Rawreth Court

On this page

• 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 requires improvement. At this assessment the rating has changed to good.

This meant people’s needs were met through good organisation and delivery.

The provider was previously in breach of the legal regulation in relation to person centred care. Improvements were found during this inspection, and the provider was subsequently no longer in breach of this regulation.

This service scored 71 (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 made sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff ensured people’s care plans were detailed and comprehensive which helped staff fully understand the care each person required. Staff clearly knew people well as they were able to describe people’s individual needs, their backgrounds and preferences with ease. They told us how people liked to spend their days and how they supported them in a person-centred way. People’s care plans were reviewed regularly by named nurses to help ensure they remained current and accurate and both people and their family were invited to participate in these reviews, which helped support people to be involved in their own care. A person who uses the service told us, ““It’s absolutely lovely here. The staff are really responsive when I ask for things”.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

With thorough pre-assessments and pre-admission information staff had a good understanding of people from the moment they moved into the service. This helped to ensure a positive start for people and supported staff to get to know people quickly. People were cared for by a consistent staff team who knew them, their health and care needs and brought in external input when needed. A relative of someone at the service told us, “At start (of care) lots of notes taken and questions, things changed as they got to know [person], can’t fault them, constant attention since [relative] came in”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was available to people in different formats if needed. We saw effective use of pictures at mealtimes to enable informed choice. There was a public display board showing how feedback received had been acted on by the service using a “you said, we did” format. Other information displayed around the service gave people details of activities, the menu and events taking place. The registered manager also told us of how residents were invited to attend for portions of staff meetings, with sections discussing sensitive personal data being reserved for staff only. The registered manager also told us of a monthly relative meeting that gets held face to face, sometimes guest speakers are invited to increase knowledge amongst relatives. More recently, discharge coordinators, physiotherapists and speech and language therapists have joined in to these meetings to help increase knowledge of conditions faced by people at the service and answering questions.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

Whilst the service had some systems in place to gather feedback and quality assurance, these were not always reviewed by management. Some wider level quality assurance was available through NHS channels, but these were not always available to be reviewed or actioned by the registered manager. There was a paper-based feedback questionnaire provided by the service to people however although this had been completed and returned over a month prior to the inspection date this had not been analysed or actioned yet, making it ineffective. There was a system for relatives to offer feedback on mealtime provision at the service, once again there was no evidence that themes and feedback had been analysed or points actioned. Whilst feedback options were available, they were not always reviewed or actioned by the relevant leaders at the service. The registered manager acknowledged this and gave assurances that this would be improved upon.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Staff supported people to obtain external health care professional input when needed as well as working as a team internally in relation to a people’s care needs. As outlined in other areas of this report, there were extensive healthcare options available to people and everyone had equal access to these provisions. The service environment was accessible for people with physical support needs, and people were provided with equipment to promote independence and enable access to different areas of the home and outdoor spaces.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Activities were arranged with everyone in mind. These included group, one-to-one and individualised activities. People who received care in bed were also provided with opportunities to engage with activities and 1-1 time was allocated to allow for all to be engaged. One relative told us, “Absolutely outstanding. If I could give them a platinum award, I would. Brilliant activities. The food is very good. Her care is second to none—absolutely brilliant.” Another relative told us, “Staff are friendly and welcoming. There are activities happening all the time, things that she can get involved in. I came along to the fête on Saturday. They invited all of my family along. It’s nice. I’ve nothing to complain about”. Staff outlined how there were activity boxes specifically for people in their bedrooms as well as personally curated boxes.

People were 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.

End of life care plans contained comprehensive, robust and detailed information, with clear guidance on what staff would do at each stage of care and progression of illness. Mental capacity assessments relating to advance care planning also were well documented with views of all relevant people taken into account and ensuring that preferences and choices were recorded.

Some people had also made advanced decisions such as the wish of not being resuscitated or receiving hospital treatment. This ensured people had the opportunity to express their views at this stage in case they were no longer able to communicate if their health deteriorated.