Ryland View 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 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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider told us there was a system in place to assess people’s needs and put a care plan in place to meet them. These reviews identified actions which were required to ensure people’s care plans were accurate and up to date.

Staff adapted their approach to ensure people were supported safely while maintaining independence. Staff told us, “A lady had to be re-assessed for a stand aid, the senior sorted that out,” and changes were made to ensure the person continued to receive the most appropriate support. A person living at the service told us that they had requested that they are not to be resuscitated if they fell unconscious, we found this had been put in place for them.

Support plans were created and used to reflect individual needs and included 24-hour plans that summarised essential information to make them accessible for staff.

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

Support plans were available for staff and contained information on how to provide care to the people they supported. For example, staff used tools such as Malnutrition Universal Screening Tool (MUST) and International Dysphagia Diet Standardisation Initiative (IDDSI) to monitor people using the service. Whilst care plans were in place, we found staff did not always follow this guidance meaning strategies in place were not always consistent with recognised evidence-based practice.

Leaders told us they used observations, policies and procedures to ensure that staff provided care in line with best practice. They also told us that they accessed external research and were signed up for updates.

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 made sure that staff, teams and services worked together effectively to deliver safe and consistent care.

The provider worked collaboratively with local authority disability teams, commissioners and therapists to adapt plans, review risks and amend care plans where appropriate. These partnerships ensured people’s support was informed by professional oversight.

Within the service, leaders told us staff communication and teamwork was supported by structured systems, such as handovers and team meetings. Staff and leaders described some friction between staff members; however, leaders had been working to address this with the team through a clear consistent approach.

This demonstrated that the provider ensured staff worked cohesively within the service and with external professionals, supporting consistency of care and safe outcomes for people.

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.

Staff encouraged people to participate in activities that supported physical and mental engagement, adapting approaches to build trust and respect personal preferences. Health concerns, such as suspected infections or dehydration, were promptly escalated to nursing staff and medical professionals, with records maintained to ensure continuity of care. Individuals were involved in decisions about their personal care, staff offered choices and supported those with limited capacity to make meaningful choices.

The provider did not always make sure outcomes for people were consistently monitored or that documentation reflected the most up-to-date information, which risked staff working with unclear or outdated guidance.

Documents were made available to staff to capture people’s health care needs, this included items such as food and fluid intake, and what activities people had taken part in throughout the day. Although this was in place we noted a significant number of gaps where these checks had not been completed as intended. Additionally, although care plans were regularly reviewed, we identified inaccurate information within the plans.

This showed that while staff supported people to achieve outcomes, weaknesses in the documentation and review process meant the provider could not always demonstrate that outcomes and associated risks were consistently monitored and recorded to the required standard.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Records showed that some people had their food and fluid intake monitored without a documented medical or clinical rationale. There was no evidence that people had provided informed consent for this monitoring, nor was there evidence of decision-specific capacity assessments or best-interest decision-making. As a result, this practice was not demonstrated to be person-centred and may have represented an unnecessary and potentially restrictive intervention.

The provider supported most people to give informed consent to their care and treatment, and staff demonstrated an understanding of the principles of the Mental Capacity Act 2005. People were supported to understand and prepare for decisions, particularly where changes might cause anxiety or distress. Staff told us they worked with families, GPs, advocates and social workers when people were unable to make decisions for themselves. Relatives told us they felt involved in decisions, and people and their families said they were able to make choices about the care they received.