Rynes Healthcare Ltd

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

People’s care had not always been provided in accordance with the Mental Capacity Act 2005 or in their best interests. People were supported by familiar staff who knew their needs well. Staff understood the importance of providing person-centred care which focused on people’s individual needs and preferences. When necessary, the provider worked effectively with other professionals involved in people’s care.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s relatives gave positive feedback about how well staff understood and assessed people’s needs. One relative told us, “They have it all written down in a file and anything they don’t do properly we leave them a note because I am at work all day”. A third relative commented, “Yes they are very thorough and ask him before they do things”.

Staff gave examples of how they contributed to the assessment process to ensure people received person-centred care and support. One staff member told us, “Maybe at the time of assessing they say I need to be washed when I’m sitting, but as time goes by, we may find it’s a bit easier to give them a wash when the person is standing, and I will suggest that.”

People’s needs had been assessed before they began to use the service. Assessments addressed areas including mobility, continence, personal care, and nutrition and hydration. The views of people receiving care and their family members had been taken in to account when assessments were carried out.

People’s relatives told us they were involved in planning care and support for people. Comments included, “We have a care plan, along with my notes that I leave”, “Yes they [staff] all follow the care plan.”

Staff told us they had undertaken training to understand about best practice in care delivery. This included training about dementia, moving and handling, and equality, diversity and human rights.

People received support in line with good practice standards. Staff received training to ensure they kept up to date with legislation and required standards. Care plans reflected people’s individual needs and incorporated good practice guidelines, such as those issued by the National Institute for Health and Care Excellence (NICE) in areas including moving and handling and medicines management.

People’s relatives provided feedback about how staff worked with external professionals to share information about people’s care. Comments included, “They all work together”, and “They contacted the GP on [person’s] behalf”.

Staff told us they worked with professionals such as district nurses and GPs to share information about people in order to promote positive health outcomes.

The provider had not always worked effectively with partner agencies to make improvements where these were needed. The local authority highlighted concerns about some aspects of the service at a meeting with the provider in May 2024. The local authority followed this up with a monitoring visit, which found insufficient action had been taken to address the shortfalls discussed at the meeting.

Communication logs demonstrated that the provider liaised effectively with other professionals regarding people’s care. For example, the provider communicated with hospital staff to coordinate hospital discharges, and with healthcare professionals such as district nurses regarding people’s ongoing care.

People’s relatives confirmed staff supported people as much as possible to manage their own health and wellbeing.

Staff gave examples of how they supported people to live healthier lives, including working with professionals and promoting healthy choices. Their comments included, “I have gotten in touch with the GP for my client and they advise accordingly. It’s working hand-in-hand with the other health professionals”, and “I let them know the impact of each kind of food and encourage them to lower some foodstuffs and increase others, like vegetables and fresh foods”.

People’s health needs were assessed before they began to use the service and reviewed regularly to ensure they received the support they needed to maintain good health. Care plans recorded people’s health needs and any support they needed from staff.

People’s relatives confirmed the registered manager reviewed people’s care needs and made changes when appropriate. Comments included, “[Registered manager] comes regularly to see how things are going”, “[Registered manager] is very helpful so I just call her as and when”, and “I speak to [Registered manager] if any changes are required”.

We received mixed feedback from staff about the provider’s systems for monitoring outcomes. One staff member told us processes used by the registered manager to monitor people’s outcomes were not always effective. The member of staff said, “I noticed [Registered manager] spot checked and reassessed the client but failed to update the documentation”.

Staff recorded notes of the care they provided at each visit. People using the service and their relatives had access to these records. The care notes we checked demonstrated that staff recorded any concerns or changes in need in addition to the care they had provided.

People’s relatives confirmed staff sought people’s consent before providing care and support. Their comments included, “Yes they always ask my husband first” and “He is not able to sign his name, but they do ask him verbally anyway”.

Staff told us they sought people’s consent when providing care and support. They also supported people to understand their rights around consent.

The provider had not always provided people’s care in accordance with the Mental Capacity Act 2005 or followed their own policy in relation to the Act. One of the Act’s key principles is that providers should assume a person has capacity to make decisions about their care and treatment unless an assessment has determined they lack capacity. One person’s records stated they lacked capacity to make decisions, but this was not supported by a mental capacity assessment. Another of the Act’s principles is that decisions made on behalf of someone who lacks capacity should be made in their best interests. In one case, the provider had acted in accordance with a decision made on someone’s behalf which was not in the person’s best interests. The provider had not obtained evidence of the decision-maker’s legal authority to act on behalf of the person, or consulted relevant professionals about the decision.