Rakewood House Care Home

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 changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The registered manager ensured a thorough assessment was completed prior to people moving into the home. Information was requested from the local authority prior to people transferring from home or hospital. People, where able, and their relatives confirmed they had been actively involved in the assessment and planning of the care and support required. One person’s relative told us, “[Registered manager] sat us down and explained what would be happening and what they would do for [relative] and asked all about their needs. She seems a very committed person.”

As outlined with the homes service user guide, staff would then meet with people to discuss their individual preferences, likes, dislikes and routines. This information was then used to develop an individual care plan.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Following a person’s death, areas of improvement in the recording of people’s nutrition and hydration had been raised by the coroner. From our observations we found people were provided with regular food and drinks. Jugs of water or juice were available in people’s room and regular hot drinks were provided.

We observed lunch time and found people were effectively supported with their meal. A menu was displayed, including meal arrangements for someone with a halal diet. Most people we spoke with said they were provided with a choice of meals, which they enjoyed. We were told, “The food is good”, “I am fussy with food but it’s not bad here” and “The food is okay, but they give you quite a lot and I can’t always manage it.”

People’s nutritional needs were assessed and planned for. Where potential risks had been identified, such as swallowing difficulties, referrals had been made to the speech and language therapist (SALT). Some people were fed through a feeding tube, whilst others required the use of ‘thickener’, to help prevent people from choking. Support required was clearly documented ensuring best practice was followed.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider worked with other healthcare services ensuring people’s needs were met. This included the local GP, hospice staff, district nurses and SALTs. We were told staff had a good working relationship with the GP who actively supported the team.

People we spoke with confirmed their health care needs were met. Relatives also told us they were kept informed if people’s needs changed. Comments received included, “I can see a doctor when I want”, “A GP comes round every week but if I wanted one earlier I could get one they would arrange it for me” and “Any problems they call us straightaway.”

Should people need to be transferred to hospital a hospital pack would be provided. This details the person’s care and support needs, their wishes such as advanced care plans, DNACPR and prescribed medication. This helps to ensure consistent support is provided when moving between services.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to maintain their health and well-being. Additional monitoring records were completed where areas of risk had been identified, such as weight loss or pressure care, so changing needs could quickly be responded to . The relative of one person told us, “ [Person] needs palliative care. This place is brilliant because they really care and look after [person]. We are grateful they are here and in safe hands.”

The GP responded to people’s current and changing needs. Additional guidance and support were offered from the hospice team for those people requiring end of life care. Arrangements were also made for people to see the dentist, chiropodist and optician when required.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Both the registered manager and regional manager were actively involved in the day to day running of the service and had developed good working relationships with staff, people and their relatives. All those we spoke with acknowledged the improvements being made within the service.

Opportunities were provided for people and staff to share their views or ideas. One person told us “There is a notice on the cupboard there about making suggestions. The Manager had it put up.” People’s relatives also said, “The Manager is always visible in the place and very approachable and she pops in and sees mum” and “I had a survey recently and all my replies were positive and complimentary.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Where people were being deprived of their liberty, the registered manager had sought legal authorisation to do so. People’s care records reflected information about their ability to give informed consent. Where able, people were actively involved in making decisions about their care and support, including advanced care plans in the event their needs change. Where people were not able to express their wishes and feelings, staff would consult with relatives and other agencies, so decisions were made in their best interests.