Archived: Care Management Group - 361 The Ridge

Updated 21 November 2019

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 Care Act 2014.

Inspection team

The inspection was carried out by an inspector.

Service and service type

Care Management Group – 361 The Ridge 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.

The service did not have a manager registered with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided. There was a manager in post who was in the process of registering with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided. We spoke with six members of staff including the regional manager, manager, senior care workers and care workers.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 21 November 2019

About the service

Care Management Group – 361 The Ridge is a residential care home providing personal care to 11 people living with a learning disability at the time of the inspection.

The service was a large home, bigger than most domestic style properties. The service can support up to 12 people in one adapted building. This is larger than current best practice guidance. 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 outside to indicate it was a care home. Staff did not wear uniforms and therefore were not immediately identifiable as care staff when coming and going with people.

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

Quality assurance checks and the governance of the service was not always robust. There had been a delayed response to a person’s changing needs. This had led to delays in the person receiving the right healthcare support. People and their relatives’ feedback about the service had not always been acted on or responded to. There was a lack of management oversight of incidents and accidents that meant there was an increased risk of reoccurrence. Notifications had not always been submitted to CQC.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice. However, when people had authorised Deprivation of Liberty Safeguards (DoLS) this was not always known by staff. The manager recognised this as an area in need of improvement.

People told us they felt safe. Staff understood safeguarding, types of abuse and how to report any concerns they had about people’s safety and well-being. People received their medicines safely and were protected by the prevention and control of infection.

People and staff had positive relationships. Staff interactions with people were kind and caring and showed they knew people well. People were treated with dignity and respect, their independence respected and promoted.

There were enough staff available to support people. There were staff vacancies at the time of the inspection and the manager was continuing to recruit new staff. Staff new to the service were supported with induction and then ongoing training and supervision. The staff team met regularly together to discuss the service.

People needs and wishes were assessed before they moved into the service. Care plans included various aspects of people’s lives including life histories, their likes and dislikes and health conditions. When people had specific health conditions these were well planned for. People were supported to access healthcare professionals.

The service applied the principles and values of Registering the Right Support. This is to 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 maintaining their current independence and having opportunities to gain new skills and become more independent.

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 this service was Good (published 11 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.