The Ranch

Updated 22 March 2022

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 Care Act 2014.

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

One inspector carried out the inspection.

Service and service type

The Ranch is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before inspection

We spoke with people’s relatives to hear their feedback about the support their family members received at the home. We reviewed information we had received about the service, including notifications of significant incidents. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the people who lived at the home, the registered manager and a member of staff. We checked recruitment records for two staff, staff training records, quality audits, minutes of staff and residents’ meetings, and satisfaction surveys. We reviewed one person’s care records, including their risk assessments and support plans, and the arrangements for managing medicines.

After the inspection

We received feedback about the quality of care from three professionals who had worked with the service.

Updated 22 March 2022

About the service

The Ranch is a care home providing accommodation and personal care for up to three people with learning disabilities and/or mental health conditions. There were two people living at the home at the time of our inspection.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support

Staff supported people to have the maximum possible choice and control over their lives. Staff involved people in discussions about their support, including support to travel wherever they needed to go.

Staff focused on people’s strengths and promoted what they could do, which enabled people to enjoy meaningful, fulfilling lives. Staff supported people to pursue their interests in their local area.

Staff enabled people to access specialist health and social care support in the community. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Staff communicated with people in ways that met their needs. Staff supported people to make decisions about their day-to-day care and support. For complex decisions, staff ensured decisions were made in people’s best interests.

People lived in a clean, homely environment that met their sensory and physical needs.

Right care

People received kind and compassionate care. Staff respected people’s privacy and dignity. They understood and responded to people’s individual needs.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People understood information given to them because staff supported them consistently and knew their individual communication needs.

People’s care and support plans were holistic and reflected their individual needs.

People received care that supported their needs and aspirations, and was focused on their quality of life.

People could take part in activities that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Staff had identified any risks people might face and put measures in place to mitigate these.

Right culture

People led empowered lives because of the values and behaviours of the registered manager and staff. Staff knew and understood people well and were responsive to their individual needs.

People were involved in planning their care. Staff listened to and acted on people’s feedback about the support they received.

The registered manager monitored the quality of support provided to people, involving the person, their family and other professionals as appropriate.

The registered manager and staff worked well with other professionals when necessary to improve people’s quality of life.

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

Rating at last inspection and update

The last rating for the service was requires improvement (published on 13 December 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 2 October 2019. Breaches of legal requirements were found. We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

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 requires improvement to good. This is based on the findings at this inspection.

We assessed whether the service was applying the principles of Right support right care right culture.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.