Romney House

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 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 58 (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.

Regular reviews of people’s care were not always undertaken, and care plans were not always up to date. This meant some information was inaccurate and not reflective of people’s needs. Leaders told us they were aware of this, but said staff knew people, including their needs and preferences, well. They said staff assessed people daily during interactions and care interventions.

People were thoroughly assessed before being offered a placement at the service. This included visiting the person in their current environment and inviting them to meet people and staff. Some people had a short stay before deciding to become a permanent resident.

People told us they were assessed before it was agreed they could move to the home. Specific comments included, “[Managers] came to see me in my home and chat about me and the place here” and “They did ask me lots of questions before I came here.”

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

Records did not always demonstrate care delivery. For example, risk assessments did not consistently identify, assess or mitigate risks, and care plans were not always reflective of people’s needs or preferences.

Staff used nationally recognised tools such the Waterlow Assessment to identify a person’s risk of developing pressure ulcers, but not regularly. This did not ensure the effectiveness of the tool or accurate outcomes to inform care delivery. Staff had not monitored people’s weight at the recommended frequency following completion of Malnutrition Universal Screening Tools (MUST). This did not ensure control measures were effective, and placed people at risk of further weight loss. Leaders told us they were aware record keeping needed to be improved and would do this accordingly.

However, records seen demonstrated consultations and interventions from other health and social care providers.

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.

Staff told us they all supported each other and worked together to achieve the same aim. They said it was like a family, and everyone helped where they could. This included doing different roles if needed. Leaders confirmed this and said they worked a night or weekend shift to provide cover.

Leaders told us they spoke to staff daily and communication between the different teams was good. They said they had built established relationships with health and social care professionals. These professionals were contacted for advice and support as required and visited regularly.

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.

People told us they enjoyed the food. Specific comments included “There is plenty to eat and drink”, “Our meals are brilliant” and “The food is wonderful”. Relatives were equally complimentary about the food. One relative said, “The food is so delicious”

People and relatives confirmed the meals were varied and there was a choice. One relative told us, “If [family member] doesn’t like anything, they will usually cook something else like an omelette.”

The catering staff told us they regularly spoke to people about the food to gain their feedback. They said they got to know people’s individual preferences including those who liked a cooked breakfast or bacon sandwich. They knew the importance of food and how the senses of sight and smell promoted good intake.

People told us their mobility was promoted and they were able to choose where they spent their day. One person told us they preferred meals in their room but enjoyed going to the dining room for their lunch. They said staff walked with them to do this.

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

People’s care plans and risk assessments were not up to date and did not always reflect the individual’s needs and preferences. However, risks associated with this, were minimised as there was a consistent team of staff who knew people well. Leaders recognised the information needed to be reviewed and had started to do this.

People were happy with the service they received. They said they could choose their own routines and spend their time as they wished. People said they could join in with the arranged social activities and have visitors at any time. Specific comments included, “I love the gardening, we go out on trips, I go to Bingo and I do the exercises” and “The entertainer people come in; singing makes you happy, there is enough to keep me busy.”

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

People told us staff always asked for their consent before undertaking any care intervention. One person told us, “They always ask me if it’s alright to help me. They don’t just do things to you.” We observed this in practice, when a staff member asked, “Can I take this from you?”

There were consent forms in people’s care plans. These covered taking photographs for the purpose of identification, social activities and social media and monitoring wounds or other injuries. However, one person’s capacity had not been assessed in terms of having bedrails in situ. There was no evidence of the decision-making process including if any less restrictive options had been considered.

Staff told us another person lacked capacity to make day to day decisions, but their capacity care plan was blank. This did not sure the person’s preferences were respected and adhered to.