Ryland Residential Home

Updated 31 January 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 3 inspectors 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.

Service and service type

Ryland Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ryland Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also reviewed information shared with us by the local authority. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people and 8 relatives. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 7 staff members. This included kitchen, housekeeping, and care staff. We spoke to an external professional visiting the service. We also spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We completed observations of people being supported by staff and the service environment. We reviewed a range of documentation including people’s care plans, medicine records, staff recruitment files, training records and manager audits.

Updated 31 January 2024

AAbout the service

Ryland Residential Home is a residential care home providing personal care for up to 17 people. The service provides support to older adults. At the time of our inspection there were 16 people using the service.

People’s experience of the service and what we found:

The provider failed to have sufficient systems and processes to assess, monitor and mitigate the health, safety and quality of the service. Their quality assurance systems failed to identify people were at risk of harm from lack of risk assessments, plans to mitigate risks and lack of adherence to policies and procedures.

People were at risk of infection and harm from a service which was unclean and required repair and refurbishment.

The provider, registered manager and staff did not understand their roles in safeguarding people. Incidents of alleged abuse were not recorded or reported to the local safeguarding authority. Medicines were not managed in line with best practice. Staffing levels were not safe and left people at risk of falls and social isolation.

People’s specialised diets were not followed or planned effectively. The provider did not work well with professional agencies to mitigate risk and improve outcomes. Staff had not received relevant training to support them to be competent in their roles.

Care was not person-centred and was task oriented. People were not always treated respectfully or with dignity. People did not receive personalised activities and were left at risk of social isolation.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not support people to live in the least restrictive way possible.

People were supported to have contact and visits from relatives. Staff recruitment was safe. Some staff showed a caring and compassionate attitude. Relatives told us they felt the service was safe, person-centred, and meals were of good quality. Relatives felt the registered manager was friendly and approachable.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service under the previous provider was Good (published 17 November 2017).

Why we inspected

The inspection was prompted in part due to concerns received about medicines management, staffing levels and the environment. A decision was made for us to inspect and examine those risks. We made a decision to complete a comprehensive inspection due to the change of service provider since the last inspection.

Enforcement

We have identified breaches in relation to safety, safeguarding, person centred care, staffing and training.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.