Archived: Ramsgate Care Centre

Updated 28 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 2 and 3 August 2016 and was unannounced. The inspection team consisted of two inspectors and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications received by the Care Quality Commission which a provider is required to send us by law. Notifications are information we receive from the service when significant events happen, like a death or a serious injury.

During our inspection we spoke with nine people living at the service, four people’s relatives and friends, the registered manager, the area manager and staff. We visited some people’s bedrooms, with their permission; we looked at care records and associated risk assessments for six people. We looked at management records including staff recruitment, training and support records, health and safety checks for the building, and staff meeting minutes. We observed the care and support people received. We looked at their medicines records and observed people receiving their medicines.

We last inspected Ramsgate Care Centre in April 2015. We rated the service Requires Improvement overall. We asked the provider to take action to improve records and staffing at the service.

Updated 28 September 2016

This inspection was carried out on 2 and 3 August 2016 and was unannounced.

Ramsgate Care Centre provides accommodation and personal care for up to 42 older people, some of whom may be living with dementia. The service is a large purpose built property, with accommodation arranged over two floors. A lift is available to assist people to get to the upper floor. The service has 40 single bedrooms and one double bedroom that people could choose to share, this is usually used as a single bedroom. All bedrooms had en-suite toilets. There were 40 people living at the service at the time of our inspection.

A registered manager was leading the service, supported by a deputy manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection we found there were not always enough staff to meet people’s needs. The registered manager had taken action to make sure they were always sufficient staff on duty to provide people’s care when they wanted it.

At our last inspection we found that records of people’s medicines were not always accurate. At this inspection we found action had been taken to correct this but other medicines records were not accurate. The registered manager took action to make sure that all records were correct during the inspection. People received the medicines they needed to keep them as healthy as possible.

People told us they liked the food at the service but the menu was ‘boring’ with meals repeated every week. Meals were balanced and included fruit and vegetables. All meals were homemade. People were offered a choice of food to help keep them as healthy as possible.

People had been asked for their views of the service. They had told the registered manager that the menu was not varied enough and they would like to go out on day trips. Their views had not been acted on. Checks had been completed on all areas of the service. These had not identified the shortfalls in the service we found at our inspection.

People told us they did not always have enough to do. Some people were not supported to fully take part in their chosen activities. We have made a recommendation about activities.

Assessments of risks to people were not always accurate. Detailed guidance had not been consistently provided to staff about how to support people to manage risks. However, staff provided the care people needed to keep them safe, in the way they preferred. Action was taken to identify changes in people’s health, including regular health checks.

People were supported to make decisions and choices. When people could not make a particular decision, staff made decisions in people’s best interests with people who knew them well. The requirements of the Mental Capacity Act 2005 (MCA) had been met.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). Risk to people had been identified and arrangements were in place to apply to the supervisory body for a DoLS authorisation when necessary.

People and their relatives told us staff were kind and caring and treated them with dignity and respect. Staff knew the signs of possible abuse and were confident to raise concerns they had with the registered manager or the local authority safeguarding team. When concerns were raised action had been taken promptly to keep people as safe as possible. Plans were in place to keep people safe in an emergency.

People and their representatives were confident to raise concerns and complaints they had about the service. People were satisfied with the response they received. Systems were in operation to regularly assess the quality of the service.

The registered manager provided leadership to the staff and was supported by a deputy manager and area manager. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs. They were motivated and felt supported. Staff told us the registered manager was approachable.

The provider had a ‘philosophy of care’ which was shared by the registered manager and staff. This included the values of independence and ‘person centred’ support. Staff were supported to provide good quality care and support. They had completed the training they needed to provide safe and effective care to people. Most staff held recognised qualifications in care.

Checks were completed to make sure staff were honest, trustworthy and reliable. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.