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Ralphland Care Home Inadequate

We are carrying out a review of quality at Ralphland Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary

Overall summary & rating


Updated 13 November 2019

Ralphland is a residential care home providing accommodation and personal care to older people, some of whom are living with dementia. The service can support up to 39 people. At the time of this inspection there were 34 people living at the service, which is provided over three floors in one adapted building

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

There were significant and widespread shortfalls in the governance of the service. The provider and managers had failed to identify issues we found including with health and safety and record keeping, including risk assessments. The leadership was weak, inconsistent and overbearing. Systems were ineffective in driving improvements and high quality care. The provider had failed to act on concerns identified during our inspection. This left people at risk of harm.

People were at risk of avoidable harm because risks were not recorded accurately, monitored or managed. We raised a safeguarding concern for one person who was at risk of choking, as we could not be sure this had been managed appropriately.

Health and safety was not well managed. This put people at risk of potential harm. We contacted the fire service, who attended the home and introduced measures to reduce the risk of harm to people in a fire situation. These were implemented with immediate effect. No control measures had been introduced following positive samples of legionella being found in the service.

Good outcomes were not always achieved for people living at the service. People were at significant risk of dehydration due to their low fluid intake. The environment was not suitable for the needs of people living there. Access to communal areas was limited.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff did not always understand people’s care needs. They had not received sufficient training or support to equip them for their roles and responsibilities.

Care was provided in task-centred, institutionalised ways. Little consideration was given to people’s wellbeing or emotional needs. People were not always treated with dignity and respect; they were not able to have privacy in their bedrooms. People’s independence was not promoted.

People did not receive responsive care. When assistance was requested there were delays in this being provided, which caused people discomfort. People were socially isolated, with no access to the wider community.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 10 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.


We have identified multiple breaches in relation to safe care and treatment, fit and proper persons employed, person-centred care, staffing, dignity and privacy, premises and equipment, need for consent and good governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

The overall rating for this service is inadequate and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvem

Inspection areas



Updated 13 November 2019

The service was not safe.

Details are in our safe findings below.



Updated 13 November 2019

The service was not effective.

Details are in our effective findings below.


Requires improvement

Updated 13 November 2019

The service was not always caring.

Details are in our caring findings below.


Requires improvement

Updated 13 November 2019

The service was not always responsive.

Details are in our responsive findings below.



Updated 13 November 2019

The service was not well-led.

Details are in our well-led findings below.