Rift Solutions Limited

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 the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

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. Risk assessments relating to the health, safety and welfare of people using services were not always completed or reviewed regularly. We found that effective systems were not always in place to assess, monitor and mitigate risks to people. We identified some people’s needs were not met in respect of management of, continence, medication and falls. We found some people’s care plans, and risk assessments were not detailed enough regarding their skin integrity when there was a risk of pressure injury.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. There wasn’t always effective recording and monitoring of people’s nutritional and fluid intake, while some reference to nutrition and fluid intake was documented by staff in people’s daily notes. We found one person’s care plan stated they required a soft diet and their food and fluid intake recorded and monitored, however it was not clear how soft the food should be in the care plan and there was no food and fluid intake chart in place to monitor.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. We found incident forms where staff had made contact with healthcare professionals. However, we found that investigations and care plan updates were not always completed following support received from healthcare professionals. For example, we found occasions where people had been reviewed by a healthcare professional following a fall, however the provider had then not updated care plans and risk assessments to reflect this.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. The provider and staff told us how they had supported people’s independence with a view of minimising their care and support. Staff supported people to manage their health and wellbeing to maximise their independence, choice and control. People living with specific health needs, had been cared for by external professionals such as district nurses. However, care records did not reflect those care needs and did not demonstrate a partnership approach between the health care professionals and care staff.

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 andconsistent, or that they met both clinical expectations and the expectations of people themselves. We found that audits were carried out but not always as frequently as stated in the providers policy. We found that care plans and risk assessment were not always updated or reviewed. For example, we found one person had recently had 4 falls. Their risk assessment was not updated following these falls. This approach was not a proactive process to identify and mitigate risks and left people at risk of further harm.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We saw risk assessments that incorporated capacity assessments. However, we did not see evidence of best interest decisions or mental capacity assessments for specific restrictions, for example the use of bedrails. Staff confirmed they had received training about the requirements of the Mental Capacity Act 2005 (MCA) within their induction, however, we found that on the providers training matrix some people had not completed their annual update for Mental Capacity Act training. Staff we spoke to were able to describe the principles of the Mental Capacity Act.