Ridgeway Manor Residential Care Home

People’s experience of using this service:

Some aspects of people’s care were not always provided safely. For example, some people did not receive their medicines as prescribed on the day of our inspection. People who had specific dietary needs were not supported to eat in line with guidance issued by a speech and language therapist.

A recent fire risk assessment found improvements were needed in fire safety and some areas of the building presented health and safety risks to people. The home was not adapted to meet the needs of people living with dementia. Some parts of the home were not adequately maintained or sufficiently clean. Quality assurance systems were not effective in assessing, monitoring and improving the quality and safety of the service.

People’s care was provided in line with the Mental Capacity Act (MCA), although there were some inconsistencies in the completion of documentation. We have made a recommendation about this.

People told us they enjoyed the food at the home. They said they had choices at each meal and could have alternatives to the menu. However, meals for people who required texture-modified food were not attractively presented. We have made a recommendation about this.

There were enough staff on each shift to meet people’s needs. People said staff were available when they needed them and that they did not have to wait when they needed care. Staff were recruited safely and understood their role in safeguarding people from abuse. Relatives praised the efforts staff had made during the COVID-19 pandemic to keep people safe.

If accidents or incidents occurred, these were reviewed to identify any themes and actions that could be taken to prevent a similar incident happening again. There was a business continuity plan in place to ensure people would continue to receive their care in the event of an emergency.

People were supported to maintain good health and to access healthcare services when they needed them. Staff monitored people’s health and made referrals to healthcare professionals if they identified concerns.

Staff carried out assessments to identify any risks people faced in areas such as mobility and skin integrity and kept these under review. Pain assessments had been implemented for people who may not be able to express when they were in pain, such as people living with dementia.

Staff were kind and caring and treated people with respect. People and relatives told us there was a friendly, family atmosphere at the home. Staff respected people’s choices about their care and enabled them to be as independent as possible. People had access to activities they enjoyed.

Staff had an induction when they started work and access to ongoing training. Staff told us they received good support from the management team and said they worked well as a team.

People’s care was planned to meet their individual needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s wishes about the care they received towards the end of their lives had been recorded where they chose to discuss this aspect of their care.

People told us staff knew their needs well and how they preferred their care to be provided. Relatives told us the management team communicated well with them and said they were able to be involved in planning their family members’ care. People and their relatives felt able to raise any concerns they had and were confident these would receive an appropriate response.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was requires improvement (published 4 November 2019).

Why we inspected:

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations:

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to health and safety, the environment and governance.

Please see the action we have told the provider to take at the end of this report.

Follow up:

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Ridgeway Manor Residential Care Home is a care home providing accommodation and personal care for up to 43 people. At the time of the inspection 26 people were living in the home. The home is set out over three floors and is situated in extensive grounds in a rural location in Surrey.

People’s experience of using this service and what we found

Risk associated with hot water temperatures were not being fully managed. Risk assessments were in place and some required additional information to ensure they reflected people’s current needs.

People’s needs were identified in care plans, people and their relatives were involved in writing and reviewing their plans. Some of the care plans we viewed required additional information and daily records were not always fully completed.

There were systems in place that ensured people who were deprived of their liberty were done so with the appropriate legal authority. However, we found improvement could be made in relation to the application and recording of the Mental Capacity Act 2005 and we have made a recommendation about this.

There were systems in place to monitor the standard of care provided at the service. The systems were not fully effective in identifying all of the areas for improvement we identified during the inspection.

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; the policies and systems in the service supported this practice.

Staff were recruited safely. There were enough staff available to support people. The provider had a recruitment plan in place to address staff vacancies. Staff received regular one to one supervision and told us they felt supported.

People told us they felt safe living at Ridgeway Manor Residential Care Home. Staff felt confident to raise concerns with the manager and were aware of external agencies where they could report concerns. Staff supported people to manage their medicines safety.

People’s healthcare needs were identified and met. Staff worked with a range of healthcare professionals to meet people’s needs.

People were supported by caring staff who worked towards promoting their dignity and independence.

People felt confident to raise any concerns. People and staff commented positively about the management of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Ridgeway Manor Residential Care Home is a residential home providing support to older people, some of whom are living with dementia. The home is registered to provide care for up to 43 people. At the time of our inspection there were 26 people living at the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were sufficient staff present to safely meet people’s needs. Staff had undergone checks to ensure that they were of good character to be working with people. Staff had appropriate training and support to meet the needs of people living at the home.

People’s legal rights were protected as staff provided care in line with the Mental Capacity Act (2005). Correct procedures were followed when depriving people of their liberty.

People’s medicines were stored and administered safely and staff worked alongside healthcare professionals to ensure that people’s health needs were met. Staff responded quickly to changes in people’s healthcare needs.

Accidents and incidents were recorded and measures were taken to prevent a reoccurence. Staff routinely carried out risk assessments and created plans to minimise known hazards whilst encouraging people’s independence. Staff understood their responsibilities in safeguarding people and knew what to do if they suspected abuse had occurred.

Systems were in place to keep people safe in the event of an emergency. A contingency plan was in place to ensure people’s care could continue in the event of evacuation.

People told us that they enjoyed the food and we saw evidence of people being provided with choice and also being consulted on food during meetings and reviews.

People lived in an inclusive atmosphere in which they had access to a range of meaningful activities and were involved in making decisions about their home. Staff provided care in a way that was personalised and caring.

Staff felt well supported by the registered manager and had input into how the home was run. Systems were in place to ensure care at the home was of a good quality. People’s feedback was regularly sought and complaints were responded to appropriately.

We noted that there were a variety of social events and opportunities provided, in both group and individual settings. The home also operated it's own minibus, used for the purpose of outings. The people we spoke with were happy with the number and types of activities on offer.

We saw that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. There were enough qualified, skilled and experienced staff to meet people's needs. We also found that systems were in place for people and relatives to make a complaint about the service if necessary and that complaints were dealt with in a timely and satisfactory manner.

During out inspection we looked at medication administration. and how the service monitors quality assurance.