Rialto Care & Support

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 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 check and discuss people’s health, care, wellbeing and communication needs with them. Some care records were insufficiently detailed. We raised this with the provider who took immediate action to rectify this.

People’s needs were assessed. One’s person’s tailored epilepsy plan ensured they remained safe during and after a seizure. Reviews of people’s care ensured any changing needs were met. For example, one person with mobility difficulties was moving into a bungalow to enable them to move around their property with ease and continue to maintain their independence. Staff were knowledgeable about people’s needs and the support they required.

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. The provider demonstrated several positive outcomes for people such as a reduction in behaviours that communicate a need, planned weight loss and reductions in medication. For example, one person had been able to reduce the amount of medication they need to take. One family member stated, “[Name] used to have 8 medications a day and down to 4 now”. One health professional told us, “[Name] appears to be happy, healthy and in their last review had lost weight, which was planned. They are more active and appear very comfortable in their own home.”

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. Information and guidance received from other health professionals were acted upon and care records were updated with newly received information. One health professional told us, “I needed information, the staff team completed several risk assessments and monitoring to provide the information that I needed.” Teams received handovers between shift changes to ensure a smooth continuation of support and hospital passports were in place to convey information to the emergency services, should that be needed.

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 were supported in several activities including accessing leisure centres, gyms, parks, forests and going on regular walks and cycle rides. Activities also included engagement in the community. One staff member told us, “I focus on empowering peopleby engaging them in activities they enjoy and find meaningful. This approach promotes happiness, builds mental and emotional wellbeing and enhances overall quality of life.” Due to the continuity of staff, one health professional told us, “They are in a position to identify any deterioration or risks to health and safety quickly.”

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 completed a quality-of-life tool for people to better understand what really matters to people in their everyday life. Due to consistent support, behaviours communicating a need had significantly reduced. This was confirmed by a health professional. Epilepsy seizures were shared with specialist health professionals enabling one person to have a change to their medication resulting in reduced seizures. This enhanced the quality of their life. Routine clinical appointments and medication reviews were also monitored to ensure these vital appointments were not missed.

The provider told people about their rights around consent and respected these when delivering person-centred care. However, we found improvements were needed in the recording and documentation of mental capacity assessments and best interest decisions. Some records were inconsistent. We raised this with the provider who agreed to review how consent and capacity was evidenced and recorded. Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and had completed training in MCA. Staff gained consent from people throughout the support they gave and were not applying unnecessary restrictions. We observed this practice in action during our assessment, and we observed respectful interactions. Staff told us, “We always gain consent.” Another staff member said, “They are always included in conversations, they are never ignored.