Background to this inspection
Updated
21 August 2021
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 Care Act 2014.
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
The inspection was undertaken by three inspectors, two assistant inspectors and a specialist advisor. The specialist advisor was a nursing professional.
Service and service type
Ryland View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection
Notice of inspection
This inspection was unannounced.
Inspection activity started on 24 June and ended on 12 July 2021. We visited the service on 24 and 29 June 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection-
We spoke with 20 people who used the service and eight relatives about their experience of the care provided. We also spoke with 19 staff (which include care staff, nurses and unit managers), two activities co-ordinators, two domestic staff, housekeeper, maintenance person, deputy manager, area manager and a visiting healthcare professional.
We reviewed a range of documents and records including the care records for 18 people, 19 medicine records, and three staff recruitment files. We also looked at records that related to the management and quality assurance of the service.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
After the inspection
We continued to seek clarification from the manager to validate evidence found. We reviewed various records such as care plans and quality assurance records. We had telephone discussions with the manager to discuss these records and the service.
Updated
21 August 2021
About the service
Ryland View is a residential care home providing personal and nursing care and accommodation for up to 144 people across five separate units, each of which have separate adapted facilities.
Manby unit provides short-term step-down support for people, Palethorpe unit is specifically, for younger adults with physical disabilities, Heronville unit alongside Bloomfield unit provides Dementia care and Haines Unit is for people who require general nursing care. At the time of the inspection the service was supporting 127 people across the five units.
People’s experience of using this service and what we found
There was not always enough staff to meet the needs of people in a timely manner. Staff met peoples core needs, but support was task focused and staff did not appear to have any other quality time with people. People received their medicines when they needed them. Systems were in place to protect people from the risk of abuse. Overall, we were assured measures were in place to prevent the spread of infection. Action was taken following our inspection to address any equipment which presented an infection control risk to people.
A manager who is registered with CQC was not in place at the time of the inspection. There has been changes to the management of the service and a new manager has now commenced in this role. Staff morale was reported to be low. The provider was seeking feedback from staff, people and relatives and had actions plans in place in order to move the service forward and to make improvements.
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 Good (published 03 September 2018).
Why we inspected
We received concerns in relation to staffing levels, poor quality care, infection control, and record keeping. As a result, we undertook a focused inspection to review the key questions of safe and well led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ryland View on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified a breach in relation to the lack of staffing provided to people. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.