Archived: Ryland View Care Home

This inspection took place on 12 and 13 September 2017 and was an unannounced inspection.

Ryland View Care Home was previously registered under the provider name of BUPA Care Homes (CFH Care Limited) up until February 2017. We were notified in December 2016 that the provider intended to simplify its structure and applied for all of its registered locations across the UK, (which at that time were registered across 13 different legal entities) to transfer over to just two legal entities. This meant that Ryland View Care Home became newly registered under the provider name Bupa Care Homes Limited in February 2017. Therefore, this was the provider's first inspection at this location since newly registering with us in February 2017. The inspection history for the location under the previous provider was used to inform the planning of this inspection because there had been no other changes at the location; the registered manager and the running of the service had remained consistent.

Our last comprehensive inspection of this location took place in January 2016; the service was rated as Good. The report from this inspection is available in the full history of inspection reports, which can be found in the previous provider's archived records for this location on our website at www.cqc.org.uk.

Ryland View Care Home provides accommodation and nursing care for up to 144 people. At the time of our inspection, there were 144 people living at the home. Care was provided within five units. Bloomfield and Heronville units provided care to people who lived with dementia, whilst Palethorpe unit provided care to younger adults who lived with a physical disability. Haines unit provided care to people who lived with conditions and frailty relating to old age. Manby unit facilitated intermediate and step down support and care for people for a short duration of time; some people on this unit had been discharged from hospital and required short term support to regain their health and/or mobility.

There was a registered manager [RM] in post. 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. On the day of our inspection the RM was not available so we were supported by the acting manager in the RMs absence [also a unit manager] and the Regional Director.

Medicines administered to people in food or drink or via a tube to their stomach did not have all of the necessary safeguards and guidance for staff in place. Some medicines used for pain relief had been administered beyond their expiry date. Medicines administration records clearly demonstrated that people were receiving their medicines at the times they needed them.

Risks to people in relation to the support they required to maintain their health had been assessed; however these had not been consistently monitored on all units in relation to the equipment in use for supporting and maintaining skin health.

People felt safe living at the home because staff supported them well with their health care needs. The provider ensured enough staff were on duty to ensure their needs were met in a timely manner and reviewed staffing levels on a daily basis. The provider operated safe recruitment practices, ensuring the necessary pre-employment checks were carried out.

The provider had identified some staff as ‘safeguarding champions’ who had received advanced training in this area to act as an additional source of support and information for other staff. The provider operated clear processes and had a policy in relation to the reporting and learning from incidents. Staff understood how they should respond to a range of potential emergencies.

The oversight and application of the Mental Capacity Act [MCA] and Deprivation of Liberties Safeguards [DoLS] was in need of review at the home. Staff understanding of DoLS was variable. Staff established consent from people before providing care.

Resuscitation issues were discussed with people or their representative and the appropriate documentation was completed. The staff team were well trained and the provider ensured staff were supported in keeping their knowledge and skills updated. New staff were provided with a structured induction. People were provided with choices of food and drink that met their needs and preferences. People were supported to access all the health care support they needed in order to maintain their wellbeing.

People’s right to privacy was protected and they were treated with dignity and respect. Staff demonstrated they were kind and compassionate when meeting people’s needs. People and/or their representatives were involved in the planning of their care wherever possible.

Communication within the service was effective and staff used a variety of methods of communication to establish people’s requests and ensure their understanding. A broad range of activities were available and events took place that people enjoyed and engaged in.

Regular meetings and discussions took place to review and respond accordingly to people’s changing needs. Clear information about the service, the facilities, and how to complain was made available to people. Complaints received were fully investigated and responded to.

Peoples’ feedback was actively sought, encouraged and acted upon. People were overwhelmingly positive about the service they received. Staff were clear about the leadership structure within the home and were fully involved and updated in relation to its development.

Audits were carried out about every aspect of the service to identify how it could improve and monitor its effectiveness; however we found some deficits that these quality checks had not identified. When the need for improvement was identified, remedial action was taken to improve the quality of the service. A variety of regular staff and senior management meetings took place to share and review updates about the service.