Rathgar 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 remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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.

The provider carried out a pre-admission assessment before people moved to the service to ensure they could meet people’s needs and that people’s differing needs were compatible.

Relatives told us they had generally been involved in the development and review of people’s care plans. For example, one relative told us, “A care plan is in place, and it has just been reviewed.” However, another said, “I am not aware of any care plan – they may have done one internally, but I was not informed.”

We found care plans were not always person-centred. For example, care plans would move between first and third person. We also found some information was generic and not personalised to people. For example, in relation to bowel health, continence and diet.

While most people had care plans we identified these were not in place for two people who had lived in the service for several weeks. We found this did not follow the provider own admission’s procedure.

Although staff knew people and their needs well, the absence of care plans for two people meant people were at risk of not receiving the care they required.

The provider had told us by the end of the assessment that adequate care plans were in place and shared their admissions policy to assure us of the process that would be followed for future admissions.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The provider used nationally recognised evidence-based tools to assess people’s needs. For example, people’s skin integrity risk had been assessed, and where a need was identified, plans were in place to reduce the risk, including the use of an air mattress to reduce the risk of pressure sore development.

Staff received regular training to make sure their practice was in accordance with up-to-date best practice guidelines and legislation. For example, staff had received training to support people effectively with dysphagia.

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.

The provider had a collaborative approach to meeting people’s needs. Staff worked well together and with external professionals to ensure people received consistent care. We observed several calls between the provider and health professionals during our assessment that demonstrated effective inter-agency working.

A staff member told us, “We work closely with the surgery and they always come back to us if we ask to speak to a doctor about a resident.”

The provider had a handover process between staff, who told us this was an effective communication tool. For example, a staff member returning from several days leave told us they would look back through all the previous handover records since they had last worked.

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

The provider supported people to access healthcare services, and staff worked collaboratively with external professionals. For example, district nurses, dentists, dietitians, opticians, and speech and language therapists. The service also had access to GP Connect. GP Connect supports the delivery of direct care across a range of health andcare settings such as a care home. It is used by authorised professionals and organisations when people are cared for outside their registered GP practice.

The provider supported people with nutrition and hydration and, where required, to access an appropriate modified diet. A relative told us, “[Name of person] gets a special diet to put on weight.”

We observed the mealtime experience. There was a relaxed atmosphere that contributed to a positive mealtime experience for people. We found people had a choice of meal options from a seasonal menu and that snacks were also available. A person told us, “There are always 2 options to pick and desserts.” Another person told us, “Food - is OK. I get asked each day what I would like from some options.” A relative told us, “[Person’s name] has always eaten well and likes the food.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent and that they met both clinical expectations and the expectations of people themselves.

The provider identified goals and outcomes as part of people’s individual care plans. For example, the desired goal/outcome for a person’s personal care plan was to support them to maintain a good standard of personal hygiene.

We found that care plans and risk mitigation plans were regularly reviewed. The manager told us care plans were reviewed every 28 days and that this included a review of the medicines system, care notes, health professional notes, shift handovers, weights, and a review of care plans and risk assessments.

The provider did not always record people’s consent in line with the principles of the Mental Capacity Act.

The provider had carried out mental capacity assessments and best interest decisions for individual decisions. However, some mental capacity assessments and best interest decisions had not been completed in line with the principles of the Mental Capacity Act (2005).

For example, there was not sufficient detail in relation to how people had been supported to understand the decisions being made. We also found some mental capacity assessments had been amended where capacity had changed without a new decision- and time-specific assessment being completed.

Staff and leaders had completed Mental Capacity Act training and demonstrated an understanding of consent, and staff were seen to seek people’s permission before care interventions. However, the records in relation to people’s capacity and consent required improvement.

The provider told us the action they would take to improve mental capacity assessment and best interest meetings and we were assured this work had commenced by the end of our assessment.