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Archived: Rydan Lodge Residential Home

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Inspection report

Date of Inspection: 17, 18, 22 October 2013
Date of Publication: 15 March 2014
Inspection Report published 15 March 2014 PDF | 118.17 KB

Suitable management of services is provided (outcome 24)

Not met this standard

We checked that people who use this service

  • Have their needs met because it is managed by an appropriate person.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 17 October 2013, 18 October 2013 and 22 October 2013, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, reviewed information sent to us by commissioners of services and reviewed information sent to us by local groups of people in the community or voluntary sector. We talked with commissioners of services and talked with other authorities.

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

Our judgement

The registered person was not fit manage the carrying on of the regulated activity as they did not have the skills to do so.

Reasons for our judgement

Due to the number and range of concerns raised with us and our findings during our inspection visits we looked at this outcome. We had serious concerns about whether the care home and domiciliary services were well led.

We found that the registered manager did not have the necessary skills to manage the carrying on of these services. We found that poor management had a serious impact on some people who used the service.

The registered manager was experienced and had worked in the care sector for many years. They had a level 4 qualification in Health and Social Care. However, they did not demonstrate basic management skills in their day to day running of the care home. Although they were also the registered manager for the domiciliary service they had delegated complete responsibility for that service to a manager and did not maintain effective oversight of that service. They told us "I don't have anything to do with that side". We reminded the registered manager of their responsibilities for oversight of the service. We were told "I can't do both anymore, I can't be here every hour of the day".

We found that people at the home had been exposed to an on-going risk of abuse due to a lack of action by the registered manager. Care workers told us they had raised concerns about abuse on a number of occasions with the registered manager and that no action was taken. A staff memorandum from the registered manager in April 2013 recorded that they had been made aware of the concern and that they understood that this amounted to abuse. We asked why no action had been taken in respect of this other than issuing a memorandum to say it must stop. We were told by the registered manager that, "It had only been raised by one staff member, I did not think there was much to do about it". The manager said that the situation had been monitored, but there was no written record of this. No action was taken regarding the concerns of abuse until September 2013. We were told by care workers that the registered manager only took action when care workers said that they would report the matter to external authorities. The registered manager said that five staff members had complained about the abuse by that time which was the reason they took action then.

We saw records which showed that the actions which were taken in September were not robust. We discussed the records with the registered manager. We asked if they thought the action recorded in those records had managed the risk effectively and had protected people from further risk. They replied, "Maybe not".

We found that the manager did not have skills or up to date knowledge to manage the service. They were not familiar with their own policies and did not put them into practice. They required assistance to locate policies including the safeguarding policy. Under a heading of "Action to prevent abuse" the policy recorded, "Management undertakes to take such criticism (allegations of abuse) seriously, to investigate all of the points made and to protect staff that speak out in this way." This policy had not been put into practice.

We asked why the issue of abuse had not been referred to the local adult safeguarding team. The registered manager told us, "I did not know I had to". We found that the manager of the domiciliary service had similar limited knowledge of their responsibilities to report and escalate concerns. This meant that the management team in both services did not have the necessary skills to knowledge to protect people from the risks of abuse.

We looked at the quality assurance skills demonstrated by the manager in the day to day running of the home. We saw from a number of staff memorandums that the same issues of poor practice had been raised over a number of months at night time, with regard to staff sleeping outside of break times, issues of cleaning standards and incorrect care. We asked the registered manager how many night time spot checks they had undertaken. They said