Ridgeview

Ridgeview is a residential care home providing personal care and support for up to four adults with learning disabilities. At the time of our inspection, three people were using the service.

The home is a terraced house in a residential area of Enfield, North London. Each person had their own well-kept bedroom. There was a large rear garden that people were able to freely access.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

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. The service consistently applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People appeared happy and relaxed living at Ridgeview. Staff understood how to support people as individuals and gave them choice in their day-to-day lives. People were kept safe through clear risk planning and staff understanding each person’s behaviours and care needs. There were systems in place to safely manage people’s medicines. Staff were recruited safely, and appropriate checks were in place to ensure staff suitability.

Staff were supported in their role through regular supervision, appraisal and training. People were supported with their communication needs and staff understood how to communicate with people as individuals. Information was provided to people in easy to understand formats. People were consulted around what they wanted to eat and drink.

There was good management oversight for the home. People’s outcome and the quality of care was monitored through regular audits and surveys. Staff told us they felt supported in their role.

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 26 June 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.

At the last inspection on 29 December 2014 and was rated ‘Good’.

At this inspection we found the service remained ‘Good’.

People and relatives told us that they felt safe with the staff that supported them. Staff understood how to keep people safe and protect them from abuse.

People’s individual risk associated with their health and care needs had been identified and appropriate guidance had been provided so that staff were able to support people in order to reduce or mitigate risks.

Safe recruitment practises were noted which ensured that all staff employed by the service were assessed as being safe to work with vulnerable people.

Medicines were managed, handled and stored securely. Appropriate systems and processes were in place to ensure medicines were administered to people safely and appropriately.

The service always ensured that people were assessed as having capacity and were supported to have maximum choice and control of their lives. Staff were observed supporting people in the least restrictive way. The provider had policies and systems in place to support this practice.

Staff demonstrated a good level of understanding of the key principles of the Mental Capacity Act 2005 (MCA) and how this was to be implemented when supporting people.

Staff received a comprehensive induction as well as relevant training which supported them to carry out their role effectively. Staff confirmed that they were appropriately supported through various ways which included regular supervision and annual appraisals.

People were involved in devising their own weekly menu plans which took into account their choices and preferences of what they wanted to eat.

People were supported to access a variety of health care services such as GP’s, chiropodists, community mental health nurses and psychiatrists.

Care plans were person centred and provided detailed information about the care and support that people required. Staff knew people well and were aware of each person’s individual needs which included their likes, choices, needs and preferences.

Relatives confirmed that they did not have any concerns about the care that was provided and they knew who to speak with if they did have any issues to raise.

Appropriate systems and processes were in place which monitored the quality of the care and support that was provided within the home in order to learn and make improvements to the delivery of care. This included medicine audits, health and safety checks and the completion of satisfaction surveys.

We observed care staff and management approach and speak with people in a way that was caring and positive. Relatives and staff also confirmed that they were able to approach the registered manager at any time and were listened to.

Further information is in the detailed findings below.

At this inspection we found that improvements had been made. One new staff member was working at the service. We found that the provider completed appropriate recruitment checks, to make sure the new staff member was of good character. This took place before they began working with people using the service.

We also found that staff were trained to deliver care to people safely and to an appropriate standard. Further training had been provided to staff, through the local authority's training department, in the areas of emergency first aid and safeguarding adults from abuse. New staff were now completing a documented induction process.

We spoke with people using the service and a visiting healthcare professional during the inspection. They all spoke positively of their experience of the service. For example, a person using the service told us, 'it's a nice home.' The visiting healthcare professional said, 'the people here seem happy.' We found that there were effective systems to assess and monitor quality and risk at the service.

People confirmed that staff were respectful to them and listened to them. Comments included, 'they treat me nicely.' We saw that staff understood and responded to people's communications. We found that people's views and experiences were taken into account in respect of the care provided.

People spoke positively about food and drink. Comments included, 'it tastes nice.' We found that people were protected from the risks of inadequate nutrition and dehydration.

People told us they were happy with the staff provided, saying for example, 'the staff are alright.' We found minor concerns, however, that some staff had been working with people before written references in relation to previous care employment had been acquired. This put people at risk of receiving care from someone who may not be of good character.

We also found that staff training arrangements, in respect of safeguarding adults, emergency first aid, and induction of new staff, did not provide appropriate support to enable them to deliver care to people safely and to an appropriate standard.