Ridge House Residential Care Home

We found the following examples of good practice.

The provider was following best practice guidance in terms of ensuring visitors to the home did not introduce and spread Covid19 providing good information and support for all. In house activities continued with staff working hard to keep residents entertained throughout the day. The local school children had written to the residents and had since become pen pals to some. A member of staff who is also a trained hairdresser visited outside of working hours to do the residents hair. A large selection of newspapers were bought daily for all residents to read and enjoy.

Staff were adhering to Personal Protective Equipment (PPE) and social distancing guidance. People were supported to see their visitors in the specially designed pod in the garden with direct access to outside. When this was not possible people were supported to speak to their families on the phone, or on a portal (a video calling device) the portal had a clear screen and was very loud to enable those with hearing difficulties to use.

The provider had a clear policy designed for people who were admitted to the home from the community or from hospital.

Staff had completed training including infection prevention and control, handwashing and donning and doffing. Regular and frequent spot checks and competency checks were made to ensure staff continued to follow best practice guidance. Staff were trained and knew how to immediately isolate individuals with symptoms to avoid the virus spreading to other residents and staff members. All staff in high risk groups have been risk assessed, and adjustments have been made. Plans are in place to protect vulnerable staff in the event of an outbreak.

Ridge House Residential Home is a residential care home providing personal care to 15 people aged 65 and over at the time of the inspection. The care home accommodates 15 people in one adapted building.

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

People told us they were very well cared for by staff who were passionate about providing the best possible care. People and their families described how lives had been enriched since moving to the home. Comments included, “They are just such kind, caring people and [person] is so much happier now than they were at home by themselves every day”. People told us staff treated them with respect and dignity. A person said, “They don’t just walk in and out of the room. They knock, and they check I’m happy before they leave.”

Staff were responsive to people’s changing needs. Staff were observant and worked with other professionals to overcome problems and make sure people received the best possible care. Staff understood each person’s individual communication needs.

People’s social needs were met following discussion and agreement with people. An activities calendar was displayed in the lounge. A health professional told us, “I have seen activities taking place where residents willingly get involved and enjoy themselves, which of course is such a joy to see”. If people did not want to join in group activities staff spend time with them individually. People were supported and encouraged to go out regularly, and to participate in the local community.

People living in the home, their relatives, staff and professionals were unanimous in their praise for the management of the home. A member of staff said, “[Registered manager] has so much patience. She is wonderful. She always helps out with everything. She is dedicated”. The home had been recognised for the high standard of care they provided. The home was rated one of the top 20 care homes in the South West by a national care organisation in 2018 and 2019. There were detailed and thorough audits and regular checks on all aspects of the service, such as medicines, food, cleaning and care plans which ensured people received a safe and effective service. Comments included, “The managers run a tight organisation and actually check things get done correctly, not just leaving it to chance. There are regular checks”

People told us they felt safe. Comments included, “I have actually heard [the registered manager] discussing safety as their top priority with the carers on more than one occasion.” There were sufficient staff to meet people’s needs safely. Staff were carefully recruited and the turnover of staff was very low. Care was taken to ensure all aspects of the service were entirely safe. Medicines were stored and administered safely. The home was clean, well maintained, and regular checks and servicing was carried out on all equipment. Risks to people’s health and safety were recognised, and systems were in place to reduce risks where possible.

The service was effective. Staff were well trained, received regular supervision and good support. People’s needs were carefully assessed before they moved into the service and a plan of their care needs was drawn up and agreed with them. Care plans provided very good detail setting out all aspects of each person’s needs, likes and dislikes. People told us they enjoyed the meals and were offered a good range of food and drinks to suit their dietary needs and preferences. Comments included, “Care is not just provided without thought; it’s based on the person’s own capacity and adjusted to suit what they personally need support with, so they retain the skills they have”.

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.

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 Outstanding. (Published 3 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Ridge House is registered to provide personal care and accommodation for up to 15 older people. The home does not provide nursing care. At the time of our inspection there were 14 people living at Ridge House.

When we visited there was 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.

The registered manager and staff team were inspired to provide exceptional care to people. The atmosphere in the home was warm and very friendly. People had developed strong relationships with staff. This was evident throughout our inspection with the general conversations and banter which were observed. People commented: “I feel part of the family” and “Its outstanding here. The kindness, the atmosphere.”

People and their relatives told us the most wonderful comments about the staff and the home. Comments included: “Fantastic here, excellent”; “They (staff) are charming, kind”; “We are very lucky” and “You couldn’t better it. This is better than the Ritz.”

People received extremely personalised care and support specific to their needs and preferences. There was an excellent understanding of seeing each person as an individual, with their own social and cultural diversity, values and beliefs. A staff member commented: “We get to know the person first and then plan their support needs with them.”

All staff took pride in their work and our conversations with them showed they worked as a team to create a better quality of life for people.

The registered manager provided strong leadership and was a good role model for all staff. They had established a service where staff were clear about the values and ethos of the home. The service had a positive culture that was person-centred, open, inclusive and empowering.

People felt safe and staff were able to demonstrate a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

People’s views and suggestions were taken into account to improve the service. They were supported to maintain a balanced diet. Health and social care professionals were involved in people’s care to ensure they received the right care and treatment.

There were effective recruitment and selection processes in place. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received training and regular support to keep their skills up to date in order to support people appropriately.

The providers took an active role running the home, for example by carrying out maintenance, or helping to cover for staff during sickness and holidays, and were present in the home on a daily basis. The registered manager and providers told us that working alongside staff on a regular basis enabled them to fully understand every person’s care needs.

People and their relatives spoke fondly of the registered manager, providers and their staff team. They felt the service was an inspiration due to how it was run. One person commented: “I feel the management and staff are exceptional.” There was a sense of collaboration between the registered manager, staff, relatives, visitors and people living at the home; all with the goal to make the home a pleasant place to live, work and visit.

The registered manager strived to provide the best possible service for people. A number of effective methods were used to assess the quality and safety of the service people received and changes and improvements were made in response.

We spoke to eight people living at the home, two visiting relatives and a district nurse who confirmed that people were always involved in decisions about the care, treatment and support they needed. Relationships between staff and people were respectful, warm and friendly. We observed lots of gentle banter and humour between people throughout the day. People were encouraged to be involved in the running of the home and everyone who was able, fully participated in the life of the home. For example, people who liked to maintain their domestic skills were encouraged to do so.

People told us that they were happy at the home and that 'staff did everything they needed'. They said 'nothing was too much trouble' and if they ever wanted anything, they would ask and it would be provided. People said 'that if I cant be in my own home, then this is best home from home to be in', 'nothing I ask for is ever too much trouble'.

Care is centred on the person and carefully planned and delivered. Care plans were well organised and were up to date. Plans contained relevant information which ensured that potential risks were identified and managed. Assessments for people's care reflected individual needs, preferences and diversity.

A healthy nutritious balanced diet was provided which met people's individual preferences and needs. Everyone said the food 'was excellent' and we saw that drinks and snacks were always available.

Sufficient staff were on duty to meet the care and support needs of people. The home benefits from additional support from the owners who also assisted with emergencies. Staff said they were allowed time to spend with people chatting and engaging in conversation. People told us that staff were always available to help them. Staff receive a varied programme of regular training which updated their knowledge to ensure that people's needs were appropriately met.

Accurate up to date records were held at the home which are stored safely and securely. People were assured that personal records remained confidential. Verbal communications about care and treatment were documented promptly in personal records. Anyone living at or visiting the home were encouraged to make write whatever they wanted about life at the home, in the comments book, which was seen in the entrance hall.

People experienced care, treatment and support that met their needs and protected their rights. Care needs were well documented and showed that the home had assessed all potential risks and taken action to prevent occurrence. Care needs were regularly reviewed. A person said 'They look after me very well. I am properly spoilt!'

People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff received training and information to help them recognise potential abuse and take appropriate action. People told us they felt completely safe.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. The staff were well supervised, trained and supported. One person said 'They are all so helpful ' very pleasant and kind'

The provider had an effective system to regularly assess and monitor the quality of service that people received. People told us they were able to 'air their views' and make suggestions and they could speak with the providers at any time 'They are easy to talk to. It is a nice homely atmosphere!"