Rastrick Hall and Grange

At our last inspection we rated this key question requires improvement. At this assessment the rating remains unchanged. We looked at all of the quality statements for this key question. We identified a breach of the legal regulation in relation to safe care and treatment. Risks to people’s health and welfare were not always managed safely or consistently. People and their relatives expressed concerns about the safety of the care provided. Action to learn and improve was not consistently taken when concerns were raised about the safety of the service, or how the quality of the care could be improved. Systems and processes were in place to ensure medicines were managed safely, but they were not always effective. However, robust and safe recruitment and vetting processes were in place. Systems were also in place to provide and monitor staff training and completion of supervisions. Care and support was planned and organised in collaboration with people and partner agencies, to ensure continuity of safe care across different services.

At our last inspection we rated this key question good. At this assessment the rating has changed to requires improvement. We looked at the following quality statements: assessing needs, delivering evidence based care and treatment, how staff teams and service work together and supporting people to live healthier lives. People’s care plans were not always sufficiently detailed, or person centred. Relatives we spoke with consistently told us they did not feel involved in the care planning process. However, systems were in place to improve working relationships with health and social care professionals involved in the care of people living at the service.

At our last inspection we rated this key question good. At this assessment the rating has changed to requires improvement. We looked at the following quality statements: treating people as individuals, independence choice and control and responding to people’s immediate needs. People and their relatives were not always entirely involved in assessing and reviewing their needs, and people’s assessments did not consider the full range of their diverse needs. We observed mixed practice regarding the responsiveness of staff. For example, staff were not always vigilant, or able to respond in a timely way, to people’s needs. However, most staff appeared to know people well and were kind and respectful in their approach.

At our last inspection we rated this key question good. At this assessment the rating has remained unchanged. We looked at the following quality statements: person-centred care, listening to and involving people and equity in experience and outcomes. We observed inconsistencies in the provision of person-centred care and found people’s care records did not always demonstrate a person-centred approach. Systems were not effective in ensuring people’s experience was equitable, particularly for those people being cared for in their bedrooms. However, systems and processes were in place to seek feedback from people, their relatives and staff.

At our last inspection we rated this key question good. At this assessment the rating has changed to requires improvement. We looked at all of the quality statements for this key question. We identified a breach of the legal regulation in relation to good governance. Systems for auditing safety and quality were in place, but the provider had failed to make sure that robust oversight of the service had been maintained. Staff gave consistently positive feedback about the new manager. Most staff told us they felt confident to raise concerns and were assured they would be dealt with appropriately. Systems were also in place to ensure there was equality and inclusion amongst the workforce.