Ramsey Step Down and Care Centre

Care plans and risk assessments lacked detail and did not provide enough information about people's current and changing needs to assist the registered manager to plan care and decide on staffing levels. Staff recorded the support they provided; however, the information was not effectively analysed to check for gaps or trends.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not support the registered provider to meet their legal requirements when supporting people who lacked capacity to make decisions about their care.

People received their medicines as required, though medicine care plans lacked detail. There were enough safely recruited staff to keep people safe. Systems to safeguard people from abuse were improving, however greater transparency was required during internal investigations and complaint management. The registered manager had measures in place to minimise the risk of infection.

Staff were knowledgeable about people's needs and provided personalised care. They worked well with other agencies to meet people's needs in a holistic manner. People had support to eat and drink in line with their preferences and health needs. The registered manager was enhancing the environment to meet the needs of the people living at the service.

There was a positive culture at the service. Care was compassionate and respectful. People and their representatives were positive about the culture of the service and told us people achieved good outcomes.

Staff communicated well with people and their representatives to ensure they were involved in making decisions about care. People were supported to remain active and stimulated. Staff encouraged people to maintain their skills, enabling them to return home where appropriate. People received compassionate care at end of life from a team of committed staff supported by external professionals.

Stakeholders told us Ramsey Step Down and Care Centre provides a strategically important and flexible service which supports hospital discharge at a time of high demand for health and social care services. In 2021, the CQC report, "Enabling innovation and adoption in health and social care: Developing a shared view" highlighted one of the principles of innovation as "Focus on outcomes and impact." We found the provider reflected this innovative approach and achieved positive impact and outcomes. Following our inspection, the provider responded positively to address the concerns we had raised around risk management and care planning, whilst still retaining a commitment to innovation.