This inspection took place on 20 October 2016 and was unannounced. Ridgemede Care is a care home that provides accommodation for up to 36 people, including people living with dementia care needs. There were 25 people living at the home when we visited. The home is based on two floors with an interconnecting passenger lift. All bedrooms have en-suite facilities. In addition, bathrooms are provided on both floors, together with a range of communal rooms for people’s use.The home had a registered manager. 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.
At our previous inspection on 4 & 5 August 2015, we identified four breaches of regulations. Medicines were not always managed safely; risks to people were not always assessed and mitigated; staff did not follow guidance designed to protect people’s rights; information about the employment histories of staff was not always available; and quality assurance processes were not always effective. The provider sent us an action plan detailing the steps they would take to become compliant with the regulations. At this inspection we found action had been taken, but further improvement was required.
Providers are required to conspicuously display their CQC performance ratings on their website and within the home. The rating from the previous CQC inspection was not displayed on their website. Within the home, the rating was displayed on the office wall, but was not easy for people to see.
A new policy had been introduced which required staff to act in an open way when people were harmed. Whilst staff had been open with family members after a person fell, they had not followed this up with a written explanation as required.
There were appropriate arrangements in place for managing medicines. However, the quantity of medicines in stock was not carried forward from month to month, so the provider was not able to check that people had received their medicines as prescribed. The registered manager was still developing a system to regularly check the competence of staff to administer medicines.
Regular checks were conducted to make sure the building was safe for people, although these had not identified that some first floor windows did not have restrictors fitted to prevent people from falling out.
Improvements had been made to the way staff assessed people’s ability to give informed consent. Staff sought verbal consent before providing care and support, and knew how to protect people’s freedom. However, further work was needed to ensure that action taken to protect people’s rights was fully documented.
A quality assurance process had been developed. This had identified and addressed some areas that needed improvement. However, it needed further time to become embedded in practice to ensure it was effective.
People were protected from harm in a way that supported them and respected their independence. Staff knew how to keep people safe and how to identify, prevent and report abuse. They engaged appropriately with the local safeguarding authority.
There were enough staff to meet people’s needs and recruitment processes helped ensure only suitable staff were employed.
People’s needs were met by staff who were skilled and suitably trained. New staff completed a comprehensive induction programme and all staff were suitably supported in their roles by the management team
People praised the quality of the food. Their dietary needs were met and staff provided people with appropriate support to help ensure they ate and drank enough. Staff monitored people’s weight and took action if they started to lose unplanned weight. People could access healthcare services and were referred to doctors and specialist nurses when needed.
People were cared for with kindness and compassion. Staff interacted with them in a positive way. They spoke about people warmly and demonstrated a detailed knowledge of them as individuals. They were skilled at communicating with people living with dementia.
Staff protected people’s privacy and encouraged them to remain as independent as possible. They involved people in the care planning process and kept family members up to date with any changes to their relative’s needs.
People received personalised care and support that met their needs. Care plans had been developed which provided staff with detailed information about they should meet people needs. People were encouraged to make choices about every aspect of their daily lives.
People praised the range of activities they could access. These had been tailored to their individual interests and included trips to local attractions. Positive links had been built with the community. For example, the home hosted ‘mother and toddler’ groups and children from local schools visited to interact with people, which people enjoyed.
People felt the home was run well. There was a clear management structure. Staff understood their roles and worked well as a team. They were happy in their work and felt supported by managers. The provider promoted values of kindness and dignity, which staff worked to.
There was an appropriate complaints procedure in place and people knew how to make a complaint. The provider sought and acted on feedback from people. They had invested in the service and had plans to develop it further.
We identified a breach of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.