Ranis Healthcare Limited

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this service. This key question has been rated requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 40 (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 consistently treat people with kindness, empathy and compassion, or respect their privacy and dignity. People and their relatives told us where they received care and support from regular staff, they were treated with kindness, empathy and compassion and their privacy and dignity was respected. However, often this was not the case as different care staff supported them. People said this was because staff who did not provide their care on a regular basis did not know them well enough and the basis of trust had not been established.

Feedback received from people and their relatives was variable. One person told us, “Some are kind and caring, some are on the rough side.” Another person said, “They are not unkind ever, just always in a rush. They do care, but it’s a bit robotic sometimes, like they are going through the motions. They’re polite, just not very warm.” Another person said, “I don’t think they always care – they seem too tired to be kind.” People did not always feel staff provided dignified care. One person told us, “Staff are not very good at closing the bathroom door when I’m in the shower. I get cold. I’ve told [Nominated Individual], but it’s happened lots of times since.”

Other people were more positive about the kindness and approach of staff. People who had regular staff were generally happier with the care provided, as this enabled them to build up positive relationships. One relative told us, “Some [staff] are genuinely kind, you can feel it in the way they treat you.” Another person said, “They’re kind and warm, I really feel they do care about me.” A relative also said, “They’re doing their best despite being exhausted- you can tell they care.”

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Care plans were not always person centred and did not provide staff with all the information they required. One person told us, “Most stuff gets done eventually, just not always how I’d like.” Another person told us, “They don’t always understand what I need – especially the newer staff.”

People told us that they did not always feel treated as individuals and at times communication was difficult. One person told us, “There are definitely communication issues – they don’t always understand me properly.” Another person told us, “There is a definite language problem and a lot of miscommunications.”

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. For example, people and their relatives told us they did not know when staff were arriving or who would be arriving. Many people did not recall being involved in discussions about their care and had not seen their care plan and therefore no meaningful opportunity to be involved. One person told us, “I don’t have access to my care plan – I don’t even know if there is one.”

Other people were positive about the way in which staff engaged with them and supported them to make decisions about their care. One person told us, “They [staff] treat me with respect and always ask how I’m doing.” A relative gave the example of how staff had supported their family member on their return home from hospital to regain their independence. They stated, “They [staff] helped improve [relative]’s incontinence when they came out of hospital; they helped them get back to using the loo.”

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. One person told us, “Care plan is pretty non-existent… I need a shower 3 times a week and they can’t even do that.” A relative told us, "They don’t always respond to [relative’s] needs in the moment – especially if they don’t understand [relative]."

People’s needs and wishes were not consistently met, particularly regarding the timing of their care calls and the consistency of staff providing support. Where people had raised concerns about this, they told us the service had failed to listen to these requests and understand the negative impact for them.

One relative told us, “If we had to rely on the carers solely and not me and [other relative], [family member] would not do so well; they [staff] only do very basic care. I get the impression they do what’s needed but no more.”

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

We received mixed feedback from staff, but they told us they were generally happy with the support they received from the provider. One staff member told us, “They are a very good employer. They provide support very well. I am always treated with kindness and respect.” However, another staff member told us they were expected to work long days and were “too tired” which “impacted on their mental health” and “impacted on the care provided” to people. People and their relatives did not feel that staff were happy and well supported. One person told us, “The carers are miserable and not happy in their jobs." Another person told us, “They [staff] are very tired, they come and just sit here exhausted.” A relative told us that staff were “overworked, underpaid and exhausted.”

People were not consistently receiving personalised care from staff who themselves were well supported. We identified gaps in staff supervision and oversight of their individual wellbeing and performance. This impacted on the standards of care and support people received. Team meetings were held; however, these were not always fully attended, and we were not assured that information was shared to those who did not attend. This meant that information regarding people’s care was not widely discussed.