Rowanbrook 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 newly registered service. 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 service was in breach of legal regulation in relation to person centred care as evidence based guidance was not being followed to ensure people with learning disabilities received care and support that met their needs.

This service scored 58 (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 all people’s care and treatment was effective because they did not always check and effectively assess the specific needs associated with learning disabilities and mental health conditions, including Dementia.

Where people had a learning disability diagnosis, their associated needs around this diagnosis had not been effectively assessed and planned for. This placed people with learning disabilities at risk of not receiving the specialist care and support required to meet their individual needs.

People with behaviours that challenged as a result of a mental health diagnosis had assessments in place that identified some needs relating to this. However, these were often generic and not tailored to enable staff to consistently support people in a manner that reflected their individual needs and preferences.

However, people’s needs around their physical health were appropriately assessed and planned for. Care records contained evidence of assessments and plans for physical health conditions and we saw these plans were reviewed and updated as required. Staff demonstrated a good understanding of people’s physical health needs.

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

The service provided care and support to a number of people with a learning disability diagnosis. Therefore we assessed the service against ‘Right support, right care, right culture’ to make judgements about whether the provider guaranteed people with a learning disability respect, equality, dignity, choice, independence and access to local communities that most people take for granted. We found this guidance was not being used to help plan and provide care and support to people with a learning disability diagnosis. This placed people with a learning disability at risk of receiving inappropriate care and support to meet their specific needs.

However, we found nationally recognised tools were used to assess people’s physical health needs, such as people’s risk of malnutrition and skin deterioration. These tools were then used to formulate care plans to guide staff in how to meet these needs effectively.

The provider worked across teams and services to support people.

Staff told us they worked well as a team, and they described the systems in place that enabled them to work effectively when shifts changed. One staff member said, “There is always a handover from the senior carer to know what people’s needs are.”

Care records showed staff worked with visiting health and social care professionals in response to changes in health. For example, when a GP or specialist nurse visited and prescribed treatment, staff followed any advice given.

The provider supported people to manage their health and wellbeing. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People and relatives told us support was provided to facilitate good physical health. One person said, “I saw a Doctor yesterday. I’ve got a bit of an infection.” A relative said, “[Relative] loves the food, she always cleans the plate” and, “She has gained a tremendous amount of weight here. They are not concerned about her weight.”

Care records showed people were supported to maintain good health. Referrals to health care professionals were made when required and people were supported to access health professionals such as; doctors, speech and language therapists, occupational therapists and specialist nurses.

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.

People and their relatives told us they could not recall having formal reviews of the care and although care records showed evidence of review’s relating to specific aspects of care such as eating and drinking and skin care, records did not demonstrate people had been involved in these reviews.

There was no evidence to show holistic reviews of people’s needs and outcomes were being completed. For example, 1 person’s records showed that visiting a close relative was very important to them. However, there was no clear plan in place that recorded how they would be supported to do this and staff could not tell us how often these visits were facilitated. As there was no formal plan in place for this, no formal monitoring was in place to ensure this person had consistent and positive outcomes relating to this aspect of their care.

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

People told us their consent was sought by staff before they received care and support. Staff demonstrated they understood the requirements of the Mental Capacity Act 2005. One staff member said, “Even if people don't understand, I still ask for consent.” Staff described how they supported people to consent and gave examples of when decisions were made in people’s best interests when they were unable to consent to their care. Care records we reviewed confirmed this.