Archived: Ribbon Court

Ribbon Court is a housing with care service which provides personal care to people in their own homes within the premises of Ribbon Court. At the time of our visit there were 46 people occupying the flats at Ribbon Court and 27 people within those flats were being supported with personal care. Those people supported with personal care received calls from staff at set agreed times. The number of calls and length of time for each call was agreed with people on an individual basis to ensure their needs could be met. There were 19 care staff employed to deliver care and support to people.

The service had a registered manager. 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.

Most of the time people felt safe using the service and staff understood how to protect people from abuse. There were processes to minimise risks to people’s safety which included information about individual risks to people in care plans and risk assessments. This information helped staff to provide safe and personalised care. However, some risks were not sufficiently detailed in people’s care records to ensure they could be effectively managed. This included risks related to medicine management and health conditions which impacted on people’s independence.

Recruitment checks were carried out prior to care staff starting work to ensure their suitability to work with people who used the service. Staff told us these were completed before they started work.

The registered manager and staff understood the principles of the Mental Capacity Act (MCA). Staff respected people’s rights to make their own decisions and gained people’s consent before they provided personal care.

People were supported by all members of the care staff team which meant staff knew people and their needs well. There were enough suitably trained staff to deliver care and support to people but sometimes staffing arrangements were not effective. For example, sometimes staff did not arrive to undertake personal care at the times agreed with people to ensure their needs were met. This was due to other duties they were required to complete or sometimes due to emergencies they encountered. However, people felt their needs were met most of the time and staff knew about people’s personal preferences regarding their care to help ensure people were supported how they wished.

Some people were provided with support to prepare meals and drinks on a daily basis to meet their nutritional needs. There was also a restaurant providing a choice of meals each day which people could access independently or with staff support if they wished.

Staff received an induction to the service and training was ongoing to support them in meeting people’s needs effectively. Overall, people were positive about the staff and felt they were supportive in meeting their needs.

People knew they could approach the registered manager if they had any concerns and the registered manager told us she always responded to any concerns promptly. However, the provider’s policy for raising a complaint was not sufficiently clear to assist people in this process.

There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. This included regular communication with people and staff, service satisfaction surveys and some audit checks carried out by the registered manager and provider. The results of the most recent survey people had completed showed an increase in their satisfaction of the service in comparison with the previous survey. This demonstrated the improvements that had been carried out at the service by the registered manager and provider had been recognised by people.

We found that record keeping was not always accurate so there was clear information for staff to support them in their role. Audits did not always identify improvements in progress or made.

The people who lived at Ribbon Court received varying levels of personal care and support. Some people only required well being checks, whilst others received a higher level of care and support.

People we spoke with were very satisfied with the level of service provided. One person told us: 'It's very nice here and I like it very much.' Another person said: 'The home and staff are lovely.' People told us the staff treated them with dignity and respect and asked permission before carrying out personal care. They confirmed staff turned up on time and delivered care as they wished. Staff we spoke with were knowledgeable about people's needs and what support they required.

Staff we spoke with knew what they would do to keep people safe if they observed or suspected abuse. We saw there was an effective recruitment procedure that ensured staff were both suitable and competent to meet the needs of the people who lived at Ribbon Court.

We saw there were systems in place to monitor the quality of the service provided and to gain the views of the people who lived there.

This was a follow up to our previous visit on 18 February 2013. During the previous visit, we had concerns about the consistency of the planning and delivery of care, particularly in relation to pressure area care. We were also concerned that information and instructions were not communicated to staff to ensure people's needs were met effectively.

We also found that there were no clear agreements in place about how emergency and non-emergency calls were managed. On 18 February 2013 the manager explained they were currently reviewing the system. They told us this would include the introduction of job cards to ensure non-emergency calls were more effectively managed.

During our latest visit we found our concerns had been addressed. We saw evidence that care plans and risk assessments had been reviewed; jobs cards had been introduced to manage non-emergency calls and an effective process had been put in place to manage emergency calls.

We saw that people received varying levels of support depending on their needs. Some people received minimal support whilst others received support with nutrition, continence care and mobility. People signed to consent to the care and support provided.

Care plans we looked at provided staff with information about the support people needed and how that support was to be provided. One care plan we looked at did not provide staff with sufficient information to manage a risk to that person. We could not be sure that information and instructions were being effectively communicated to all staff.

During our visit we observed that there appeared to be enough staff on duty to provide the support people required.

Staff we spoke with demonstrated a good understanding of what abuse was and understood their responsibility to report any observed or suspected abuse.

We saw that systems were in place to enable people to raise any concerns about the service provided.