The Ridings Care Home

The Ridings Care Home is a residential care home providing personal and nursing care to up to 83 people. The service provides support to younger and older adults living with dementia. At the time of our inspection there were 79 people using the service.

People’s experience of the service and what we found

People were not always protected from the risk of harm; we found systems were not effective in reducing risks to people from incidents, the spread of infection or the environment. Systems in place to safeguard people from abuse were not robust and processes for learning lessons were not effective in driving improvements.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People were not treated in a compassionate, respectful way. People’s autonomy, independence and choices were not upheld. People’s dignity was not maintained by staff practices.

People’s preferences and person-centred needs were not always fully considered and met. Group activities and community visits were facilitated by the service, but access to these was not offered to everyone. Some people spent long periods without any social interaction.

Quality assurance systems were not always effective for people. This meant the action taken by the provider had not always ensured people received consistent, caring and safe support. People did not always experience a positive and empowering culture at The Ridings Care Home.

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 this service was Good (published 6 February 2020).

Why we inspected

The inspection was prompted in part due to concerns received about the quality and safety of the service, including how the provider was responding to safeguarding concerns. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report. Please see all sections of this full report.

Enforcement

We have identified breaches in relation to how people's safety was managed, how people were safeguarded from abuse, their rights promoted, people being treated with dignity and respect, how people’s person-centred needs were met and how the service was run at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow Up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The Ridings Care Home is an 83 bed care/nursing home supporting people with dementia. At the time of our inspection there were 81 people living at the home. The building is divided into six separate households. The six households are situated on three floors and divided into areas to support people with different dementia related care and support needs. This included; three dementia care unit for older people, two dementia care units for people of a working age and one nursing unit.

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

People were supported by staff that were caring, compassionate and treated with dignity and respect. Any concerns or worries were listened and responded to and used as opportunities to improve. Staff were aware of the risks to people and how to manage those risks.

People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life histories and individual preferences. They used this information to develop positive, meaningful relationships with people. Staff were very knowledgeable about people’s changing needs and people and their relatives confirmed that changing needs were addressed.

People told us they felt well cared for by staff who treated them with respect and dignity and encouraged them to maintain relationships and keep their independence for as long as possible. People could maintain friendships and contact with families, and when needed had access to advocates.

People were supported by staff who had the skills and knowledge to meet their needs. Staff understood and felt confident in their role. People told us the atmosphere at the home was relaxed and calm. People told us their cultural and religious needs were being met.

Staff liaised with other health care professionals to ensure people's safety and meet their health needs. Where people lacked capacity, staff worked with the local authority to make sure they minimised any restrictions on people's freedom for their safety and wellbeing.

Staff spoke positively about working for the provider. They felt well supported and that they could talk to management at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role. Staff had received an induction that provided with the training, information and support they required to effectively and safely meet people’s needs.

Audits were completed by staff and the registered manager to check the quality and safety of the service. The registered manager worked well to lead the staff team in their roles and ensure people received a good service.

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 this service was Good (published 10 July 2017).

Why we inspected: This was a planned comprehensive inspection based on the rating of good at the last inspection.

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The Ridings Care Home is an 83 bed care/nursing home supporting people with dementia. At the time of our inspection there were 81 people living at the home. The building is divided into six separate households. The six households are situated on three floors and divided into areas to support people with different dementia related care and support needs. This included; one dementia care unit for older people, two dementia care units for people of a working age and three nursing units.

There was a registered manager 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.

People were kept safe and secure, and relatives believed their family members were safe from risk of harm. Potential risks to people had been assessed and managed appropriately by the provider.

People received their medicines safely and as prescribed and were supported by sufficient numbers of staff to ensure that risk of harm was minimised.

Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual care and support needs.

Staff sought people’s consent before providing care and support. Staff understood when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) should be followed.

People’s rights to privacy and confidentiality were respected by the staff that supported them and their dignity was maintained.

People had a variety of food, drinks and snacks available throughout the day. They were able to choose the meals that they preferred to eat.

People were supported to stay healthy and had access to health care professionals as required. They were treated with kindness and compassion and there were positive interactions between staff and the people living at the location.

People’s choices and independence were respected and promoted. Staff responded appropriately to people’s support needs. People received care from staff that knew them well and benefitted from opportunities to take part in activities that they enjoyed.

Relatives and staff were confident about approaching the manager if they needed to. They provider had effective auditing systems in place to monitor the effectiveness and quality of service provision. People and relatives views on the quality of the service were gathered and used to support service development.

We were told that people living at the home were helped to stay clean and look nice each day. We saw staff offer this care with compassion. We found that people were helped to stay healthy but that for some people records to support all aspects of their care were not available.

People were being supported by staff to take their prescribed medicines at the required times. We found medicines were safely stored and administered by staff who were trained to handle them. Comments about medicine management included;"The medicines are well organised" and "I am confident medicines are well managed."

We found that staff had opportunities to attend training. New staff were offered training and support before they started work in the home. Staff we spoke with said;"I do feel well supported. My manager and the home manager are approachable." One relative said; "All the staff are very friendly, they chat to people as they come and go."

There were systems in place to ensure that The Ridings was a safe place to live, work and visit. We found there were opportunities to make suggestions about how the service could be improved. One person living at the home said; “I have nothing to complain about, when I’m here I’m always happy.”