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Inspection Summary


Overall summary & rating

Good

Updated 16 January 2019

The inspection was undertaken on 29 November 2018 and was unannounced.

Ravenstone is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The provider of Ravenstone is registered to provide accommodation and nursing care for up to 43 people who have nursing needs. At the time of this inspection 36 people lived at the home.

The provider had a registered manager in place who supported this inspection. 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.

Our last inspection took place on 28 and 29 June 201, we rated the service as 'Requires Improvement’. We identified five breaches of the regulations. These included the provider had not make sure risks to people from avoidable harm was reduced. The staffing arrangements did not reduce risks of people care needs being met in a safe and timely way. Staff did not respond to people's needs in a way which promoted care was centred on their needs and their dignity was respected to enhance their welfare. The provider did not effectively use their quality checks to bring about improvements in a timely way so people lived at a home where high-quality care was promoted.

As a result of the inspection, we asked the provider to send us a report explaining the actions they were going to take to improve the service.

At this inspection we found the registered provider’s oversight and quality checks were more effective. These were used to drive through improvements to support people’s needs in a timely way and safely, with people at the heart of all their care. The provider had now met legal requirements in these areas although further improvements required.

People’s medicines were available to them as prescribed however the management of medicines needed strengthening to ensure risks to people continued to be reduced. Risks to people's safety from avoidable harm and injury in relation to some electrical items had not been assessed so actions to minimise identified risks completed. Staff practices in infection prevention and control was not effective in all areas of the home environment so the spread of infections continued to be reduced.

People’s needs were responded to and met without any unreasonable delays which was an improvement made since our last inspection. Staff were knowledgeable about the subject of abuse and what actions to take if they had concerns. The provider had systems in place to support staff in reporting accidents and incidents. The management and staff team used learning from accidents and incidents to inform their caring practices and continually improve.

Staff were supported to maintain and improve their skills through ongoing training and support from the registered manager and deputy manager. Checks were completed before staff started to work at the home to ensure they were of good character and safe to work with people living at the home.

People’s individual needs were assessed when they came to live at the home and regularly reviewed. Staff worked well together to meet people’s varied needs and where people would benefit from equipment this was provided. People were referred to healthcare professionals when needed and staff followed the guidance shared with them.

People were encouraged and supported to eat a nutritional diet which met their needs and recognised their choices. Risks to people's nutritional health had been assessed and when weight loss was identified, people were not offered extra calories in their meals or as snacks. Drinks were offered to people and support was given when n

Inspection areas

Safe

Requires improvement

Updated 16 January 2019

The service was mostly safe.

People�s needs were assessed with potential risks reduced however other risks within the home environment had not always been identified with actions taken to keep people as safe as possible.

People received their medicines as prescribed but the management of medicines required actions to be taken to ensure arrangements were as strong as they could be.

Staff practices were inconsistent in making sure risks to people from the spread of infections was reduced.

People�s needs were met in a timely way due to the effectiveness of staffing arrangements and staff knew how to recognise signs of potential abuse and how to report any concerns.

Effective

Good

Updated 16 January 2019

The service was effective.

Staff had the knowledge and skills required to meet people�s individual needs and promote their health and wellbeing.

People were supported to make their own decisions wherever possible and staff had a good understanding of how to support people who lacked the capacity to make some decisions for themselves.

Food and drink were provided to a good standard and in line with people�s eating and drinking guidelines.

Caring

Good

Updated 16 January 2019

The service was caring.

Staff were kind and caring towards people, knew them well and respected their dignity and privacy.

People were consulted about their care and enabled to express their views.

Staff understood the importance of people�s relationships and visitors were made welcome.

Responsive

Good

Updated 16 January 2019

The service was responsive.

People received personalised care that was responsive to their changing needs and preferences.

People�s social and recreational interests had been considered.

Complaints procedures were in place in formats to empower people in raising any concerns they had so these were responded to and addressed.

Well-led

Good

Updated 16 January 2019

The service was well led.

People and their relatives were encouraged to voice their opinions and make suggestions for service improvement.

The registered manager showed an open, accountable leadership style and staff at all levels worked well together.

The provider�s quality checking systems and the registered manager's passion to continually drive through improvements contributed to the improvements made so people received a good standard of care.