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Archived: Ryedale Court Nursing Home

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Inspection report

Date of Inspection: 14 January 2011
Date of Publication: 2 June 2011
Inspection Report published 2 June 2011 PDF

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People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

Our judgement

Although some very positive strengths were found with the planning and delivery of personal and health care, the service needs to demonstrate a more individualised approach to care planning and Life History work.

User experience

“I enjoy the chat (with staff)”

“I think that my brother’s needs are being met perfectly”

“Very happy with mum’s care”

“Staff should be made aware of his background and interests to establish better communication”

We spoke to people about their care, although the vast majority of the people were unable to comment on whether their more complex needs were being met. People stated that they were offered choices, such as their favoured routine (for example, a bath or a shower, and when to get up and when to go to bed). Discussions with visitors confirmed that the service identified and strived to meet individual preferences.

Other evidence

We read several of the care plans, speaking to these people (and/or their families) where possible. The care plans we looked at were randomly selected but chosen from units where people have different needs; for example, people with dementia and people with short-term and long-term physical health care needs.

We found that there were some good examples of care planning for people with health care issues, such as people with diabetes and pressure sores. We had previously spoken to a specialist National Health Service nurse that had recently visited the care home to assess the needs of a couple of people with pressure sores. We were informed that the staff had well managed the holistic care of these people.

We found that the service had adopted some risk assessment tools that could be streamlined. For example, staff were assessing the susceptibility of people to developing pressure sores using two different nursing models. We felt that this created extra work for staff and could potentially lead to some confusion when relaying information to external medical and nursing professionals. It was noted that sometimes abbreviations were used, without an explanation of what it meant, such as TVN (Tissue Viability Nurse). This would make it difficult for people and their representatives to be more actively involved in planning and reviewing care.

We spoke to the manager about the need for the care plans to be written in a more concise way that demonstrated a more individualised understanding of a person’s needs. For example, the care plans for supporting people with their washing and dressing stated actions that would form part of the service’s safety policies (such as checking the temperature of bath water) but did not specify if a person liked to be assisted to use a particular aftershave/perfume or have items of make-up applied. Care plans did specify if a person had a preference in regard to the gender of the staff providing personal care.

Another care plan identified that a person that sometimes displayed challenging behaviour responded well to having the television in their room switched on as a distraction. Although this type of recording was appropriate, an individualised approach might state if they prefer news, sports or other programmes.

We also found that there was an inconsistent approach to creating individualised Life Histories, which are used to understand and respond to the needs of people with dementia. For example, a person provided us with an interesting account of their earlier life including memories of the Second World War but this had not been recorded in their individualised Life History. Care plans appropriately stated the need to ‘try and stimulate short and long-term history’; hence there is a recognised need to gather as much information as possible about a person’s life.

We met with the Activities Organiser and looked at the records regarding social activities and entertainment. Through speaking to the Activities Organiser, people living at the care home and their families, we found that a varied programme was offered. This included bingo, soft ball games, armchair exercises, arts and crafts, board games, film sessions and cream teas. Entertainers regularly visited the service and people were offered opportunities for local trips.