Yarborough House RCH

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 Requires Improvement. At this assessment the rating has remained 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 management team gathered information to assess people’s needs, though information provided by other health and social care professionals was not always reflective of people’s needs. This meant it was difficult to create accurate and detailed care plans for people’s admission to the service and staff could not provide consistent care to meet their needs. Information gathered about people’s needs was shared with staff during handover. Care plans and risk assessments were reviewed and updated where possible following people’s move to the service, though they were not always detailed.

The provider’s care planning system meant risks to people’s health, safety and wellbeing were assessed using evidence-based tools which supported greater accuracy with assessing levels of risk for people.

The management team understood where to seek advice from to support them to follow best practice guidance. Referrals had been made to relevant professionals and staff were informed of changes to people’s needs.

Staff worked with health and social care professionals and external services to ensure people had access to the services they needed. Referrals were made and followed up by staff if needed and they approached professional relationships positively. Staff recorded information to share with professionals to support the referral process. However, the provider’s systems did not always allow for detailed information to be recorded. For example, one person had been referred to the local mental health team due to some of the behaviours they were displaying. Behaviour monitoring charts and reports were in place, though these did not allow for staff to record detailed information about incidents. This meant health professionals would not have access to the information they needed to fully assess the person’s needs.

A consistent staff team worked closely with people and each other across the service. Staff told us of positive teamwork among staff including support from the management team when needed.

The management team and staff attempted to support people to manage their health and wellbeing to maximise their independence, choice and control. Though processes did not always support this.

Staff considered people’s dietary needs through fortifying meals and preparing meals to modified consistencies in line with people’s requirements. However, the impact of the appearance of modified meals had not been considered. For example, some meals were blended, and food moulds were not used. This meant food no longer looked like the food it was and could be less appealing to people. Where people needed assistance with food and drinks, staff offered appropriate support.

Staff assisted people with their mobility where needed and encouraged people to be as independent as possible.

The provider’s systems did not always support the effective monitoring of the care people received. There were regular staff handovers and pressure care and food and fluid monitoring charts were available and used to record the support people received. Though, monitoring forms for behaviours that challenge others were unsuitable for staff to record details about what caused the behaviour, the behaviour itself and the result of the behaviour. This meant the management team and relevant professionals would not be able to effectively assess people’s needs and provide appropriate advice. We raised this with the management team who implemented new behaviour monitoring forms during the assessment.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff sought people’s consent, respected their right to refuse and provided people with support when people were ready to accept support. Staff were trained in mental capacity and DoLS.