Royal 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.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s outcomes may not always be consistently good.

The service was in breach of legal regulation in relation to the good governance of the service.

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 service did not always make sure people’s care and treatment records were effective and as robust as they should be, though they did engage people’s relatives in developing their care plans.

People had various assessments in place, though not all were as detailed as they could have been. Care records were not always as detailed as they needed to be and at times were contradictory so we could not be assured that people’s needs were being appropriately assessed/reviewed/monitored. The registered manager told us they would work to improve care plan records.

People’s relatives felt they had been involved in developing their/their loved one’s care plan. One relative said, “We are very much involved as a family in any discussions on her care or wishes.” Staff told us that peoples relatives were involved in creating peoples care plans. Staff told us they knew people well. One staff member said, “I know people, any changes I see are recorded”

The service did not always appropriately plan people’s care.

People’s nutritional care plans and nutritional risk assessments were inaccurate and at times contradictory meaning we were not assured people were being appropriately supported in this area, though there had been no impact from this. The registered manager told us they would work to improve care plan records.

We found some examples of necessary referrals should anyone need clinical support. However, records relating to some aspects of care were not as clear or detailed as they should have been. For example, for one person that required assistance to turn every 2 hours, records indicated this was not happening or being offered. The registered manager told us they would work to drive improvement in this area.

People said they received enough to eat and enjoyed the food. One person said, “The food is lovely.”

The service did not always work well across teams and services to support people in a timely way.

We saw evidence of the registered manager working with other services to try and make necessary improvements, though improvement was at times slow and in some areas inconsistent. Health professionals feedback on handover of information was mostly positive, but one professional did say, “I note that the home do not do baseline or routine monthly observations for their residents”

Staff spoke about how they are told when people’s needs change including at handover. One staff member spoke about how the management was not as proactive as they could be.

People and their relatives felt they were kept updated about any appointments and outcomes. One relative said, “They let me know about any appointments, they are good, they ask if I am taking (person using the service) or do they want them to take him.” We saw evidence of handover records with staff.

The service supported people to manage their health and wellbeing.

The service supported people to live healthier lives where possible. People had access to healthcare support when they needed it and staff spoke about how they monitor/recorded people’s health.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that they met clinical expectations.

The registered manager told us how they review and monitor people’s care, though care plans audits needed to be implemented. The registered manager told us this would be actioned. One person’s assessment that was in place for their skin integrity was not as detailed as it needed to be. One person that was obese did not have an appropriate assessment tool in place. People’s care plans were reviewed, though this did not always effectively identify the issues we found in peoples care plans.

We gained limited feedback in this area from people and their relatives, though one relative said, “I don’t know if he has increased his mobility but he hasn’t lost what he had before, they had a hook a duck thing, I tell him to join in the activities he raved about the exercises they did, they have a Facebook page and I can see pictures of him doing activities.”

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

People told us that staff asked for consent before delivering care. One person told us, “Yes, they (staff) do (ask for consent).” Staff said they always ask for consent before delivering care, one staff member said, “I will always ask people for consent, if unsure I will go to a senior.” Consent forms were in place for various aspects of people’s daily life.