Ronti Care Solutions Ltd

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 Inadequate.

This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The provider was in breach of legal regulation in relation to staffing.

This service scored 33 (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 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.

Assessments of people’s needs were not robust, comprehensive, or kept up to date, placing individuals at significant risk of receiving unsafe or inappropriate care. Initial and ongoing assessments lacked essential detail. They did not fully consider people’s physical and mental health or communication needs. Furthermore, systems and processes for maintaining oversight of care plan quality were not effective. They had not identified that some plans lacked vital details regarding risk management and known medical conditions, with several health conditions lacking risk assessments entirely. There was insufficient management oversight of ongoing assessments and care planning. As a result, we could not be assured people consistently received safe care that met their individual needs.

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

Care and treatment was not consistently delivered in line with current legislation, best practice, or evidence-based guidance, such as National Institute for Health and Care Excellence (NICE) guidelines. Support plans did not fully reflect people’s changing health, risk management, and emotional needs. For example, individuals at high risk of skin breakdown due to continence concerns completely lacked effective skin management, monitoring, or preventative care plans. Additionally, those experiencing high levels of confusion and agitation lacked personalised de-escalation strategies or behaviour monitoring, leaving staff without clear guidance on how to safely reduce their distress. This shortfall extended to communication needs, which were not consistently identified or addressed in line with best practice standards. For example, 1 care plan for an individual who could no longer speak or understand English, instructed care staff to "speak slowly and clearly", while offering no guidance other than to rely on family members to interpret. This meant care staff were left without[ET3.1] meaningful tools to overcome language barriers. Consequently, the provider could not demonstrate that care was personalised, effective, or safely adapted to meet people's complex and evolving needs.

The provider did not work well across teams and services to support people. They did not share their assessment of people’s needs when moving between different services. Additionally, there was an absence of documented evidence to show that staff teams and external services worked together to deliver joined-up, continuous care. A widespread lack of recorded care plans and risk assessments meant we found no objective evidence that people, staff, and visiting professionals had access to the up-to-date information required for safe care transitions.

Furthermore, the provider could not demonstrate they had a reliable system for sharing essential health updates with care staff, leaving no proof that staff received clear direction on how to meet individuals' immediate needs safely. This lack of verifiable communication records also meant there was no evidence to confirm effective collaboration with external health and social care professionals, who could not rely on the service's poorly documented records to make informed decisions. Ultimately, due to a lack of evidence regarding internal communication or reliable paperwork, the provider could not prove that care was delivered seamlessly or that information was shared safely across teams.

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.

We found an absence of documented evidence to show that the service focused on the early identification of risks to people’s health and wellbeing, or that they proactively supported people to prevent physical deterioration. The provider could not demonstrate that care staff had completed sufficient training to ensure they possessed adequate knowledge of relevant healthcare concerns, how to spot early warning signs in the people they supported, or how to respond appropriately to mitigate risks. For example, records did not show that staff were trained to recognise or manage complications related to catheter care, such as blockages, bypassed fluids, or the early symptoms of a catheter-associated urinary tract infection (UTI). This gap in clinical competence meant that subtle changes in people’s health could easily go unnoticed. Ultimately, due to this lack of proactive monitoring and verified staff training, the provider could not assure us that people were safely supported to maintain their health or protected from avoidable hospital admissions.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People’s care plans did not always reflect their personal needs, aspirations, or medical conditions. The documentation lacked the essential details care staff needed to spot and respond quickly when a person's health began to change. Because these records were not kept up to date or thorough, there was a high risk that growing healthcare concerns would go unnoticed. Ultimately, these gaps in paperwork left care staff without clear guidance, which compromised the safety and continuity of people's care. For example, our review of care records revealed that while individual continence care needs were explicitly noted in assessments, the provider completely omitted any corresponding risk mitigation or management plans. There were no documented protocols to guide care staff on skin integrity monitoring, scheduled toileting programmes, or fluid management. By failing to translate known clinical needs into actionable, monitored care plans, the service could not track the effectiveness of its support or evaluate whether people's health outcomes were improving. This lack of robust quality monitoring meant the provider was unable to identify trends, prevent avoidable physical deterioration, or demonstrate that they were delivering safe, evidence-based care.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. The service did not consistently ensure people gave valid consent to their care and treatment, and improvements were needed to ensure full compliance with the Mental Capacity Act (MCA).

The provider did not maintain robust or verifiable records to demonstrate that valid consent to care and treatment had been obtained in line with legal requirements. Our review of documentation revealed significant omissions across multiple consent forms, for example, 1 consent form lacked a printed name to identify the person signing, and the agreement had been signed off by a staff member rather than the service user or their legal advocate. A second record contained a signature but failed to include a printed name to confirm the identity of the person giving consent. Additionally, a third form completely lacked both a printed name and a signature date. These widespread administrative gaps meant the provider could not confirm who had authorised the care plans, when the consent was given, or whether the individuals had the legal capacity to sign, undermining the validity of the entire consent process.

However, care staff demonstrated a commitment to delivering care that actively promotes people's autonomy and control over their lives. Care staff spoke about their role in helping people maintain control. One staff member told us, “Fostering independence involves offering readily available information and resources for self-reliance, while refraining from interfering in their choices” whilst another said, “Encouraging independence, and supporting choice are core parts of person-centred care and support.” Rather than taking over tasks, staff work to encourage people's independence and assist them to make choices regarding their daily routines. This positive, person-centred approach ensures that people receive respectful care that values their independence.