Archived: Rayleigh House

We considered all the evidence we had gathered under the outcomes we inspected.

This is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were well organised and the information was clear.

There were risk assessments in place which identified the risks for the individual and how these could be reduced or managed. We saw risk assessments relating to such matters as mobility and tissue viability.

We saw there were robust systems in place to assess and check appropriate and safe care was being delivered. These included daily and monthly internal audits. These audits included monitoring checks on the safety and maintenance of the service and to speak to staff and people who used the service to obtain their views.

The provider had appropriate security arrangements in place to protect people who lived at the service. We found that the entrance door was secure and visitors could only enter the building with the knowledge of the staff. People told us they felt safe and secure in the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

We saw that medicines were handled appropriately by staff who had been adequately trained and who had access to regular updates. We found that the documentation associated with the giving of medicines showed that people received medication they needed when they needed it.

Is the service effective?

People told us the care they received met their needs. Relatives told us they had been involved in planning the care they received.

Staff we spoke with were clear about the needs of the people they supported and what they told us was reflected in people’s care plans. The care plan for one person (who was cared for in bed) identified they were at risk of pressure sores. We saw this person was regularly turned from side to side and these actions were consistently recorded. After a prolonged period of bed rest the person had not developed tissue damage; this demonstrated the effectiveness of care given.

We spoke with staff who told us they felt well supported by the manager who ensured access to regular training and development.

We saw that medicines were handled appropriately by staff who had been adequately trained and who had access to regular updates. We found that the documentation associated with the giving of medicines showed that people received medication they needed when they needed it

Is the service caring?

We saw staff treated people with dignity and respect and maintained their privacy and dignity. We heard care staff speaking courteously and kindly with people, asking permission before helping to support them and explaining what was happening. We observed care staff supporting people where needed in a calm and unhurried manner.

We observed people who lived at the home were supported by caring and attentive staff who were patient and encouraging when they were supporting them. We observed how staff interacted with people whilst medicines were administered. Staff were respectful when they spoke with people and enabled people to take their medicines in an unhurried manner.

During our visit we saw the atmosphere was calm and relaxed. Some people were relaxing in their own rooms. Others were chatting in the lounges or watching television. People appeared comfortable and were well dressed and clean, which demonstrated staff took time to assist people with their personal care needs.

This showed us staff treated people who lived at the home with compassion and respect and encouraged them to retain their independence wherever possible.

Is the service responsive?

Care and support was provided in accordance with peoples’ preferences, interests and diverse needs. Records we looked at, discussion with staff and observations showed that people's wishes were respected and acted upon.

People had access to activities and were supported to maintain relationships with their relatives. We also saw care staff regularly visited people cared for within their own rooms.

This meant the home was organised so that it met peoples’ social and emotional care needs, in addition to their physical care needs.

Is the service well-led?

We found the service had an effective quality assurance system in place and any identified actions had led to improvements in the service that people received.

Discussion with staff, relatives and the manager showed us there was a commitment to provide a quality service that took account of people's views. Some of the people who lived in the home were not able to be directly involved in decision making processes about how the home was run. Management processes ensured that their views were represented through relatives' meetings and individual consultation with families and others involved in their care.

Staff told us they were clear about their roles and responsibilities. Staff told us the leadership at the service was inclusive and their views were taken into consideration.

People told us they were happy living there and staff were very kind. One person said,”They look after you well here.” Staff knew people’s needs and how to care for them.

The majority of people we spoke with told us staff asked for their consent before they undertook tasks for them for example personal hygiene. One person told us, “They always ask my permission before they do anything.” We were told by another person care staff did not always ask permission to do things for them. During our observations we saw staff ask people if they wished to receive care and they respected their response.

Staff were supported to deliver care and treatment safely to people and to an appropriate standard. Staff had received regular training.

Staff had received training and knew how to administer medicines appropriately. People told us they had their medicines on time. Two controlled drugs no longer in use were returned to the chemist during our visit. Controlled drugs are drugs that are controlled under the Misuse of Drugs Regulations 2001.

People told us they felt staff knew how to do things for them. One person told us, “They all know what they are doing.”

The provider had systems in place to regularly assess and monitor the quality of the service in order to protect people from unsafe or inappropriate care. They had contracted a company to undertake regular health and safety checks at the home.