Archived: Rievaulx House Care Centre

We found the following examples of good practice.

We were assured that this service met good infection prevention and control guidelines.

The home was clean and there were no malodours.

At the time of our inspection the home was allowing visitors. Risks of visiting professionals spreading infection were reduced. Visitors had their temperature taken and were asked about their health before entering the service. There was a decontamination procedure between visits.

Cleaning schedules were in place and touch points were being cleaned four times a day.

The provider had appropriate arrangements to test people and staff for COVID- 19 and was following government guidance on testing.

Staff were trained on how to keep people safe from the risk of infection. All staff wore their PPE in line with government guidance.

People admitted to the service were supported following government guidelines on managing new admissions during the COVID-19 pandemic.

The home's infection prevention and control policy was up to date and in line with current guidance.

Further information is in the detailed findings below

Rievaulx House Care Centre is registered to provide accommodation for people who require personal care and people living with dementia. During our inspection, there were 49 people living in the home. At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service Good.

The provider had robust systems and procedures in place to keep people safe. There was a whistleblowing policy in place and staff knew how to raise concerns should this be required. Risk assessments had been completed and reviewed regularly. Accidents and incidents were managed effectively and action taken to prevent future risks.

Medicines were managed effectively and they were stored correctly in line with the provider's policy. People told us they received their medicines as prescribed and said regular reviews meant their needs were met and health had improved.

Staffing levels were sufficient to meet people's needs and robust recruitment processes were in place to ensure people were of suitable character. Staff carried out training to ensure they had adequate skills and knowledge to meet people's needs. Staff were supported with regular supervisions and appraisals.

Health and safety checks were completed regularly and staff followed the provider’s procedures for infection control. However, we did observe staff not wearing aprons at lunch. Fire evacuations were carried out to ensure people could be supported in an event of a fire.

Staff were aware of people's nutritional needs and we found people were offered choices about their food preferences. Some people told us the quality of food could be improved. People also received appropriate support from staff to maintain their health and wellbeing.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People told us staff were kind and caring. We saw people were encouraged to remain as independent as possible and people told us staff resected their need for privacy. The provider had an equality and diversity policy in place, which staff followed. Care plans included people’s preferences, likes and dislikes so their individual needs could be met.

Initial assessments were carried out before people moved into the home to ensure their needs could be met. Care plans were person-centred and reviewed regularly or when people's needs changed. People accessing the service were supported to participate in activities, to prevent social isolation. The provider had recently employed a mini bus driver, which meant people could do activities outside of the local area and facilitated further choice.

Staff told us the registered manager was supportive and approachable. Some people living in the home did not know the registered manager but all people said they would feel confident to raise any issues. Complaints were managed and the provider had responded to people in a timely manner to address any concerns raised. The provider also received compliments from people and their relatives.

Surveys were carried out to gather people and their relatives view. This meant actions could be taken to address issues to drive improvement. Meetings were carried out with people living in the home, staff and management to ensure communication was open and people kept informed of any provider changes. The provider had a home improvement plan in place to address improvements that were required. The registered manager had also taken action to drive improvement within the home; one action included recruitment of new staff to ensure consistency of care being provided.

We found some records had not been completed and did not follow the providers documentation systems. We made a recommendation that all documentation used within the home must be recorded accurately.

Rievaulx House provides accommodation and personal care for up to 50 people. The home is located in a residential area close to the city of Leeds. Accommodation is in single rooms which all have en-suite facilities. At the time of inspection 43 people were living there. The service did not have a registered manager at the time of our inspection. An acting manager was in place until the newly appointed manager took up their position. 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.

We found people were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. Robust recruitment procedures were in place to make sure suitable staff worked with people who used the service. Staff received the training and support required to meet people’s needs.

There was opportunity for people to be involved in activities within the home. The home did not at the time of inspection have an activity coordinator in the home. The acting manager told us they were recruiting for someone due to the previous activity coordinator leaving the service only a few weeks before the inspection.

Staff understood people's needs and provided care and support accordingly. Staff were aware and knew how to respect people’s privacy and dignity.

Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect people they supported. People told us they felt safe with staff and we saw there were systems and processes in place to protect people from the risk of harm. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines safely.

The acting manager and staff understood the requirements of the Mental Capacity Act 2005. The care plans we looked at contained relevant mental capacity assessments where appropriate.

Care plans were detailed and provided an accurate description of people's care and support needs. People were supported with their nutritional and hydration needs and had access to a range of healthcare services

There was an effective system in place to respond to complaints and concerns. Effective systems were in place which ensured people received safe quality care. People had opportunity to comment on the quality of service and influence service delivery.

Below is a summary of what we found. As one visit was undertaken to collect information from the manager only, the summary is based on our observations during two inspection visits, speaking with people who used the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The provider monitored the environment and ensured maintenance and servicing of equipment was completed as required.

Staff employed to work at the home were suitable and had the necessary skills and experience. Although people who used the service and staff members told us there were enough staff on duty to ensure people's safety there were not always sufficient staff to meet people's needs in a timely way.

Although nobody living at the service required a Deprivation of Liberty Safeguards (DoLS) authorisation staff were aware of DoLS and the requirements of the Mental Capacity Act 2005 (MCA).

Is the service effective?

People told us they were generally happy with the care they received and their needs had been met but this was sometimes impacted by a lack of staff.

From speaking with staff it was evident they had a good knowledge of the people they supported.

Is the service caring?

People were supported by kind and attentive staff who knew them well and spoke positively about people as individuals. Staff were very knowledgeable about people's needs. One person who used the service told us, 'The staff are marvellous, very helpful.'

We spoke with a health professional who told us they visited the service on a regular basis. They told us they felt all staff were, 'Very caring and genuinely compassionate.'

Is the service responsive?

People's needs were assessed before they were provided with support by the service. People's needs were regularly reviewed and their health monitored. Where necessary referrals were made to other health professionals.

A visiting health professional told us staff were responsive when supporting people with their end of life care needs.

People who used the service told us they felt their suggestions were considered when making improvements to the service.

Is the service well-led?

Staff had a good understanding of the ethos of the service and quality assurance processes were in place. People told us they felt involved in the running of the service and felt their opinions mattered.

Staff were clear about their roles and responsibilities. Records showed the management team worked with all staff and people who used the service to maintain standards and secure improvement.

Care records were individualised detailed and contained all the information staff required to ensure people were supported to meet their needs in the way they preferred. We were told by people who used the service and staff that people could choose when they got up or went to bed.

The catering manager told us the menu was planned around people's choices. One person said 'We're having Lasagne today, because we asked the chef for it.' On arrival at the home at 6.10am we checked what food was available out of kitchen hours. We found supplies of porridge, milk, bread, butter, jam, marmalade and biscuits.

The provider had policies and procedures in place for safeguarding adults and whistleblowing. Staff had a clear understanding of the different types of abuse and who they would report concerns to.

We looked at the staff rotas for the last two weeks. We found there were four occasions when four staff were on duty at night. The manager explained there had been several episodes of staff sickness. Following the inspection we met with the registered manager and the operations manager, who agreed that they would ensure, where feasibly practicable, that four night staff would be on duty.

We spoke to three people who used the service, three relatives or visitors, four staff, the registered manager, deputy manager and following the inspection the operations manager and catering manager.

People told us staff were professional in their approach to providing care. People said they can generally make decisions and choices about the care they receive. They also told us they were very happy with the care and support provided by staff and staff were kind, considerate, caring and showed them respect. People who used the service said they would have no hesitation in talking to the manager or staff if they wanted to talk about their and/or a relative's care or any concerns. All the people who use the service and their relatives were complimentary about the service with such comments as:

'I can't say there's anything wrong with living here'

'Staff are wonderful and respectful'

'I can get up when I want and go to bed when I want'

'My carers are excellent, nothing's too much trouble'

'Food's nice and the home is spotlessly clean'

'I know [my relative] is secure, safe and happy here'