Ranger Home Care Ltd – Main Office

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.
At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.
 

This service scored 61 (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 were at the centre of their care and treatment.

People did not always receive person centred care as they had not always been involved with all care decisions and the care they received was not always individual to them.

We received mixed feedback from people and relatives. Some people told us their preferences were not always supported. For example, one relative told us how their family member is safe but does get anxious and frustrated if a male carer come and how there is need for continuity.
 

There were some shortfalls in how the provider understood the health and care needs of people so there was the potential for care to not always be joined up between services.

We contacted health and social care professional partners for feedback about the service and partnership working; however, we did not receive feedback. There were some omissions in people’s support plans or a lack of clarity and detail around information provided by other healthcare professionals. This meant people were at potential risk of lack of continuity in care delivery and supporting individual needs.

Some relatives told us staff contacted the GP when needed and attended appointments with people where required. Other relatives told us they contacted healthcare professionals for appointments directly.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The registered manager told us, “On request we can access the facility to change things into formats which are accessible. All telephone calls are recorded now with AI (Artificial Intelligence), and they give a summary of the call. This is helpful when I have spoken to a healthcare professional and the family want to know what was discussed, I can send the transcript/AI notes from this.”

Relatives told us, “Yes we have a care plan but I don’t look at it”, and “The carer and I worked to produce a decent care plan which included our input. Hoist procedures are now in black and white, and things are made clear as to what is allowed and what isn’t now—so its formalised.” One relative told us, “Pro-active communication could be better.”
 

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

The registered manager told us they did not receive any formal complaints. The provider had a complaints policy in place which set out clear guidance on how to respond to complaints, and it stated the registered manager had overall responsibility for complaints handling, investigation and resolution. The provider’s policy stated, ‘a full record will be held of all complaints and concerns received regardless of the level of seriousness and means of communication.’ However, the provider was unable to evidence a complaints log was in place in the event of recording a complaint.
 

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Staff supported people to access services in the community when needed. Relatives told us staff provided the support they needed. Comments included, “In the early days [person] couldn’t speak but they persevered and they can understand [person].” And “They also take my advice on board too about her independence and talk about her Disability Skiing.”
 

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff, people and family members did not identify any concerns about discrimination. Relatives told us how staff supported people with obtaining equipment such as wheelchairs. One relative said, “[Staff] diary things about [person’s] personal hygiene. They also assist [person] with that whilst promoting [person’s] independence where they can.”
 

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider was unable to demonstrate people’s care plans included evidence they had supported people to make informed decisions about their future including at the end of their life. Care plans were not developed for these areas and staff had not had end-of-life discussions with people or noted where it would not be appropriate . Training evidence provided showed staff had not received training in end-of-life care.

The registered manager told us, “We have those discussions with people and families, it depends on the conditions. You can see the decline. We will always ask them what they want, make sure there is a ReSPECT form and DNAR in place and everyone is involved in the process.” A ReSPECT form (Recommended Summary Plan for Emergency Care and Treatment) is a personalized plan in the UK that records a patient's wishes for emergency care, created through conversations with healthcare professionals, to guide treatment if the person cannot communicate, focusing on what matters to them, especially regarding interventions like CPR. DNAR stands for Do Not Attempt Resuscitation, a medical order instructing healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if a patient's heart or breathing stops.