Archived: Ramsgate Care Centre

Ramsgate Care Centre provides accommodation and personal care for up to 42 older people, some of whom may be living with dementia. The service is a large purpose built property, with accommodation arranged over two floors. A lift is available to assist people to get to the upper floor. The service has 40 single bedrooms and one double bedroom that people could choose to share, this is usually used as a single bedroom. All bedrooms had en-suite toilets. There were 40 people living at the service at the time of our inspection.

A registered manager was leading the service, supported by a deputy manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection we found there were not always enough staff to meet people’s needs. The registered manager had taken action to make sure they were always sufficient staff on duty to provide people’s care when they wanted it.

At our last inspection we found that records of people’s medicines were not always accurate. At this inspection we found action had been taken to correct this but other medicines records were not accurate. The registered manager took action to make sure that all records were correct during the inspection. People received the medicines they needed to keep them as healthy as possible.

People told us they liked the food at the service but the menu was ‘boring’ with meals repeated every week. Meals were balanced and included fruit and vegetables. All meals were homemade. People were offered a choice of food to help keep them as healthy as possible.

People had been asked for their views of the service. They had told the registered manager that the menu was not varied enough and they would like to go out on day trips. Their views had not been acted on. Checks had been completed on all areas of the service. These had not identified the shortfalls in the service we found at our inspection.

People told us they did not always have enough to do. Some people were not supported to fully take part in their chosen activities. We have made a recommendation about activities.

Assessments of risks to people were not always accurate. Detailed guidance had not been consistently provided to staff about how to support people to manage risks. However, staff provided the care people needed to keep them safe, in the way they preferred. Action was taken to identify changes in people’s health, including regular health checks.

People were supported to make decisions and choices. When people could not make a particular decision, staff made decisions in people’s best interests with people who knew them well. The requirements of the Mental Capacity Act 2005 (MCA) had been met.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). Risk to people had been identified and arrangements were in place to apply to the supervisory body for a DoLS authorisation when necessary.

People and their relatives told us staff were kind and caring and treated them with dignity and respect. Staff knew the signs of possible abuse and were confident to raise concerns they had with the registered manager or the local authority safeguarding team. When concerns were raised action had been taken promptly to keep people as safe as possible. Plans were in place to keep people safe in an emergency.

People and their representatives were confident to raise concerns and complaints they had about the service. People were satisfied with the response they received. Systems were in operation to regularly assess the quality of the service.

The registered manager provided leadership to the staff and was supported by a deputy manager and area manager. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs. They were motivated and felt supported. Staff told us the registered manager was approachable.

The provider had a ‘philosophy of care’ which was shared by the registered manager and staff. This included the values of independence and ‘person centred’ support. Staff were supported to provide good quality care and support. They had completed the training they needed to provide safe and effective care to people. Most staff held recognised qualifications in care.

Checks were completed to make sure staff were honest, trustworthy and reliable. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We saw that care plans had been written and regularly reviewed based on people's individual assessments of their needs and contained detailed information. We saw evidence of monitoring and regular evaluations of the support that was provided, together with involvement and liaison with relatives and various health professionals, to ensure they were kept informed of changes in people's conditions when necessary.

We found that the home was clean, bright and spacious. We saw evidence of appropriate infection control measures in use at the home. We found that there was a regular programme of infection control training available for staff.

We saw evidence which demonstrated that appropriate checks were completed before a new staff member commenced work at the home, and that new staff were supported and monitored by senior staff. The staff members told us that they felt well supported by the management team and their colleagues. We noted that the manager had implemented regular audits across various areas of the service, to ensure that any issues of concern could be quickly addressed. People told us that the staff asked them regularly if they were happy with the care they had received.

People told us that they felt safe and well looked after. People looked relaxed, comfortable and at ease with each other and staff. One person said 'I am safe here. I do not feel at all in danger.' A visiting relative said 'The most important thing to me is that (my relative) is safe here. I trust this home.'

People said that they thought the staff were kind and caring. One person said 'The staff help me to get up, they are very good'.

People said that they had enough to do and enjoyed the organised activities. People said that the food was good and that they always had a choice.

People's health needs were supported and the service worked closely with health and social care professionals to maintain and improve people's health and well being.