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Inspection Summary


Overall summary & rating

Good

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.

Inspection areas

Safe

Good

Updated 11 January 2018

The service was safe.

People were protected from abuse because staff knew how to recognise and report it.

Risks were assessed and actions taken to mitigate them.

Staffing levels were sufficient to meet people’s emotional, physical and social needs.

Recruitment practice was well managed. The provider was able to demonstrate staff were suitable to work with vulnerable people.

Medicines management was safe.

Effective

Good

Updated 11 January 2018

The service was effective.

People were cared for by staff with the knowledge and skills required to meet people’s needs. Staff had regular training and received support through regular supervision and appraisals.

People were supported in making their own decisions wherever possible. Staff understood their responsibilities in relation to the Mental Capacity Act (MCA) 2005 and demonstrated this in their practice.

People were supported to lead a healthy lifestyle with prompt access to healthcare services.

Caring

Good

Updated 11 January 2018

The service was caring.

Staff demonstrated kindness and compassion towards people in their daily care.

Positive relationships were developed and each person’s personal preferences and needs were respected.

The atmosphere was warm, friendly and relaxed.

Responsive

Good

Updated 11 January 2018

The service was responsive.

People received personalised care from staff who knew about each person’s life, personal interests and hobbies.

A varied programme of activities was on offer. People were encouraged to pursue their own interests and retain contacts in the community.

Well-led

Good

Updated 11 January 2018

The service was well led.

The registered manager worked closely with the provider alongside a cohesive team of committed and motivated staff.

She had established an open culture which promoted person centred care. The views of people, their families and staff were sought and taken into account in improving the service.

There were systems in place to monitor the quality of the service. A programme of changes and improvements in response to findings was planned and implemented.