We found the following examples of good practice.
Systems were in place to support staff and people to undertake regular testing.
People were admitted safely into the home.
Internal activities had been increased during the times when the home has been closed to visitors.
Ridgeway Court Care Home is a residential care home providing personal care to 34 people aged 65 and over at the time of the inspection. The service can support up to 39 people.
The provider’s systems to monitor quality had not always identified where there were errors in people’s care records. People knew who the registered manager was and told us the service was well led. People were given opportunity to feedback on the quality of the service.
People were supported by staff who knew how to report concerns of abuse and manage risks to keep people safe. Although medication recording required further work, there was no indication that people had not had their medication as required. There were sufficient numbers of staff to support people and staff were recruited safely.
People were supported by staff who had received training relevant to their role. People’s dietary requirements were met and they had access to healthcare services where required. The design of the service met people’s needs. 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 kind and caring to people. People were involved in decisions about their care and were treated with dignity. People’s independence was encouraged.
Staff knew people well. People had access to activities that met their preferences and complaints made were investigated and resolved. People’s end of life wishes had been explored with them.
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 15 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The provider is registered to provide accommodation and personal care for up to 39 people. On the day of our inspection 33 people lived at the home, five people were in hospital which meant 28 people were on-site. People lived with a range of age related conditions which included dementia.
At our last inspection of 4 November 2015 we identified that some improvement was needed so that staff followed the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The provider also needed to demonstrate that they maintained the safety of the premises and or equipment used in a timely manner. At this inspection we found that improvements had been made.
The manager was registered with us as is required by law and was present on the 2nd day of the inspection. 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.
People were protected from the risks of harm or abuse by staff who had been trained to recognise and report concerns. Risks to people’s safety had been identified and planned for, however staff needed to be consistent in monitoring people who required catheter care. People were supported with their medicines and took them as they had been prescribed by their doctor. People reported and we saw that there were enough staff available to meet people's needs and to keep them safe. The provider had recruitment procedures in place to ensure checks were carried out on the suitability of new staff.
Staff had a planned induction to prepare them for their role and had training and support to ensure they understood and met people’s needs effectively. The provider had booked training for all staff to ensure they understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People enjoyed their meals and were supported eat and drink to avoid malnutrition or dehydration. People had access to health care professionals to promote their health and well-being.
People were supported by staff who we saw were caring, kind and patient. Staff showed they protected people’s privacy and dignity when they undertook care tasks. People were happy that staff encouraged their independence.
People were enabled to make decisions about their care and felt that staff knew their preferences and routines for how and when their care was provided. Staff supported people to keep in contact with their family and people important to them. Activity provision was tailored to meet people's individual needs and interests. People and their relatives had access to a complaints process if they were dissatisfied with any aspect of the service provision.
The registered manager shared the management role with the deputy manager. She had reduced her time in the home. People who lived there, their relatives and staff reported that this had not had an impact on them as arrangements were in place for them to access management team members. People told us that they felt that the quality of service was good. Quality monitoring of the service via regular audits and checks had been undertaken. The registered manager was obtaining people’s views on service provision and was looking at ways to improve the feedback received. The provider had ensured that maintenance checks on equipment and the premises were carried out within the required timescales. This was an improvement since our last inspection in November 2015 and ensured that the safety of people was being addressed.
This inspection took place on 4 November 2015 and was unannounced. The provider is registered to provide accommodation and personal care for up to 39 people. On the day of our inspection 33 people lived at the home. People lived with a range of conditions which related to old age and included dementia.
At our last inspection in September 2013, we asked the provider to take action to make improvements to the safety of the premises and equipment used by people and this action has been completed.
There was a registered manager in post and she was present during our inspection. 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 and associated Regulations about how the service is run.
People felt safe using the service and risks to their safety had been identified. People and their relatives had no concerns about their family member’s day to day safety. Staff knew how to support people safely but not all staff had training in how to recognise and report abuse.
Staff were recruited in a safe way. People and their relatives felt that enough staff were available to meet their needs.
Staff were kind and caring. Interactions between staff and the people who lived at the home were friendly and polite. Staff were considerate and helpful to people.
Medicines were managed safely and ensured that people received their medicine as it had been prescribed by their GP. People had access to healthcare facilities to support them with their health needs.
People were happy with the meals offered. Care had been taken to ensure people had the support they needed to eat enough. Drinks were offered throughout the day to prevent the risk of dehydration.
Staff felt that they were provided with the training that they required to care for people appropriately. Staff were actively supported in their care roles.
Staff were aware of how to seek people’s consent and respect their choices. However further training was needed to ensure they effectively supported people’s rights.
People were confident their complaint would be listened to and they had access to complaint procedures.
Quality monitoring processes were in place although this had not ensured that the provider took preventative or corrective action in relation to the safety of the premises when this was needed.
People's consent was sought before staff provided care and support.
We found that care plans and risk assessments were detailed and personalised and staff used them to ensure people's needs were met. Care staff we spoke with demonstrated a good understanding about how to care for people. One person we spoke with told us, 'I am happy here, the care is excellent'.
We found that arrangements for repairs and refurbishment were not completed in a timely way and this could impact upon people's well-being.
We found that appropriate checks had been undertaken before staff began to work at the home.
People and staff we spoke with told us that they felt able to raise concerns about the service. Complaints were recorded, investigated and resolved to the satisfaction of people using the service. One person said, 'I have no complaints it is a nice home'.
People who use the service are supported to make choices about the care and support that they receive, such as the times they get up, what they eat and the things they like to do.
We saw positive interactions between people living there and the staff team, staff spoke with people regularly, and we saw people responded to this. The atmosphere was friendly and relaxed.
Relatives we spoke with told us positive things about the care and support people received. A relative said, "This is an excellent home, staff are very kind and work hard to make sure people get the right care'.
Staff we spoke with presented as skilled and knowledgeable and knew how to support people and how to meet their specific needs, such as supporting them to eat and drink enough.
There were systems in place to make sure that people could be assured that their care and support was reviewed and monitored.
We spent over three hours at the home. We spoke to five people who live at the home and three relatives. A number of people were sitting in the lounge area, they were well dressed, and everyone appeared well cared for. The home was clean and fresh. Throughout the visit all staff were observed to engage well with people. Everyone we spoke to said they were happy with the care they receive. People made some of the following comments:
'Very happy living here, if there was anything wrong I would tell you. The home is very clean, no complaints. They give me my medicines when I need them.'
'Nearly four years living in the home. The home is great. The staff are excellent, you can ask them for anything and if they don't know they find out for you. You can go to the manager if you have any problems, she is excellent. They always give me my tablets and make sure I take them.'
'I have lived in the home for 12 months. It took a good while to settle in. Staff are very good. There are enough staff around.'
Relatives we spoke to told us that they were happy with the care provided to their relative. All said the staff were great and they were able to visit anytime of the day. They said they had no concerns about the number of staff in the home. They had no complaints and said the manager and all staff were very obliging. Relatives spoken to were clear that should they have any concerns these would be addressed by the manager. All the care staff we spoke to had received the required training in moving and handling along with other essential training, so that they had the skills to meet the needs of the people using the service. There were 31 people living in the home at the time of our visit and care staff said there were sufficient staff to enable them to care for the people living there. Care staff were clear that systems were in place to increase staffing levels if necessary.
This means that people living at the home receive their medicines as prescribed. There are sufficient numbers of staff trained to meet their needs and they are confident their concerns would be listened to and acted upon.