24 February 2016
During a routine inspection
Rydal is a residential care home with nursing based in the Lascelles area of Darlington, County Durham. The home provides personal care and nursing care to older people and people with dementia type conditions. It is situated close to the town centre, close to local amenities and transport links. The service was registered for 60 people and at the time of our inspection there were 41 people using the service.
The home had a registered manager. 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.
We spoke with a range of different team members; care, nursing, kitchen, maintenance, laundry, activities co-ordinator and student nurses who told us they felt well supported and that the registered manager was supportive and approachable. Throughout the day we saw that people who used the service and staff were comfortable, relaxed and had a positive rapport with the registered manager and with each other. The atmosphere was welcoming, and relaxed. We saw that staff interacted with each other and the people who used the service in a friendly, supportive, positive manner.
From looking at people’s detailed care plans we saw they were in two parts. One held personal information and detailed accounts of care needs and a record of daily activity. The second file in addition to the care plan files was a person centred file that was stored in people’s bedrooms and these included a ‘one page profile’ that made good use of pictures, personal history and described individuals likes, dislikes, care and support needs. Both were regularly reviewed and updated by the care staff and the registered manager.
Individual care plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary, for example: their GP, optician or chiropodist.
Our observations during the inspection showed us that people who used the service were supported by sufficient numbers of staff to meet their individual needs and wishes.
When we looked at the staff training records they showed us staff were supported and able to maintain and develop their skills through training and development opportunities were accessible at this service.
The staff we spoke with confirmed they attended a range of training opportunities but not in dementia awareness. These types of specific courses help to raise awareness and meet the needs of the people who use the service and those living with dementia.
We saw that the physical environment throughout the home was not dementia friendly and did not always reflect best practice in dementia care or meet the standards set out in national guidelines.
They told us they had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their care practice and identify further mandatory and vocational training needs. We also viewed records that showed us there were robust recruitment processes in place.
We observed how the service administered medicines and how they did this safely. We looked at how records were kept and spoke with the nursing staff about how this was carried out and how senior staff was trained to administer medicine and we found that the medicine administering process was safe.
People were encouraged to participate in activities that were organised, including, outings and regular entertainers. We saw staff spending their time positively engaging with people as a group and on a one to one basis in activities. We saw evidence that people were not only being supported to go out and be active in their local community, but were also valued members of the local community and helped the local school to manage their vegetable plot.
We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered a varied selection of drinks and fresh homemade snacks. The daily menu that we saw offered choices and it was not an issue if people wanted something different.
We saw a complaints and compliments procedure was in place. This provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. The compliments that we looked at were complimentary to the care staff and the service as whole. People also had access to advocacy when we inspected and there were services promoted if needed.
We found an effective quality assurance survey took place regularly and we looked at the results. The service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found. We found people who used the service and their representatives were regularly asked for their views at meetings.