Royal 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 newly registered 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 63 (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 ensure people’s care and treatment were effective because they had not always fully assessed, reviewed and recorded people’s health, care, wellbeing and communication needs.

Care records did not always show people’s individual needs had been assessed in enough detail to guide staff when providing care. For example, a person’s catheter care plan did not include information about their catheter management needs, the support they required, or when concerns should be escalated. Another person’s diabetes care plan referred to the signs of low and high blood sugar levels but did not explain how these might present for the individual or what actions staff should take.

This showed assessments had not always identified and recorded people’s specific needs in sufficient detail. As a result, staff did not always have the information they needed to understand people’s needs and provide safe, effective and consistent care.

The provider demonstrated a commitment to delivering evidence-based care using recognised assessment tools, person-centred care planning, and timely involvement of healthcare professionals. Staff sought specialist advice when people's needs changed, and records showed information and recommendations from health and social care professionals were obtained. However, this information was not always reflected in care and support plans, meaning staff did not consistently have clear, up-to-date guidance based on people's assessed needs and professional recommendations. Although the provider monitored people's health and wellbeing to support positive outcomes, opportunities were missed to ensure all relevant information was incorporated into care planning to support safe, consistent, and person-centred care.

The service worked with relevant professionals to help ensure people received coordinated care. Records showed staff made appropriate referrals, sought professional advice when concerns were identified, and acted on recommendations. Relatives told us staff kept them informed and communicated effectively with external professionals.

People were supported to access healthcare professionals when needed, and records showed staff sought advice and intervention when concerns about a person's health were identified. For example, the provider had contacted GPs to request medicines reviews and discuss healthcare needs to help ensure people received appropriate treatment and support.

People's nutritional needs were monitored, and systems were in place to record dietary intake where this was required. Records showed staff responded to changes in people's nutritional needs, including providing additional support when people experienced weight loss. This included offering fortified drinks, milkshakes, and other nutritional supplements to help improve people's dietary intake and maintain their health.

The manager had also taken steps to improve people's dining experiences by increasing meal choices available within the service. This helped support people's preferences and provided greater flexibility in the meals and drinks they could access.

The provider did not consistently monitor people's care and treatment in a way that ensured continuous improvement or positive outcomes. While care records and monitoring tools, including those for weight, nutrition, falls, and skin integrity, were in place, records did not always demonstrate that identified concerns or changes in people's wellbeing were effectively translated into care planning. Although staff sought support from healthcare professionals when needed, recommendations and relevant information were not always incorporated into care records, increasing the risk that care was not delivered in line with people's current needs.

The provider had processes in place to support consent and decision making, but there was insufficient evidence available to demonstrate these were consistently embedded in practice. Records relating to the administering of covert medicines were not always consistent, with some differences noted between care records and MAR charts. We also required assurances that appropriate consent processes had been followed and that best interest decisions had been clearly documented and reviewed in line with legal requirements. These issues meant records did not always provide clear evidence that arrangements for administering medicines covertly had been fully authorised and implemented consistently. The manager acted promptly to review records, address inconsistencies, and ensure appropriate documentation was in place for covert medicines arrangements.

Records showed that best interest decisions had been completed for some people where needed, and care plans referred to assessments of mental capacity. This demonstrated that consideration had been given to supporting people to make decisions and ensuring decisions were made in their best interests when they lacked capacity.