Archived: Ridgeway Lodge Care Home

Ridgeway Lodge is a residential care home in Dunstable, providing accommodation and support for up to sixty-one older people. At the time of our inspection there were sixty people living at the home, some of whom were living with dementia.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 found that people’s medicines were not managed safely, and the staffing levels were not adequate to meet people’s needs. Some moving and handling practices carried out within the service were unsafe and had not been risk assessed. This meant that people were not always safe at the service.

The provider had a robust recruitment policy in place and staff had been trained in safeguarding people and were aware of the reporting procedures in relation to concerns they may have.

People, their relatives and staff did not feel listened to by the management team. In addition, the provider’s quality monitoring system was not effective in identifying and addressing shortfalls in the service. Improvements were also required in the management of people’s care records.

During this inspection we identified that there were breaches of a number of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to the safe care and treatment of people, staffing and good governance. You can see what action we told the provider to take at the back of the full version of the report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Ridgeway Lodge is a residential care home in Dunstable, providing accommodation and support for up to sixty-one older people. At the time of our inspection there were sixty people living at the home, some of whom were living with dementia.

The home did not have a registered manager in post from December 2015 because they had moved to another location within the BUPA brand. This was a breach of the condition of registration that the location must have a Registered Manager. As a consequence of this the service has not been able to sustain the quality of care delivery or continue to make improvements seen at the last inspection on 23 February 2015. A new manager had been appointed and they were going through the application process to become the registered manager of the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People or their relatives had been involved in determining the way in which people’s care was to be delivered, and their consent was sought before care was provided. However, the requirements of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards were not always met. We found that some people had been assessed to lack the mental capacity to make certain decisions, but the provider did not carry out best interest decisions meetings in line with the MCA.

People were safe living at the home as the provider had effective systems in place to protect them from avoidable harm. Staff were trained in safeguarding people and they understood the process they needed to follow, if there were concerns about people’s safety. People’s care needs had been identified and care plans that gave staff guidance on how best to support them put into place. There were risk assessments in place for each person and for the home environment, in order to minimise and manage risk effectively. People’s medicines were administered safely however, we found gaps in one person’s medicines administration records. They were supported to access other healthcare services to maintain their health and well-being.

The provider had a recruitment policy in place to ensure staff that were employed to the service were suitable to work with people who lived there. There was a sufficient number of skilled and qualified staff to meet people’s care needs. They were trained in areas that were relevant to their role, and they were supported by way of regular supervisions and appraisals.

Staff demonstrated a kind and caring attitude towards people and provided care that was consistent and person-centred. The home had a pleasant atmosphere where people’s friends and relatives were encouraged to visit and spend time with them. People were treated with dignity and respect and had their right to privacy observed. Their dietary needs were identified and the service offered them a choice of food and drink based on their individual preferences.

The provider had a formal system for handling complaints and concerns. They encouraged feedback from people and acted on this to improve the quality of the service. They also had an effective quality monitoring process in place to ensure they were meeting the required standards of care.

• Respecting and involving the people who use the service

• Care and welfare of people who use the service

• Safeguarding vulnerable people who use the service

• Staffing

• Complaints

• Records

During our visit one person said “I love it here. I am very well looked after. I prefer to stay in my room even to take my meals and no one makes a fuss about that.” Everyone we spoke with told us they were happy with the care provided and staff were kind to them.People were seen to be wearing the aids needed, for example hearing aids and clean glasses and pressure relieving equipment. All eight care files that we looked at were clear and contained detailed information about people and how to meet their needs.

People told us they were happy living in the home and thought the staff looked after them well. One person told us “I think it’s lovely here.” We observed a distressed resident being supported so that others around them were safeguarded against the risk of harm, thereby safeguarding all involved.

One person told us the consistency of increased staffing numbers had a positive impact and so there was “More time to give to the residents.” We looked at the complaints file, and found that all concerns, however minor, were clearly logged, investigated and the outcome was recorded as well as the complainant’s response to the outcome.

We spoke with 14 of the people who used the service. We spoke with 18 members of staff during our visit and one visiting GP. One person told us, “I’m as happy as I can be.” Of the eight family members we spoke with, seven told us they were unhappy with the level of attention and care they or their family member were receiving, due to what they describe as the lack of staff on duty. Residents and relatives told us the majority of staff were “lovely”, “kind and caring”, but “there was never enough staff”. People told us that they had raised concerns, but felt there was no positive change. One relative told us; “We are fed up with keep saying the same things.”

Relatives told us they felt it necessary to visit regularly throughout the day to ensure their family member was appropriately washed, dressed and received meals, by providing most care themselves: we observed this during our visits.

Systems in place were ineffective for receiving, handling and responding appropriately to complaints or concerns. The records we looked at were not kept securely and not always up to date. As a result care was not being delivered at the level required.