361 The Ridge

Updated 23 February 2022

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 carried out by two inspectors on the first day and one inspector on the second.

Service and service type

361 The Ridge 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.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on the first day. The second day was announced.

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 and professionals working with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke to and spent time with everyone at the home. Where people were not able to verbally communicate with us, we spent time observing the care and support they received from staff. We spoke to five members of staff, this included the manager, regional manager, senior support workers and support workers. We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received a range of records in relation to staff recruitment and training. We were sent some follow up care records for people and quality assurance audits. We spoke to a further three members of staff over the phone and four people’s relatives.

Updated 23 February 2022

About the service

361 The Ridge is a residential care home providing personal care to up to 12 people. At the time of our inspection, there were 11 people living at the home. People had learning disabilities and/or autism and some people had health conditions such as epilepsy.

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

People were kept safe from avoidable harm because staff knew people well and understood the signs of abuse. Systems were in place to protect people from harm. Risks to people were well known and managed to support their safety. Accidents, incidents and safeguarding concerns were recorded and learning was taken and shared amongst staff to prevent things from happening again. There were enough staff to safely support people and staff knew people well. Medicines were managed safely. The home was clean and hygienic and people were encouraged to get involved in keeping the home and their bedrooms clean.

People's needs were assessed in line with government guidance and the law. People had support plans detailing all aspects of people's support and what was important to people. Staff had received training in areas that were relevant to people living at the home. People were supported to eat and drink enough and were encouraged to do as much for themselves as possible. Staff worked with other agencies to provide appropriate support for people. People were given choices and supported to make those choices.

Staff were kind and caring towards people. Staff knew people well and what was important to the people they were supporting. People's relatives were positive about the impact staff had made to their loved ones. People and relatives’ views were regularly sought by staff and action taken when suggestions were made. Staff respected people's privacy and dignity and supported people to be as independent as possible.

Support people received was personalised to them. Each person's support plan was different and considered the whole person. Staff knew how people communicated and understood what people were communicating. Information was given to people in ways they could understand. People were supported to go out and engage in hobbies that they enjoyed. People's end of life support had been considered by staff and discussions had taken place with people and their families.

The culture of the home was positive and inclusive. People and staff were one team working together in the home. Staff encouraged people to get involved in the running of the home and listened to people's ideas. The management team encouraged a culture of empowerment and were supportive of staff. Staff worked with other organisations to ensure people were receiving effective care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence. People were supported by staff to have different experiences using their abilities. We saw that staff encompassed people’s senses when supporting them to engage with the world around them. For example, we saw a staff member support a person to sit in a sun beam and ask them if they could feel the warmth on their face from the sun. Records showed that staff respected people’s personal space. Staff recorded in people’s daily notes that they had knocked on people’s doors before entering. We saw that staff did this before entering each person’s bedroom. Relatives told us that people were encouraged to make their own choices. One person’s relative told us, “Staff always help [person] to choose [their] own clothes, to keep that skill alive.”

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights. People were comfortable and happy around staff. We saw one person tell a staff member, “I like you” the staff member smiled and responded, “I like you too!” This made the person smile. People’s daily notes showed that staff understood how people who were not able to verbally communicate, were feeling and how staff responded to people’s individual ways of communicating. People had fun at 361 The Ridge. Themed days were regularly arranged by staff for people. For example, at the time of our inspection, people were having a pyjama party which encouraged lots of interactions between staff and people around being cosy and comfortable.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. We saw people having a good time with staff and joking with them. During the inspection we overheard a staff member singing to a person in their bedroom whilst supporting them to get washed and dressed. When we spoke to the staff member later, they told us the person loved that particular music group and enjoyed a sing song. Staff focused on encouraging people to do as much for themselves as possible. The culture of the staff team was positive and led by managers who focused on empowering people and encouraging independence.

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 the service under the previous provider was requires improvement, published on 21 November 2019.

Why we inspected

This service was registered with us on 1 December 2020 and this is the first inspection.

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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.