Ranis Healthcare Limited

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• 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 inadequate. At this assessment, the rating has changed to requires improvement. This meant people’s needs were not always met. The provider was previously in breach of the legal regulation in relation person centred care. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.

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.

At the last assessment, the provider did not make sure people were at the centre of their care and treatment choices. The provider did not work in partnership with people, or their relatives if appropriate, to decide how to respond to any relevant changes in people’s needs.

The provider had made some improvements since the last assessment to ensure care was person centred. Where care plans had been reviewed, they were accurate, detailed, and reflective of each person’s needs. Staff and managers demonstrated a better understanding of care planning being an ongoing process, not a one-off task. However, work to update care documentation was still in progress at the time of inspection, so changes made had not been fully embedded at the service.

People and their relatives gave us mixed feedback when asked if care was person-centred. A relative told us, “I don’t think they [staff] fully understand due to language barriers. I have to keep telling them [person] does not like water being poured on their head.” Another relative said, “I have been clear about communicating with them [staff] what [relative] needs and what is lacking. They [staff] are a lot better than they were but still don’t do all they could.”

At the last assessment there were significant shortfalls in how the provider understood the diverse health and care needs of people, so care was not joined-up, flexible or supportive of choice and continuity. People and their relatives consistently told us of their concerns regarding the numbers of different staff members providing support and the impact that had on the quality of care provided.

At this assessment, most people had seen some improvements in consistency of staff, although this was still variable. A person told us that they were supported by “a certain group of carers.” Another person told us that they had “quite a few different ones and one regular carer.” A relative told us, “Different ones [staff], frustrating as they change every few days.” The provider acknowledged this feedback. There was ongoing work to embed systems to ensure the monitoring of call times and continuity of care for people.

At the last assessment, the provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Communication was repeatedly mentioned by people and their relatives as an issue.

At this assessment, some people and their relatives continued to reference communication difficulties with staff. A relative told us, “They [staff] are pleasant enough but [family member] does struggle to understand them.” A person told us, “There is a language barrier, but we cope. Some have very poor English.” However, people did tell us that communication from the management team was improving and they had seen an increased responsiveness from the service.

Some people and their relatives told us they had not seen their care plan. A person told us, “There is no care plan in the property, I did ask. The carers said it was on the phone. There are no folders in the home.” People reflected that information was not always current or representative of their current needs. A relative said, “There is a care plan. It is tailor made to [family member]’s needs but it could do with a review.” The provider was aware of this and was in the process of reviewing all documentation, in conjunction with people and their family members. A relative told is, “There is a care plan refined to [relative]’s needs. The manager came a few weeks ago to check on things. They reviewed the care plan.”

At the last assessment, the provider had not made it easy for people to share feedback and ideas or raise complaints about their care. Staff had not involved people in decisions about their care.

At this assessment, the provider had made positive improvements in how they listened to and involved people in their care. A complaints policy was available, and records showed the provider acted upon concerns, comments and complaints appropriately. Responses were timely, clear, and demonstrated a commitment to resolving issues and learning from feedback. A relative told us, “I have made a complaint. I went directly to the coordinator. They do take on board what I say. They respond to my complaints.”

At the last assessment we were unable to gather sufficient evidence to score this quality statement.

At this assessment we found, the provider ensured people had fair and appropriate access to the care, support, and external services they needed. People were able to see healthcare professionals, such as their GP and community nurses, when they needed to. Staff told us they had good relationships with local health teams, who were supportive and carried out reviews or visits as required.

At the last assessment we found leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

At this assessment, the provider had made improvements to ensure people experienced fair, personalised, and positive outcomes. People and their relatives were more actively involved in the care planning process, and their views were listened to and used to shape care. This meant care plans were more reflective of people’s individual needs, preferences and what mattered to them.

At the last assessment, people were not 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.

At this assessment, the provider had made some improvements in how they supported people to plan for the future. Staff and managers recognised the importance of giving people and their relatives opportunities to talk about what mattered to them. However, work to carry out reviews and update documentation was still in progress. This meant not all care plans contained sufficient detail regarding people’s future wishes and preferences.