This was an unannounced inspection which took place on 10 September 2015. We had previously inspected this service in April 2015 when we identified eight breaches of the Health and Social
Care Act 2008 (Regulated Activities) Regulations 2014. This resulted in us serving three warning notices and making five requirement actions. As a result of our inspection findings the service was placed into ‘Special measures’.
Following the inspection in April 2015 the provider wrote to us to tell us the action they intended to take to ensure they met all the relevant regulations. This inspection was undertaken to check the required improvements had been made.
We found the service had made significant improvements since our last inspection and all regulations we inspected were being met. As a result the service has been removed from ‘Special measures’.
Ravenswing Manor Residential Care Home is registered to provide accommodation for up to 24 older people who require support with personal care needs. At the time of our inspection there were 20 people using the service.
There was no registered manager in place at Ravenswing Manor. The manager who was responsible for the day to day running of the service was in the process of completing the necessary training to register as manager for the service. 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.
People we spoke with told us they felt safe in Ravenswing Manor. Staff had received training in safeguarding adults and were able to tell us of the correct action to take if they witnessed or suspected abuse.
Staff were safely recruited. Although we observed there were enough staff on duty on the day of the inspection, some people told us they considered staffing levels needed to be increased at times.
People spoke positively about the caring nature of staff. During the inspection we noted positive interactions between staff and people who used the service. All the staff we spoke with demonstrated a commitment to providing person-centred care.
Staff had received the induction, training and supervision required to ensure they had the skills and knowledge needed to carry out their role effectively. Staff told us they enjoyed working in the service and received good support from senior staff. They told us the atmosphere in the service had improved since our last inspection.
Although improvements had been made in the way medicines were managed in the service, we noted cream charts were not always fully completed. This meant we could not be certain people had always received their creams as prescribed.
All areas of the home were clean and well maintained. Procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply. However, recent fire checks had noted that some fire doors were not closing properly and we could not find any evidence to confirm that required remedial action had been carried out. This meant some people might not be fully protected in the event of a fire.
People’s care records contained good information to guide staff on the care and support required. People told us they always received the care they needed. The care records showed that risks to people’s health and well-being had been identified and plans were in place to help reduce or eliminate the risk.
We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. We found the provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.
We found the meals provided in Ravenswing Manor were varied and nutritionally balanced. Systems were in place to help ensure people’s health and nutritional needs were met. People told us they enjoyed the food provided in the service.
People were supported to access health care services when necessary. Improvements had been made to recording systems in the service to help ensure any advice given by health care professionals was always documented and acted upon.
A programme of activities had been introduced at Ravenswing Manor to help improve the well-being of people who used the service. We noted plans were in place to organise events in the home and to support people to attend local community resources.
Records we reviewed showed people who used the service and their relatives had opportunities to comment on the care provided in Ravenswing Manor. We saw evidence that suggestions made had been acted upon. Systems were also in place to investigate and respond to any complaints people might make. People told us they would feel confident to raise any concerns they had with care staff or the manager.
Significant improvements had been made to the quality assurance processes in place in the service. The manager had introduced a series of weekly and monthly checks and was motivated to continue to drive forward improvements in the service. All the people we spoke with made positive comments about the leadership displayed by the manager and the improvements they had made since the last inspection.