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The Rylands Nursing and Residential Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 22 June 2018

The Rylands Nursing and Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. It is registered to support up to 44 people. At the time of our inspection there were 38 people using the service.

At the last inspection in September 2016, the service was rated Good. At this inspection we found that the service was rated Requires Improvement overall. The key questions of ‘is the service safe?’ and ‘is the service well-led?’ were rated as Requires Improvement. Other key questions were rated as Good.

Sometimes there were not always enough staff. The registered manager was attempting to get more staff.

There was sometimes insufficient guidance about ‘as and when required’ medicines which meant people may not always receive their medicine at the right time.

We saw risks were assessed and planned for to keep people safe, but occasionally some plans were not always updated when people’s needs had changed.

Systems in place had not always identified some concerns.

People were protected from avoidable harm by suitably recruited staff who understood their responsibilities and could recognise the potential signs of abuse.

Infection control measures were in place and the building was being appropriately maintained and checked on to keep people safe.

People were supported by appropriately trained staff who were supported by the management team. We have recommended staff continue to receive updated training so all necessary training is up to date. People had access to suitable food and drinks and were given a choice. People also had access to other health professionals to help them remain healthy.

People were treated with dignity and respect, could make decisions about their support and were encouraged to remain independent where possible.

Staff knew people well and people had plans in place which included details of they liked to be supported. Activities were available for people to partake in, both on an organised group manner and also individually. There was a system in place to record and monitor complaints. The service had considered people’s end of life needs.

It was felt the registered manager was approachable and they were supported by the provider. People and staff were encouraged to offer feedback.

Inspection areas

Safe

Requires improvement

Updated 22 June 2018

The service was not always safe.

People did not always have support from appropriately deployed staff.

There was not always sufficient information regarding medicines.

People had risks to their safety assessed and planned for but some plans were not always updated.

Lessons had been learned when things had gone wrong.

Staff understood their responsibilities about safeguarding and protecting people from abuse.

Infection control was in place and the home was clean and free of malodours. The building was appropriately maintained.

Effective

Good

Updated 22 June 2018

Staff were working within the principles of the Mental Capacity Act.

The service assessed whether they would be able to support people prior to them joining the service.

Staff had sufficient training to support people however we recommend staff continue to receive updated training so all necessary training is up to date.

People were supported to have a choice of food and drinks appropriate for their needs.

People had access to other health professionals to keep them healthy.

Caring

Good

Updated 22 June 2018

The service was caring.

People were treated with dignity and respect.

People were supported to make decisions about their care and to be independent where possible.

Responsive

Good

Updated 22 June 2018

The service was responsive.

Staff knew people’s needs and people had relevant plans in place.

People were supported to partake in activities.

Complaints were dealt with appropriately and a policy was in place.

The service had considered people’s end of life needs.

Well-led

Requires improvement

Updated 22 June 2018

The service was not always well-led.

Systems were in place however they did not always identify issues.

People were asked for their opinion about their care.

Staff felt supported and there was positive feedback about the registered manager.