Ridgeway Court 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.

This is the first assessment for this new provider. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of legal regulation in relation to Consent to care and treatment. This is because people’s rights were not always respected under the Mental Capacity Act.

This service scored 50 (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.

Assessments of people’s needs were undertaken prior to people moving into the home based on the information shared with the provider by health and social care professionals. However, these did not consider all of people’s needs to ensure these were considered and planned for. An example of this is where people’s needs included a learning disability, mental health needs or where people were younger adults. This meant some people’s care plans did not fully reflect their needs and how these should be met. Action was being taken by the provider to address this.

Improvements were being planned when reviewing people’s needs and associated care records. Although records showed people’s needs were reviewed every 2 months, there was often limited information recorded for this review. For example, ‘no changes’ were often recorded and there was limited evidence to show people, or their relatives had been involved in the review of their care.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Although people’s healthcare needs were overall met, we found aspects of people’s needs were not always met in line with best practice. For example, staff and the management team were not aware of Right support, Right care, Right culture statutory guidance although they supported people whose needs included a learning disability. This meant people’s needs were not considered and met in line with this guidance.

The provider was registered to support people who lived with dementia. Training information shared with us showed majority of the staff team had completed dementia awareness training. The provider told us they were considering Dementia best practice when planning the changes to the environment.

We saw the provider used clinical tools to monitor people’s health for example a nutritional risk assessment tool to highlight people’s risk of malnutrition, and wound assessment tool to monitor people’s skin. This meant areas of risk could be identified and guidance shared with staff to monitor and meet people’s needs.

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 and relatives told us the staff overall kept them informed if their family member had an accident or showed signs of ill health. A person told us, “The staff are good, they know me and when I am not feeling great, they check up on me and get the GP in to check me over.”

Staff confirmed changes in people’s health needs were communicated with them, through shift handovers. A staff member said, “Things are getting better here, and the communication has improved. We are starting to work more as a team.”

Health professionals confirmed staff aimed to work with them. Improvements were being made and referrals were being sent in a timely manner, and staff aimed to follow guidance and advice given.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Some people told us they did not always have food which they enjoyed, and which supported their health and wellbeing. One person said, “The food is not very tasty, and I always know what I am getting as the menu is so repetitive.” Another person told us, “The food is alright we get a couple of choices.” We saw a 2-week menu was in place. The food served on the first day of our visit was not as planned on the menu and some people had not been told a rationale for this. We were advised this was due to catering staff shortages. We saw there where missed opportunities to maximise people’s healthy intake due to a lack of vegetables being provided with their meal. For those people on a soft diet a menu was not provided to enable people to choose a preferred option. We shared our feedback with the manager and provider who told us action was already being taken to improve the mealtime experience for people. This included a new 4 weekly planned menus, which included a dedicated menu for people on a soft diet. Training had also been planned for the catering and care staff.

People and relatives confirmed the manager and staff sought healthcare advice for their family member when needed. People’s care records reflected people having the necessary access to healthcare, including GPs, hospital reviews, and opticians.

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 and consistent, or that they met both clinical expectations and the expectations of people themselves.

The management team and staff aimed to monitor key health indicators, including food and fluid intake, skin health, and weight. However, due to gaps in records we could not be assured people’s needs were being monitored effectively. For example, fluid charts did not always reflect fluid intake people received and meal records were not always detailed and accurate. The management team did advise they checked the electronic care system which highlighted where key tasks had not been completed daily to follow this up with staff.

There was limited monitoring of the effect non-clinical aspects of care had on the quality of people’s lives. For example, in the absence of regular activity provision, there was no consideration of how people passed their time and whether they were occupied with things they enjoyed and found meaningful. We observed people seated in the lounge had some opportunities to engage in some activities such as colouring, artwork, throwing a ball, but people who remained in their bedrooms did not have any access to any planned meaningful activities. The provider had recently employed an activities staff member who had started to develop an activities programme. This staff member had started supporting some people to go out to, places they enjoyed. However, when this staff member was not on duty staff told us they did not always have time to facilitate any activities for people to participate in.

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

The provider was not consistently working within the principles of the Mental Capacity Act 2005 (MCA) and people’s rights under the MCA were not always protected. We found mental capacity assessments that had been completed were generic and not decision specific in accordance with the code of practice.

People had not consented to all aspects of their care. This included aspects of care that were restrictive, such as using sensor mats. Where people lacked capacity, a best interests meeting with their representative had not always been undertaken. We found records were in place where staff had consented on behalf of people for things such as care and treatment and photographs to be taken.

However, staff understood they should only provide care and support if the person had consented to it, or that was in their best interests if the person lacked the mental capacity to decide about their care. We observed staff checking with people before assisting them with day-to-day tasks.