Roberttown Care Home 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 inadequate. 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 was effective because they did not robustly check and discuss people’s health, care, wellbeing and communication needs with them.

Some people and relatives told us they did not have discussions with the manager or staff about their care and support, and they had not all seen a care plan.

Care plans showed some signs of improvement since the last assessment, however they still contained errors. For example, information was incomplete and inaccurate. For people new to the home, there was not always enough information available to support staff to provide safe and personalised care. Managers told us they were making further improvements to care plans and aimed to have in depth reviews.

The provider did not always plan and deliver people’s care and treatment with them. They did not always follow legislation and current evidence-based good practice and standards.

The provider did not support the delivery of safe, person-centred care. For example, some people were on medication which increased their falls risk. This was not clearly recorded or mitigated against. Records did not include specific guidelines and procedures to ensure the safe handling, administration, risks and safe monitoring of such medicines. The provider took steps to address this during the assessment.

Care plans reflected people’s nutritional needs, and there was improved information for staff to respond to any dietary or weight concerns. Staff encouraged people to eat and supported them when they needed help. There was closer monitoring of people’s weight and nutrition.

The provider did not always work well across teams and services to support people. They did not always thoroughly share their assessment of people’s needs between each shift or when people moved between different services.

Since the last inspection, the provider had made improvements to the team and no longer used agency workers. This improved teamwork and stability. Staff told us they valued the consistency in the team. Handovers were completed, although we found not all information was shared to help staff understand people’s needs. One person was said to have had a ‘settled night’ at handover, but other information we reviewed showed they had been awake and distressed, which staff had not been made aware of.

Staff told us they felt informed about people’s needs, although we found information, particularly care and assessment records, did not always contain enough detail to guide staff in how to provide care and support.

There was evidence of multidisciplinary team (MDT) records and processes to support partnership working. The manager told us they had improved this recording within the care records. However, where external professionals had made recommendations, such as advice and directions on covert medicine, this was not always communicated effectively or carried out in practice. People were promptly referred to hospital where necessary for illness or injury, but care records were not always detailed enough to share key information with other professionals.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

There were some improvements to activities scheduled to promote people’s health and well-being. The service had activities staff who engaged with people in communal areas. People gave mixed feedback about activities available. One person said, “I don't really join in activities and they don't have activities all the time depends when the activities person is in” and another person said, “I tend to sit in the lounge sometimes I will play bingo or they may do bits and pieces with us or I just tend to watch the TV.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

There were some improvements to activities scheduled to promote people’s health and well-being. The service had activities staff who engaged with people in communal areas. People gave mixed feedback about activities available. One person said, “I don't really join in activities and they don't have activities all the time depends when the activities person is in” and another person said, “I tend to sit in the lounge sometimes I will play bingo or they may do bits and pieces with us or I just tend to watch the TV.”

Some people said there needed to be more staff to engage with them meaningfully or support their independence. One person told us they would like more access to the community and they felt lonely being unable to get out of bed without support.

People gave mixed views about support for their personal hygiene. Some people said they were able to have a shower when they needed one whilst others had to wait for staff members to shower them, which they said was usually once a week.

Meals were presented well and people were encouraged to eat and drink. The chef and care staff knew people’s individual preferences and most people complimented the quality of the food.

Systems and processes were in place to monitor people’s care and treatment, but these were not always used effectively to identify ways to improve. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Goals and expected outcomes for people’s care were not always recorded or followed up, particularly for people new to the home or on respite stays. This meant the provider was unable to evaluate the effectiveness of care delivery, or make sure people’s expectations were understood or met. Where one person was staying temporarily they told us they lacked opportunities to work on their goals for better mobility. They said, “Although I have been here for 3 months, I don't feel that I have moved forward any. I have had no physio or anything.”

Although the manager told us they were working to improve care documentation, there were still gaps and inaccurate information in care records, accidents and incidents reports. This affected the validity of information being analysed for monitoring and improving people’s care.

There were signs of more systematic audits being implemented, such as weekly clinical and medicines audits, although this had only improved in recent months. Whilst these audits were more regular, these were not always accurately completed or effective in identifying areas to improve.

The provider told people about their rights around consent and respected their rights when delivering care and treatment.

Staff understood people’s capacity around giving consent and this was detailed in their care records. People said they felt staff respected their rights overall, and care was discussed and agreed with them, although some people and their relatives said they did not know they had a care plan.

People and relatives said there were more regular care review meetings since the new manager came into post.

Staff respected people’s right to make daily choices and sought their consent before offering support or care.