Ruddington Manor Care Centre

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

People were safe from the risk of harm and medicines were stored and administered safely. Significant improvements had been made in relation to diabetic care. Monitoring of people’s blood sugar levels was done in a timely manner and in line with personalised recommendations from medical professionals. The provider had explored different health care pathways for people such has remote scanning of blood sugars using technology to reduce the need for manual testing.

The provider had taken action to mitigate risks associated with personal emergency evacuation plans (PEEPs) meaning staff had clear guidance on how to support people to leave the premises in an emergency. People’s health needs had been reviewed and where people required extra support due to mobility or communication these had been identified and recorded.

People told us they felt safe living at the home and that staff respected their privacy and dignity whilst helping them to remain as independent as possible. People and relatives told us staff were, “Kind and caring” and “Willing to go the extra mile”.

We saw evidence of improved auditing which identified issues and action plans that addressed and monitored progress and improvements. The registered manager held meeting with staff daily to ensure actions were communicated and staff had opportunity to feedback concerns or suggestions.

The provider was undertaking a comprehensive training programme to enhanced staff knowledge in certain areas to facilitate ‘Champions’ in areas such as safeguarding, health and safety and infection prevention control. Staff told us they felt the action taken by the registered manager had improved the quality of care within the home and felt their roles and contributions were valued and rewarded.

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.

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 this service was requires improvement (published 15 May 2023).

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 focused inspection of this service on 11 April 2023. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe and effective care and treatment, and well led aspects of the service.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. We checked whether the Warning Notice we previously served, regarding a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, had been met. 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ruddington Manor Care Centre on our website at www.cqc.org.uk.

Follow up

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

Ruddington Manor Care Centre is a care home registered to provide personal and nursing care, including to those living with dementia. The service can support up to 66 people, at the time of our inspection 51 people were living at the home. Ruddington Manor Care Centre is purpose built and split over 3 floors with communal areas on each floor and outdoor communal areas surrounding the building.

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

People did not always receive personalised care and people's care plans did not always contain relevant up to date information. People and their relatives told us they had not been included in the planning or reviews of their care.

People who required medicines for diabetes and ‘as required’ (PRN) medicines did not always receive their medicines safely. People were at risk of receiving their medicines inappropriately and against prescribed timings.

Whilst people told us they felt safe, there had been limited action to assess, monitor or improve care planning and risks. Identifying and reporting of risks were not comprehensive and completed inconsistently. Where issues had been highlighted action was slow to be taken.

Governance and audit processes had failed to identify issues with care planning and risk assessments. Personal emergency evacuation plans contained inaccurate information which placed people at risk of not being evacuated timely or safely in an emergency.

People were not always supported to have maximum choice and control of their lives; however, staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Consent to care was not clearly documented within care plans and was inconsistent. However, people told us staff treated them with dignity and requested consent prior to care being delivered.

The provider was open and transparent throughout the inspection and where issues where highlighted they worked immediately to mitigate risks and improve care plans and care delivery for people living at the home.

Safeguarding systems and processes were in place and people were protected from the risk of abuse, harm and neglect. Staff were recruited safely. People and relatives told us they were happy with the care provided and felt well supported by caring staff.

The home was exceptionally clean and well maintained throughout. Staff were knowledgeable about infection prevention control and policies were in place to support and guide staff.

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 22 August 2019).

Why we inspected

We received concerns in relation to the management of medicines, people’s nursing care needs and care planning. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, and well-led sections of this full report.

The provider did take immediate steps to mitigate the risks found on inspection and ensure people were safe from harm.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ruddington Manor Care Centre on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment and the governance of the service, specifically in relation to Diabetic care planning and personal emergency evacuation plans at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Ruddington Manor is a residential care home providing personal and nursing care for up to 66 people. At the time of our inspection 39 people were being supported to live there. The accommodation is across three floors; each floor has two lounges and a dining room.

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

People were kept safe. The home was clean and in a good state of repair. A variety of checks were in place to ensure the home remained a safe environment. Checks were made into the background and previous conduct of staff before they were offered employment. People’s medicines were managed well ensuring they received their medicines as they had been prescribed.

Support records reflected people’s needs. Any choices or cultural requirements of the person were included in their records and staff supported people in the way they chose. Staff were well trained and we saw them supporting people appropriately. People were well fed and encouraged to keep well hydrated.

We observed staff supporting people in caring and patient ways. Staff and people in the home knew each other well. Staff communicated with people appropriately taking into account any difficulties the person may have in understanding them. People were encouraged to be as independent as possible.

People were supported as individuals. A wide range of activities were on offer both in the home and the local community for people to take part in. Staff made extra efforts to arrange activities that were interesting or culturally important to people. Complaints were used to identify learning to improve the service.

The culture in the home was friendly and open. People were encouraged to speak up If they had any concerns or ideas to improve the service. The management of the home sought expertise from a variety of places to improve outcomes for people.

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.

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

Rating at last inspection

This service was registered with us on 10 July 2018 and this was the first inspection.

Why we inspected

This was a planned inspection based on the date of the service’s registration.

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.