personal care. People told us they participated in initial care assessments and care plans were reflective of agreements made. The registered manager told us they involved as many stakeholders as possible during the initial assessment process, to help ensure people’s needs were fully captured. Senior staff were in regular contact with people once their care packages commenced, this helped to ensure that care packages were set up correctly and meeting people’s needs and expectations. This included periodic reviews and auditing of people’s care plans, which helped to ensure they contained appropriate information.

The provider planned and delivered people’s care and treatment with them. They did this in line with legislation and current evidence-based good practice and standards.

People told us they were happy with the support they received with eating and drinking. Care plans outlined the assistance people required to maintain good nutrition and hydration. Staff described how they encouraged people to access food and drinks outside of scheduled care visits, which helped reduce their reliance on staff support.

Where risks were identified, care plans included clear guidance for staff. For example, one person was at risk of recurrent urinary tract infections (UTIs). Their care plan provided guidance to support good hydration and to help staff recognise early signs of infection. Staff demonstrated a good understanding of how to identify changes in people’s needs. There was also evidence that the provider made appropriate referrals to healthcare professionals when concerns were identified in relation to eating and drinking.

The provider did not always work well across teams, services and different providers to support people.

The provider needed to strengthen and develop clearer, more comprehensive processes for working in partnership with other providers where care responsibilities were shared. This included establishing procedures for shared care planning, clear lines of communication, and the use of shared care records. In addition, the provider did not always take all necessary steps to gain assurance regarding the training and competence of other providers’ staff in key areas, such as moving and handling. This increased the risk to the safety and consistency of care delivery. The registered manager acknowledged these shortfalls and told us they would be contacting partner providers to develop more effective collaborative working processes.

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 us staff provided care to manage their health conditions by completing specific tasks, such as stoma care, catheter care, and repositioning. Care plans also described how people’s symptoms could vary from day to day, with guidance in place for staff to adjust their approach and level of support accordingly.

In one example, staff took proactive action to monitor symptoms related to a person’s medical condition, which led to a reduction in falls and hospital admissions. Staff took appropriate action in contacting medical professionals when the person’s presentation changed. This early intervention helped to reduce the risk of deterioration in the person’s condition. As a result, the person experienced improvements in their overall health.

People told us the provider organised care to support them in accessing healthcare services. This included providing physical support to attend appointments or adjusting care visits to fit around them. In one example, staff supported a person to access services such as opticians, dental appointments and GP services, which they would not have been able to do without support. The provider’s flexible and coordinated approach helped to ensure the person received the healthcare input they needed.

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 the expectations of people themselves.

Senior staff regularly reviewed care notes to assess how effectively care was meeting agreed outcomes. The registered manager told us they were working to improve the clarity, detail, and quality of care records. Internal audits had identified when staff required additional support to ensure records fully reflected the care provided. These issues were being addressed through team meetings and individual supervision. Although this work was ongoing at the time of our inspection, and the care notes we reviewed would have benefited from greater detail, there was no evidence this had a negative impact on the quality of people’s care.

Systems were in place to monitor and review people’s care needs. Key outcomes for care and support were agreed with people, documented, and reflected in tasks for staff to complete at each visit. Where care needed to be adjusted, senior staff discussed changes with individuals to agree updated care plans. For example, one person received a temporary increase in support while recovering from an injury. Staff provided additional, targeted support to aid their recovery and help them regain mobility and strength.

Systems were also in place to monitor care call compliance and alert senior staff if visits were not completed as planned. This included electronic call monitoring, covering areas such as visit timings, completion of key care tasks, and medicines administration. Senior staff carried out more detailed audits of this data to assess whether care arrangements remained effective. These records were also used to demonstrate to commissioners when people’s needs had changed and adjustments to care packages were required.

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

The provider had effective systems in place to obtain valid consent to care. People or their legally appointed representatives signed care agreements to confirm they consented to the care provided. Where people had legally appointed individuals to act on their behalf, the provider made checks to confirm the scope and validity of these powers. This helped to ensure these powers were proportionally and appropriately used. Where people lacked capacity to make specific decisions, the provider followed the principles of The Mental Capacity Act 2005 (MCA) to ensure decisions were made in people’s best interests.

Staff had a good understanding of MCA. They understood people rights to make choices and decisions about their care. One staff member told us, “I ensure that people are supported to make informed decisions using clear communication and appropriate support.”