Ryecourt Nursing Home

Updated 11 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 23 May 2018 and was unannounced. The inspection team consisted of two adult social care inspectors and a specialist advisor, with clinical experience of supporting people with mental health conditions.

Before our unannounced inspection, we checked the information we held about Ryecourt. This included notifications the provider sent us about incidents that affect the health, safety and welfare of people who lived at the home. We also contacted other health and social care organisations such as the commissioning department at the local authority and Healthwatch Blackpool. Healthwatch Blackpool is an independent consumer champion for health and social care. This helped us to gain a balanced overview of what people experienced living at Ryecourt.

Furthermore, we looked at the Provider Information Return (PIR) the provider had sent us. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We found people who lived at Ryecourt used a variety of ways to communicate. During our inspection, we used a method called Short Observational Framework for Inspection (SOFI). This involved observing staff interactions with people in their care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Additionally, we spoke with a range of individuals about this home. They included four people who lived at Ryecourt, four relatives, nine staff members and two members of the management team. We further discussed care with a visiting healthcare professional. We observed care and support in communal areas and looked around the building to check environmental safety and cleanliness. This enabled us to determine if people received the care and support they needed in an appropriate environment.

We examined care records of six people who lived at the home. This process is called pathway tracking and enables us to judge how well Ryecourt understands and plans to meet people's care needs and manage any risks to their health and wellbeing. We checked the recruitment, training and support documents in relation to four staff members. We also looked at records related to the management and safety of Ryecourt.

Updated 11 August 2018

Ryecourt provides nursing care and support for a maximum of 35 people who live with dementia and/or a physical disability. At the time of our inspection there were 34 people living at the home. Ryecourt is situated in a residential area of Blackpool close to the promenade. Communal areas located on the ground floor consist of four lounges and two dining areas. A passenger lift is provided for ease of access throughout the building.

Ryecourt 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, both of which we looked at during this inspection.

A registered manager was in place. 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 the last inspection on 23 September 2015, the service was rated good. At this inspection, we found the service had improved to outstanding.

During this inspection, we found multiple examples to demonstrate the staff and management team were passionate about providing an innovative, excellent service. A relative told us, “It’s outstanding here, there is no other word to describe it.” Our observations confirmed staff were highly skilled communicators and able to engage with profound empathy and respect.

The home’s ethos was strongly focused on providing highly personalised care. We found very high staffing levels and excellent communication at Ryecourt meant care was delivered efficiently and with a timely approach. All interactions we observed demonstrated a service consistently focused upon the person’s dignity.

Staff had in-depth training in equality and we observed they demonstrated their understanding in practice by continuously promoting a highly inclusive environment. It was very clear they respected each person’s rights and treated them as individuals. We observed a strong, family-orientated service where staff were not afraid to display their love towards people.

The registered manager went to great lengths to ensure people and relatives had access to different information. This enabled families to gain a greater awareness of their care, which they said was an example of the registered manager going above and beyond.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Various evidence-based tools and best practice procedures were completed by staff to maintain high levels of effective mental health treatment.

All personnel had a very structured and supportive start to their employment, underpinned with shadow shifts and regular supervision. Staff development at Ryecourt was exceptional because the registered manager used every opportunity as a training session. This included tools to ensure learning was put in practice, such as reflective work, meetings, competency tests and learning logs.

The skilled workforce had a massive impact on people because we saw evidence this reduced unnecessary hospitalisation. Systems to effectively monitor and treat pain, anxiety symptoms and depression levels resulted in significantly reduced incidents. For instance, the rate of falls, health infections and pressure ulcers over the last year were cut to minimal or zero levels.

The provider ensured the chef was able to provide individual soft and pureed diets that resembled the original food. People and visitors were highly complementary about meals, choice and staff support. A relative said, “The food is wonderful.” Staff deployed prescribed treatment and adapted care planning to protect the most vulnerable individuals from the risks of malnutrition.

We found the continuously fluid method of treatment provided at Ryecourt maximised positive outcomes to people’s care. This was because it assisted staff to be more adaptive to their everchanging needs. The registered manager further excelled at providing multiple systems to maximise staff awareness of each person who lived at the home.

The service provided a personalised, caring and excellent end of life care. The sensitive management team approach meant they could obtain a wealth of information to guide staff about each person’s end of life preferences. We saw staff showed genuine sensitivity, compassion and love.

Care records contained detailed information to give staff an exceptional understanding of activities people enjoyed and to improve their social engagement. A relative said, “Sometimes they will spend a long time just chatting and being with [my family member] and other times they will play games or read with her. They do more here than I ever could at home.”

The registered manager had a variety of surveys and systems to obtain the best possible feedback about the quality of care. One relative stated, “Even though Ryecourt is outstanding, in my opinion, they never stop looking at how they can tweak things. That’s a sign of how excellent [the registered manager] is as a manager.”

The management team had incredible oversight by scrutinising all areas before issues occurred, which showed they had strong control measures in place. Staff confirmed the management team were keen to listen to their ideas and encouraged them to raise any concerns.

We found staff files contained required documents and checks to protect people from the employment of unsuitable staff.

Information contained in people’s bedrooms gave staff immediate access to guidance in an urgent situation. Care records held risk assessments and control measures intended to manage potential risks and maintain people’s safety. Staff had a good awareness about how to identify and report any concerns to the local authority and CQC.

Medicines records were completed accurately. Associated risk assessments for each person who lived at Ryecourt were detailed and frequently reviewed to ensure they continued to maintain people’s safety.