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Archived: Ringway Mews Care Home Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 29 June 2016

This inspection took place on 1, 2 and 3 June 2016 and was unannounced.

Ringway Mews Nursing Home was last inspected in July 2014 when we identified five breaches of the regulations we reviewed; these related to the safe management of medicines, care assessments not being fully completed or regularly reviewed, the keeping of contemporaneous records, the storing of confidential information and having effective quality audit systems in place for the service.

Following the inspection in July 2014 the provider wrote to us to tell us the action they intended to take to ensure they met all the relevant regulations. Part of this inspection was undertaken to check whether the required improvements had been made. We found improvements had been made.

Ringway Mews Nursing Home is owned by BUPA Care Homes. The service consists of four 30 bedded units; Lancaster, Shackleton, Anson and Halifax. Each unit specialises in either nursing or residential care. Each unit has a lounge, dining area, a conservatory, a smoke room and a kitchenette. All bedrooms are single with no en-suite facilities. Accessible toilets and bathrooms are located near to bedrooms and living rooms.

The service had a registered manager in place. 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. They were supported by a clinical lead for the service.

People told us they felt safe in the service and had no concerns about the care and support they received. They told us staff were always kind and caring. Staff had received training in safeguarding adults and knew the correct action to take if they witnessed or suspected abuse. Staff were confident that the unit managers, clinical lead and registered manager would act on any concerns raised.

We noted improvements had been made in the management of medicines. Guidance for the use of ‘as required’ medicines and thickeners were in place. One unit did not use the same monitoring tool to ensure the medicine administration records were fully completed. This was implemented after the inspection. Topical cream charts were not in place for staff to record when they had applied any topical creams. Body maps were not used on one unit. We have made a recommendation about the use of topical cream charts and body maps.

A process was in place to recruit suitable staff. Care staff received the induction, training and supervision they required to be able to deliver effective care. We saw that the staff were very busy during key times of the day such as when people were getting up and at meal times. Most people told us there were sufficient staff on duty to support people in a timely manner. The night staff on one unit thought more staff were required, especially when supporting people to go to bed at night.

All areas of the home were clean. There was a malodour on one unit at the entrance to the lounge area. The registered manager told us a carpet cleaner would be purchased to regularly clean the carpet in this area. Procedures were in place to prevent and control the spread of infection; however they had not prevented the malodour on one unit. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply. Regular checks of the fire systems and equipment were completed.

People and their relatives told us they received the care they needed. Care records we reviewed showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk. We found three people had additional support needs that were not covered in the standard care plans. These had not been recorded in an additional care plan. Care records on three u

Inspection areas

Safe

Requires improvement

Updated 29 June 2016

The service was not always safe.

The management of medicines had improved; however one unit has not recorded all medicines administered. Protocols were in place for ‘as required’ medicines. We have made a recommendation about the recording of topical creams.

Risk assessments were in place. However on one unit they had not all been regularly reviewed.

There was a safe system in place to recruit suitable staff. Staff had received training in safeguarding adults and knew the correct action to take should they witness or suspect abuse.

Sufficient staff were on duty to meet people’s needs. At key times the staff were very busy.

Effective

Good

Updated 29 June 2016

The service was effective.

Care staff received the induction, supervision and training they required to be able to deliver effective care.

Systems were in place to assess people’s capacity to consent to their care and treatment. Best interest decision forms were used where people lacked capacity.

People received the support they needed to help ensure their health and nutritional needs were met.

Caring

Requires improvement

Updated 29 June 2016

The service was not always caring.

We witnessed two occasions on Halifax unit where the support was not caring.

People who used the service told us staff were kind and caring in their approach. Staff we spoke with were able to show that they knew people who used the service well.

Contemporaneous records were kept for re-positioning and fluid intake. Records were securely stored.

An end of life champion had been identified for each unit to support people and staff at the end of people’s lives.

Responsive

Requires improvement

Updated 29 June 2016

The service was not always responsive.

The standard care plans contained enough information to guide staff on the care and support people required. However, care plans had not been completed for some people’s additional needs.

A programme of activities was in place, including regular day trips.

The provider had effective systems in place to record and investigate any complaints they received.

Well-led

Requires improvement

Updated 29 June 2016

The service was not always well-led.

A registered manager was in place as required by the service’s registration with the CQC.

The quality assurance processes had not identified all the issues we found during this inspection. Where issues had been found in the audits action had not always been taken to address them.

Staff told us they enjoyed working in the service and found the manager to be both approachable and supportive.

The provider had systems in place for gathering the views of people who used the service and their relatives.