Ridgeway Residential Home

Updated 11 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection took place on 4 and 6 April 2017 and was unannounced on the first day. The inspection team consisted of one adult social care inspector 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. They had specific expertise in care of the elderly and dementia care.

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 reviewed information from the PIR, previous inspection reports, and any notifications received. A notification is information about important events, which the provider is required to tell us about by law.

As part of the inspection, we spoke with the registered manager, the registered provider, five care staff, the cook, three visitors, and seven people who were using the service. We looked at a range of records including four care plans in depth and three in part to check specific aspects of care, three recruitment files, staff duty rosters covering a three-week period, staff training records, medicine administration records (MAR) and records relating to the management of the service, including accident and incident records. We also looked at quality monitoring information such as health and safety checks, cleaning schedules and audits.

We contacted four health and social care professionals with knowledge of the service and received a response from three. We undertook formal observation of a medicines administration round and informal observation of activities sessions, mealtimes, a staff handover meeting and a

“coffee chat” involving the registered manager and three staff.

Updated 11 January 2018

The inspection took place on 4 and 6 April 2017 and was unannounced on the first day. Ridgeway Residential Home provides personal care for up to 16 people over retirement age who may be living with dementia or may have a physical disability. It does not provide nursing care. At the time of this inspection there were 12 people living at the service.

We last inspected the service on 18 December 2015 and 5 January 2016 when it was rated as Requires Improvement overall. At that inspection, we found four breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to staff recruitment, people’s capacity to give consent, meeting people’s social needs and having effective quality assurance and record-keeping systems. The provider had produced an action plan to ensure improvements were made and sustained. At this inspection, we found that improvements had been made across all four areas with all breaches met.

Since the time of the last inspection, a new registered manager had been appointed. They were present on both days of the inspection. 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.

The registered manager had high aspirations for improving the service, led by example and was supported by a committed provider. A priority had been set of improving quality assurance systems. Feedback was regularly gained from staff, people using the service and family members. Concerns and complaints were investigated promptly and thoroughly, with learning identified and changes implemented.

Everyone we spoke with recognised that the new manager had effected a significant culture change at the service to promote person-centred, rather than task centred care. This was reflected in a positive and welcoming atmosphere, a sense of team commitment and positive energy within the whole staff group.

People using the service and their family members said they felt safe and that staff supported people in a kind, caring and respectful way. Comments included “I think the quality of care here is very good. I have never heard anyone raise their voice.” And “I’m quite impressed with the way they look after people here.”

People were protected from potential abuse and harm by staff who understood how to identify safeguarding concerns and what action to take. Everyone living at the service had risks relating to their care assessed, recorded and measures put in place to mitigate risks. Care plans were regularly reviewed and amended as people’s needs changed. Medicines were well managed and stored safely.

Staff levels had increased significantly since the time of the previous inspection when a recommendation had been made. They were now sufficient to meet people’s needs. The benefit of social activities had been recognised and was now met with the appointment of an activities coordinator and a visiting physiotherapist. People were able to work in the garden utilising accessible raised beds. The garden had won two national awards from the Britain in Bloom organisation.

Staff described a new feeling of team working and mutual support and were proactive in suggesting changes. They demonstrated commitment and willingness to learn in order to improve the service. The accommodation provided was well furnished and maintained to a good standard with a variety of social areas. The atmosphere in the home was relaxed and happy, with daily activities giving an obvious sense of purpose and contentment. The provider had made changes to some aspects of the building to improve safety with more planned.

Staff understood their responsibilities in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, family members and health and social care professionals were involved in “best interest” decision-making.

People were offered a varied and balanced diet and those with special needs relating to nutrition were well supported and closely monitored. Health care needs were met by access to professionals as required. Professionals visiting the service confirmed that staff were providing good quality care and acted on their health care recommendations.