Archived: Ross Wyld Care Home

Updated 9 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Ross Wyld Care Home accommodates up to 54 people across three floors. Two of the floors specialised in supporting people with complex nursing care needs, including people receiving end of life care. Another floor specialised in providing residential care to people living with physical health needs. Many of the people living in the units were also living with dementia.

Before the inspection we reviewed the information we already held about the service. This included notifications the provider had submitted to us. A notification is information about important events which the service is required to send us by law. We sought feedback from the local authority contract monitoring team.

The inspection took place on 9, 10 and 15 November 2017. The first day of the inspection was unannounced. The inspection was completed by one inspector, two specialist advisors who were experts in nursing care and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

During the inspection we spoke with five people who lived in the home and five relatives. We observed care delivered in communal areas of the home, including activities. We spoke with 13 members of staff including the home manager, regional manager, the team leader, the chef, a member of domestic staff, an activities coordinator, two nurses, a nurse support practitioner and five care workers. We reviewed the care files of five people including assessments, care plans and records of care delivered. We reviewed six staff files including recruitment and supervision records. We also looked at the training records, complaints, incidents and various other policies, documents and audits relevant to the management of the service.

Updated 9 February 2018

This inspection took place on 9, 10 and 15 November 2017. The first day of the inspection was unannounced.

Ross Wyld is a care home with nursing for up to 54 people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Ross Wyld is divided into three floors providing nursing care to people with physical health needs and for those living with dementia. It is a large purpose built care home that is fully accessible to people with mobility needs. At the time of our inspection 51 people were living in the home and one person had been admitted to hospital.

The home did not have a registered manager. The new home manager was in the process of applying to register with us. 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.

At the last inspection in December 2015 we did not find any breaches of the legal requirements.

At this inspection we found that care plans and risk assessments lacked detail or were inaccurate and were not personalised to each individual. They lacked detail regarding care preferences including personal care, dietary needs and end of life wishes. Records of care did not show people were supported to have their needs met.

People told us there were not enough staff deployed at the service to meet people’s needs and we observed that people received their meals late. Staff did not always receive the clinical support they needed to perform their roles because there was no clinical lead or deputy manager at the home.

The home had not always sought consent in an appropriate way and staff did not demonstrate a sound working knowledge of the Mental Capacity Act 2005.

The governance arrangements were not comprehensive and where those in place had identified issues with the quality and safety of the service actions had not been effective in improving the experience of people living in the home. The service was working with the local authority and clinical commissioning group to implement a plan to address concerns in the home.

Staff were knowledgeable about safeguarding adults from harm, and the provider took action to investigate and respond to allegations of abuse and other concerns raised.

The home was clean and odour-free and we observed staff using basic hygiene methods.

People living in the home had complex healthcare needs. They received support to access healthcare services and the home worked with healthcare professionals help meet people’s needs.

Medicines were managed safely and staff were appropriately trained.

Staff built positive and compassionate relationships with people in their care, and understood how to promote people’s dignity. Staff demonstrated they understood the impact people’s culture might have on their experience of care. Sexual orientation was included as part of the care assessment.

The provider had a clear complaints policy. There were systems to ensure people and relatives were able to provide feedback about their experience of the home.

Activities were delivered with enthusiasm and people felt the range of activities on offer were improving. The manager had plans in place to continue to develop the activities provision within the home.

We found breaches of five regulations relating to safe care and treatment, consent, good governance, person-centred care and staffing. You can see what action we told the provider to take at the back of the full version of the report.