Ranis Healthcare 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 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

At the previous assessment we found 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. Whilst we found some improvement in this area, changes were still being embedded at the service. We saw evidence that reviews of people’s support were taking place and for those individuals, care plans and risk assessments were significantly more detailed and personalised. However, this work was still ongoing with several relatives telling us they felt their family member’s care plan required a review to ensure it was still reflective of their needs.

At the last assessment we found the provider did not plan and deliver people’s care and treatment with them, including what was important and mattered to them. We identified limited use of recognised assessment tools within the service. The provider was at an early stage of introducing the use of tools such as MUST and Waterlow. The Malnutrition Universal Screening Tool (MUST) identifies patients who are malnourished or are at risk of malnutrition. The Waterlow Score calculates the risk of pressure ulcers developing on an individual basis through a points-based system.

At this assessment, where care plans and risk assessments had been reviewed, appropriate tools had been utilised. However, work was still underway to update and review this documentation for everybody supported.

At the last assessment we found the provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between services. People did not often have a consistently dedicated small group of staff delivering their care. This meant staff often supported them without understanding their needs, risks, or routine.

At this assessment, the provider had made improvements in how staff, teams and external services worked together to support people. Communication between staff was stronger, and information was shared more clearly and consistently. This helped ensure people received joined up and well-coordinated care.

Staff worked more closely with health and social care professionals, which helped people get the right support at the right time. General record keeping had become more consistent since the previous assessment, which supported safer day-to-day care.

Staff told us they worked well with other health and social care professionals such as community nurses, GP and social workers when needed. The local authority told us the provider had worked well with them to make the necessary improvements following the last assessment.

At the last assessment we found the provider did not support people to manage their health and wellbeing, so people could not maximise their independence, choice, and control. Staff did not support people to live healthier lives, or where possible reduce their future needs for care and support.

At this assessment, the provider had made some improvements. Where care plans had been updated, we saw they included clearer information about people’s needs and gave staff clear guidance on how to support each person safely and effectively. However, some care plans and risk assessments still lacked sufficient detail. This meant staff were not always aware of pertinent information regarding people’s healthcare needs. Nevertheless, people we spoke with were happy their health needs were being met.

At the last assessment, the provider had not effectively monitored people’s care and treatment to continually 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.

At this assessment we found the provider had made some improvements in how they monitor people’s health and wellbeing. Daily records and charts were completed more consistently and accurately. However, as at the previous assessment, people and their relatives told us their experiences were still influenced by the consistency of staff involvement in their care, which could be variable. A relative told us, “I am not sure if they [staff] know [family member] well. If they were more consistent then they would understand their needs.” This meant care was not always consistently responsive which impacted on the ability of the service to improve outcomes for people.

At the last assessment people had not always been empowered or included to make decisions about their care and support. Although staff had received training in relation to the Mental Capacity Act (2005) they were not consistently able to explain the main principles to us.

At this assessment staff had a much-improved understanding of the Mental Capacity Act (2005). One staff member told us, “I have done MCA training. This is about supporting people to make their own decisions. We encourage people to make decisions for themselves, with their family’s involvement.” People and relatives had no concerns regarding consent. A person told us, “They [staff] ask for my consent. They will also say what they are going to do before they do it.”