Rydal Care Home

Updated 6 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Act.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

An inspector carried out the inspection.

Service and service type

Rydal Care Home is a ‘care home’. People in care homes receive accommodation, nursing and personal care as a single package under one contractual agreement dependent on their registration with us. Rydal Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local commissioners and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 20 April 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people who used the service and 6 relatives and friends of people about their experience of the care provided. We also contacted 20 relatives and received their feedback about the service.

We gained the views of virtually all members of staff including the area manager, the registered manager, the deputy manager, clinical lead, a nurse, 2 senior care workers, a clinical healthcare assistant practitioner (CHAP), care workers, the chef and ancillary staff.

We reviewed 10 people’s care records, medicine administration records, 4 staff files, staff rotas and a variety of management and quality assurance records for the service.

Updated 6 June 2023

Rydal Care Home is a nursing home registered to provide accommodation for up to 60 people. The home has 3 floors and specialises in providing care to people living with a dementia. At the time of this inspection 57 people were living at the service.

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

People told us they felt safe, and staff were very kind but at times staff were stretched, particularly at night. There were enough staff on duty during the day and once the registered manager increased levels on a night, so there were always 9 staff on duty. The area manager confirmed the increase to the numbers of staff at night would be maintained.

Staff had received training around the Mental Capacity Act 2005 and associated code of practice and staff use of capacity assessments and ‘best interests’ decisions had improved. At times though the capacity assessments did not match the information in care plans and did not set out what actions staff had taken to understand if the person was able to make decisions for themselves.

Improvements to the recruitment process had been made since the last inspection, but the registered manager needed to ensure there was a more robust review of information supplied on application forms and ‘Right to Work’ records were up to date.

The assessments were intertwined in the care plans, and this made it difficult to gain a rounded understanding of people’s needs and the main areas they needed support with. These did not always give information about the rationale for admission and, for the step-down units, why the person was there. Risk assessments were in place, however at times the tick box ones did not lead staff to provide information on how to mitigate these risks.

Staff had received mandatory and condition specific training. Staff supervision sessions were regularly completed, as well as spot checks and competency assessments. Medicines management was now effective. Staff who administered medicines had the appropriate training.

People received nutritious meals and catering staff had successfully completed a variety of training around supporting individuals to maintain a healthy diet. Measures were in place to ensure staff knew how associated risks such as choking were to be managed.

Maintenance of the building had improved. Staff adhered to COVID regulations and procedures.

The management team had further developed their governance system and this now more effective at identifying issues. The management team had ensured lessons were learnt when things did not work so well. In general staff found the manager was more responsive when issues were raised and addressed these in a timely fashion.

Relatives found their views were taken on board and they were asked their opinions. Many had taken the time to give positive feedback to on-line websites gathering views about care homes. Staff were passionate about providing good care outcomes and took ownership for their practice.

Rating at last inspection

The last rating for this service was requires improvement (published 22 April 2022).

At the time we found the service was in breach of regulation regarding medicine management, delivery of safe care and governance systems. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This report only covers our findings in relation to the key questions safe, effective and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rydal Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.