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Inspection carried out on 24 July 2017

During a routine inspection

Ridgecott is a residential care home providing accommodation and support to people with a learning disability, and associated conditions such as Autism. The service is registered to accommodate and support a maximum of ten people. At the time of the inspection ten people were living in the home. Three separate flats were available for people who had been assessed as requiring more specific or separate living arrangements. The flats provided people with their own bedroom, lounge and bathroom facility. People living in the separate flats were able to access communal parts of the home with support from staff, and dependent on their care plan arrangements. Two separate garden areas were available and people accessed these either independently or with support from staff.

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, thet are ‘registered person’s. 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.

At the last inspection, the service was rated as Good.

At this inspection we found the service remained Good in all areas.

People remained safe at the service. There were sufficient staff available to meet people's needs and to keep them safe. Staffing levels were reviewed regularly and adjusted when people’s needs changed. Risk assessments had been completed to enable people to retain their independence and receive care with minimum risk to themselves or others. People received their medicines safely. Health and safety audits were completed in relation to people’s care, lifestyle and the environment.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff were competent and well trained. People had the support needed to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

People's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals. People were supported to eat and drink enough and were able to maintain a balanced diet. Staff understood any risks associated with eating and guidelines were in place in relation to choking hazards and other dietary needs.

There was a warm, caring and relaxed atmosphere in the home. We observed staff being patient and kind. Staff were attentive to people’s needs and understood when people needed reassurance, praise or guidance. People’s privacy was respected and staff worked hard to help ensure people felt valued and an important part of their home and local community.

The service remained responsive to people's individual needs and provided personalised care and support. People were able to make choices as much as possible in their day to day lives, and progress was encouraged and celebrated. People were supported to lead a full and active lifestyle, and activities were planned to meet individual needs and personal requests.

The service remained well led. Staff and relatives told us the registered manager was approachable and supportive. The registered manager had an active role within the home and maintained their own professional development by attending regular training and by keeping themselves updated with best practice. The views of people, relatives and other agencies were sought to make sure people were at the heart of any changes within the home. The registered manager and provider had a formalised auditing system in place to monitor the quality of the service and to identify any improvements needed.

Further information is in the detailed findings below

Inspection carried out on 23 & 24 June 2015

During a routine inspection

The inspection took place on the 23 and 24 June 2015 and was unannounced.

Ridgecott provides care and accommodation for up to ten people. On the day of the inspection there were ten people living in the home. Ridgecott provides care for people with a learning disability and associated conditions such as Autism and Aspergers.

The service had a registered manager in post. 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.

Relatives and other agencies spoke highly of the care provided at Ridgecott. Comments included,

“[…] is so happy at Ridgecott, […] see’s staff as her family, and they welcome me and keep me well informed and included”, and “It seems like a lovely place to work, residents and staff are always happy”.

Staff had a good understanding of people’s needs and support plans included clear information about how people chose and preferred to be supported. We observed many examples of people being supported to make choices and have control over their care and lifestyle. For example, we saw people choosing what they wanted to eat and when they wanted to get up. We also observed staff responding promptly when people became anxious and asking for people’s consent before supporting people with medicines and personal care.

People’s needs and support had not in all cases been assessed and planned in a person centred way. Some of the arrangements intended to protect people and keep them safe, such as key pads on the entrance to the kitchen and some communal areas may have limited people’s opportunity to develop their skills and independence.

Staffing levels had been organised in a way to keep people safe. All of the staff we spoke to said there were enough staff available to keep people safe. Although staff worked hard to spend time with people and support people to partake in activities there were not always enough staff available to respond to individual requests to go out or partake in a certain activity.

People were protected by staff who knew how to recognise signs of possible abuse. Staff were able to talk confidently about the action they would take if they identified potential abuse had taken place.

People had their medicines managed safely. People received their medicines on time and in a way they chose and preferred. People’s health and well-being was paramount, and systems were in place so staff could recognise changes in people’s health and take prompt action when required. The food in the home was of a high standard and catered for people’s special dietary needs and preferences.

People were supported by safe and robust recruitment practices. People were involved in the recruitment process and their views were taken into account when appointing new staff. Staff undertook training, which was specific to the needs of people they supported.

Care and support focussed on each person’s individual needs, their likes, dislikes and routines important to them. When people were unable to consent to their care or support, discussions took place to ensure decisions were made in the person’s best interest. When people’s needs changed staff reacted promptly involving other health and social care professionals if needed.

Staff felt well supported by their colleagues and management. They were supported and encouraged to question practice and were inspired and motivated to provide a good quality service. The registered manager had an active role in the home and lines of accountability and responsibilities were clearly communicated.

There were effective quality assurance systems in place. Incidents were appropriately recorded and analysed. Learning from incidents and concerns raised had been used to help drive continuous improvement across the service.

Inspection carried out on 11 December 2013

During a routine inspection

There were nine people living at the home on the day of our visit. We spent time with most of the people at various stages of our visit. Due to the complex needs of people, we were unable to speak with them in a meaningful way to tell us what they thought of the home and the care they received. We therefore used a number of different methods to gather information about people's views and experiences of the service. We spent a large amount of time observing people in the home and how they were supported by staff. This helped us decide if people were happy living at the home.

The home had a friendly, welcoming and homely atmosphere. Throughout our visit, we saw that people at the home appeared comfortable and at ease with the staff who supported them. There was a jovial and relaxed banter with much humour. People appeared well cared for. Two people were able to tell us they were happy there.

Each person had a plan of care in place which was regularly reviewed. Risk assessments were in place but would benefit by containing more information to guide staff. Any specialist advice was sought from the relevant care professionals.

People had meals which were varied, appealing and wholesome.

People lived in a home that was safe and suitable to their needs, choices and abilities.

Before people began work at the home, they had the necessary recruitment checks undertaken.

The home had a comprehensive complaints procedure in place.

Inspection carried out on 29 May and 14 August 2012

During a routine inspection

People using the service had very complex needs. This meant that it was difficult for people to tell us what they thought of the home and the care they received.

We used a number of different methods to gather information about people's views and experiences of the service. We observed people in the home and while they were being supported by staff. This helped us decide if people were happy with the way they were being supported and cared for. We also spoke to relatives about their views and experiences of the service. After the visit we spoke to other agencies such as Social Services and other Health professionals who had had involvement with the organisation and people living in the home.

The home had three self-contained flats, which were being used by people who had been assessed as requiring this type of facility. During our visit we were able to meet all of the people who lived in the residential part of the home and two people who had their own self contained flat.

The manager informed us that there were changes being made to the management and running of the service. We were told that the service was in a period of transition and policies and procedures were being updated to reflect these changes.

Staff and relatives we spoke to said that they were being kept well informed of any changes and they felt confident that the Registered Manager would take into consideration the impact any changes may have on people currently using the service.

During our visit we saw that staff treated people respectfully at all times, promoting independence and choice whenever possible.

Other agencies we spoke to said that the staff at Ridgecott worked well as a team and when asked were able to provide detailed and clear information about the people they support.

The manager and staff were aware of people's rights and we saw examples of when meetings had taken place to ensure that decisions being made were in the best interests of the person concerned. We did raise our concern about a locking device leading into the flat of one person using the service and that this may restrict them and deprive them of their rights to move freely around their home. We asked the manager to look at this issue as a matter of priority.

The day after our visit the manager informed us that a meeting had been planned to discuss this issue with all agencies involved in the persons care including their family. We have since received information from Social Services about this meeting and feel that the manager has responded promptly and appropriately to our concerns to ensure that any arrangements for this person within the service are safe and in their best interests.

We found that people engage in a range of activities inside and outside the home. On the day of our visit some people had been to a music group and others were enjoying sitting in the garden area chatting with staff and planning activities for the rest of the day.

The staff we spoke to were able to tell us about different types of abuse, and what they needed to do to keep people safe. They were able to tell us what they would do if they suspected that abuse or any type of poor practice had occurred within the home.