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Rydal House Requires improvement

Reports


Inspection carried out on 16 October 2019

During a routine inspection

About the service

Rydal House provides accommodation and personal care for people with a learning disability, mental health needs and/or autism. The service can support up to eight people and at the time of our inspection seven people were living at Rydal House.

The service was bigger than most domestic style properties. It was registered for the support of up to 8 people. 7 people were using the service at the time of the inspection. This is larger than current best practice guidance detailed in Registering the Right Support. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people. The provider had started to work towards meeting best practice guidance and people were encouraged to increase their independence. The staff culture was changing, and they understood the importance of supporting people when they needed it, whilst prompting people to make their own choices.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not support this practice.

Changes had been made to improve the design and décor of the environment, however further improvements were still required.

The registered manager demonstrated a commitment to improving the service to enhance the quality of care people received. However, the provider did not have a full oversight of the service and this impacted on the registered manager’s ability to continually drive improvement.

The service had started to apply and was further developing the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were protected from the risk of abuse and harm and staff had received training to ensure they knew how to keep people safe. Medicines were managed in a safe way. Staff knew people well and supported people in line with their wishes and preferences.

Staff treated people with kindness and consideration and people were encouraged to become as independent as possible. People’s privacy and dignity was upheld.

There was a complaints policy in place and people living at Rydal were given opportunities to feedback about how the home was run. Care plans were personalised, and people had their end of life wishes recorded.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 10 May 2019) and there were two breaches of regulation. At this inspection we found some improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 3 April 2019

During a routine inspection

About the service:

Rydal House is a residential care home that was providing accommodation and personal care to seven people in the service. People had support needs such as having a learning disability and those on the autistic spectrum and those who need support with their mental health.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

Systems were not always effective or consistent at ensuring areas for improvement were identified or rectified promptly. People were not always supported in line with the Mental Capacity Act 2005 so their rights might not always be protected. The environment was not always enhanced when it had been identified that improvements were needed.

People were supported by a sufficient amount of safely-recruited staff. Risks were assessed and planned for and people were kept safe by staff who knew their needs and who understood their safeguarding responsibilities. Medicines were managed and administered safely. People were protected from the risk of cross infection and lessons were learned when errors had been identified.

Staff received training and support to be effective in supporting people. People had access to a range of other health professionals to keep them healthy. People enjoyed the food and had a choice.

Staff were kind and caring and people had a good relationship with them and each other. People were supported to be independent and relatives could visit whenever they wished. People were treated with dignity and respect.

People had personalised care which catered for their preferences. A range of activities and events were available for people to partake in. There was a complaints procedure in place and the registered manager was aware of their responsibility to respond to complaints. No one was receiving end of life care, but the service had previously worked to support people nearing the end of their life.

The registered manager and management team were well thought of by people, relatives and staff. They felt the registered manager was approachable and ran the service well. The previous rating was being displayed as required.

Rating at last inspection:

At the last inspection the service was rated Good (report published 20 August 2016).

Why we inspected:

This was a routine inspection planned on the last inspection rating.

Recommendations:

• We have recommended the complaint policy or procedure is in an accessible format for people who used the service.

Enforcement:

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Action we told the provider to take can be seen at the end of the full version of the report.

Follow up:

We will continue to monitor the service and check improvements have been made at our next inspection.

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

Inspection carried out on 19 July 2016

During a routine inspection

This inspection took place on 19 July 2016 and was unannounced.

Rydal House is a care home for people with learning disabilities or autism spectrum disorder. A maximum of eight people can use the service. At the time of our visit, eight people lived in the home.

The service had a registered manager. 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.

Staff understood safeguarding policies and procedures, and followed people’s individual risk assessments to ensure they minimised any identified risks to people’s health and social care. Checks were carried out prior to staff starting work at the service to reduce the risk of employing unsuitable staff. Staff received training to help them meet people’s needs effectively.

The provider understood the requirements of the Mental Capacity Act and Deprivation of Liberty safeguards and the service complied with these requirements. Medicines were administered safely to people, and people had good access to health care professionals when required.

There were enough staff to meet people’s needs. People enjoyed activities within the home, and enjoyed going out to the pub, cinema, undertaking sporting activities, and going on other day trips. They had also been supported to find employment.

People received care and support which was tailored to their individual needs. They enjoyed the food provided, and helped with meal planning, preparation and cooking.

Staff were motivated to work with people who lived at Rydal House. People and staff enjoyed good relationships with each other which were supportive, friendly, and caring.

The registered manager was open and accessible to both people and staff. There were sufficient informal and formal monitoring systems in place to ensure quality of service was maintained. People and relatives felt able to raise concerns.

Inspection carried out on 2 October 2013

During a routine inspection

During our inspection we spoke with four people who used the service, three care staff and the registered manager. People told us they were happy with their care. One person told us, �I like it here. I like my room and my friends�. Another person said, "I love all the staff, they help me a lot�.

People told us they could make choices about their care. We saw that people�s choices were respected and staff were responsive to people�s individual choices and needs.

We saw that staff understood people�s needs and people received support from staff in a caring, compassionate and professional manner. People were safe, because there were adequate numbers of staff available to meet people�s individual needs.

We saw that systems were in place to protect people from the risks associated with medicines.

The service was well led. The registered manager had effective systems in place to regularly assess and monitor the quality of the service provided.

Inspection carried out on 2, 8 November 2012

During a routine inspection

We carried out this inspection as part of our schedule of inspections to check on the care and welfare of people using this service. We also reviewed areas where improvements had been required following an inspection on the 6 April 2011. The inspection was unannounced, which meant that the registered provider and the staff did not know we were coming.

We spoke with four people using this service, four relatives and three members of staff. We also spoke with a visiting health care professional. People using the service told us that they like living in the home. One person said, �I�m happy here, I love being here with my friend�s�. A visiting health care professional told us how they were happy with the service. They said, �The staff here are very proactive and any recommendations I make are always followed�.

We saw that people were supported to make decisions and access the community. Appropriate risk management plans were in place to promote independence.

People using the service were protected from harm and were supported to live in an environment that met their needs. Systems were in place to support people to make a complaint should they wish to do so.

Staff had the required training to enable them to meet the needs of the people using the service.

During our inspection we identified that adequate systems were not in place to assess and monitor the quality of the service.