Ranelagh House

Updated 22 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Ranelagh House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ranelagh House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 30 September 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who were staying at the home and we spoke with 6 relatives of people living at the home. We also spoke with 8 members of staff including the registered manager. We spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also reviewed 6 people’s care records and a sample of medication records along with records relating to the management of the service.

Updated 22 March 2023

About the service

Ranelagh House is a residential care home providing accommodation and personal care for up to 26 people in one adapted building. The service provides support to older people and people living with dementia. At the time of our inspection there were 21 people using the service.

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

People and their relatives told us they were well cared for and felt safe at the home. One person said, “It’s been a good move here, I feel safe.” Another person told us, “It’s like a family here.” However, there had been a delay in the use of the processes in place to help safeguard people from the risk of abuse. When prompted during the inspection process the registered manager took appropriate action.

The monitoring of food safety had not been maintained. There was a system in place to record safe food storage, cooking temperatures and cleaning tasks. This system had not been consistently maintained and there were gaps in the records kept. Following the inspection visit the provider took action to ensure effective monitoring of food safety.

We have made a recommendation about the deployment of staff. There were enough staff to provide safe care for people. However, staff told us the deployment of staff members with different roles during busy times, such as mealtimes was not effective as sometimes people had to wait for care and support.

Both the registered manager and provider were receptive to our feedback and acknowledged there had been some recent failings in the systems at the home. They were prompt in taking appropriate actions and assured us that lessons had been learned.

The provider and registered manager had been candid when informing people that something had gone wrong. However, some family members told us that it was at times difficult to obtain information and that confirmation of any actions taken, had took too long.

In other areas the registered manager had taken steps to make ongoing improvements at the service and learn from incidents; for example, the home was involved in a pilot project to improve how people’s risk of falls is assessed and taking preventative actions.

Staff told us they felt comfortable approaching the registered manager if they had any concerns.

There was a positive, relaxed and friendly atmosphere at the home. There were warm and caring interactions between people at the home and staff. People were empowered to take control within the home.

People told us there was a positive atmosphere at the home and the staff had a kind manner. One person told us, “The staff are lovely and now I feel that this is my home and they feel like family. I can have a laugh with them.” Other people said, “Staff are the right people and the care is good.” And “It’s brilliant, carers do stuff for me.”

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.

People’s medicines were safely managed and the provider had ensured that the risk from COVID-19 and other infections was mitigated and any outbreak was effectively managed.

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 (published 17 October 2019).

Why we inspected

The inspection was prompted in part due to concerns highlighted during our ongoing monitoring of the service in relation to the application of procedures to safeguard adults. A decision was made for us to inspect and examine those risks.

The provider and registered manger took action during the inspection window to mitigate these risks.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ranelagh House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to protecting people from the risk of abuse and good 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.