We carried out a review of the data available to us about Ryelands on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ryelands, you can give feedback on this service.
Ryelands is a residential care home providing personal care to up to 50 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 47 people using the service.
People’s experience of using this service and what we found
People were safe at the service. Staff knew how to safeguard people from abuse and keep them safe from identified risks to their safety and wellbeing. There were enough staff to support people and meet their needs. Recruitment and criminal records checks were carried out on staff to make sure they were suitable to support people. Health and safety checks were carried out of the premises and equipment to make sure they were safe. The premises was clean, tidy and hygienic. Staff followed infection control and hygiene practice to reduce the risk of infections.
People were involved in planning and making decisions about their care and support. People could state their preferences for how their care and support was provided. Staff received relevant training and supervision to help them meet people’s needs. Staff were well supported and encouraged to put people’s needs and wishes at the heart of everything they did.
People were supported to stay healthy and well. Staff helped people to eat and drink enough to meet their needs. They made sure people took their prescribed medicines in a timely and appropriate way. Medicines were managed safely. Staff supported people to manage their healthcare and medical conditions. They made sure people could access support from healthcare professionals when needed. The service worked with other healthcare professionals to ensure a joined-up approach to the care and support people received.
People were treated well at the service. People’s feedback indicated staff delivered good quality support. Staff supported people in a dignified way which maintained people’s privacy and independence. 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.
People were supported to participate in activities and events at the service. People told us, although they enjoyed these, they would like to do more. The provider was already taking action at the time of this inspection to improve this aspect of the service for people. Relatives and friends were free to visit people without any unnecessary restrictions. There were a range of comfortable spaces around the premises for people to spend time in. The provider planned to refurbish and redecorate the service in the coming year and people’s views had been sought about how these plans should reflect their needs and preferences.
The service was managed well. The registered manager was experienced and had a clear understanding of how people’s needs should be met. They undertook audits and checks at regular intervals, to monitor, review and improve the quality and safety of the service. The provider undertook their own checks of the service at regular intervals to make sure the service was meeting required standards.
There were systems in place to obtain feedback from people, staff and others about how the service could be improved. Accidents, incidents and complaints were fully investigated and people were informed of the outcome.
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 21 December 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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, which will help inform when we next inspect.
When we last visited the home on 22 September 2015 the service was meeting the regulations we looked at and was rated Good overall and in all five key questions.
At this inspection we found the service continued to be Good.
The service did not have a registered manager in post at the time of our visit. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. However, a manager was in post who was at the final stage of the application process to register with us. Shortly after our inspection we received confirmation they were fully registered with us.
People were protected from abuse and improper treatment. The provider had systems in place to respond to allegations of abuse to keep people safe and staff understood their role in safeguarding people, well. Risks to people were reduced as staff assessed risks and put management plans in place for staff to follow. Risks relating to medicines management were reduced as staff stored, administered, recorded and disposed of medicines safely.
The provider had processes in place to learn and improve when things went wrong. The provider had robust systems to review any accidents and incidents to ensure people received the right support and that learning was shared across the organisation.
The premises and equipment were managed safely and the premises were clean and hygienic with good infection control practices in place. The premises met people’s support needs and the provider had adaptations in place to cater for the needs of people living with dementia. There were enough staff deployed to support people and the provider checked staff were suitable to work with people by carrying out recruitment checks.
People received care in line with the Mental Capacity Act 2005 and the provider applied for and followed authorisations to deprive people of their liberty as part of keeping them safe. The provider supported staff to understand their responsibilities in line with the MCA by providing regular training and workshops.
People were supported by staff who were supported and received induction, training, supervision and appraisal to understand their role. There were enough staff to care for people and staff were recruited via robust processes to check they were safe to work with people.
People were supported to live healthier lives with a choice of food in line with any dietary needs. Staff supported people in relation to their health care needs. The service worked well with other organisations in providing care to people and helped people transition between services, such as being admitted to hospital.
Staff were kind and caring and knew the people they were caring for. People were involved in decisions relating to their care and staff understood the best ways to communicate with people. Relatives could visit people at any time and staff made them feel welcome.
People’s care plans contained sufficient detail to be reliable for staff to follow in caring for people. The provider regularly reviewed people’s care plans so information remained current. People were supported to participate in activities the service provided, although some people felt a wider range of activities could be developed. The provider told us they would review the activity programme.
The provider investigated and responded to complaints appropriately. The provider encouraged people and relatives to feedback their views and experiences of the service.
The manager was new in post but knew the service well as they were previously the deputy manager. They had gained experience as a registered manager at other services in the provider’s organisation and had a good understanding of their role and responsibilities, as did staff. Leadership was visible and capable at all levels.
The provider was effective in monitoring, assessing and improving the service with a range of audits in place to check the quality of service. The manager was well supported by the provider in overseeing the service and providing care to a high standard. The manager encouraged open communication with people and staff.
This inspection took place on 22 September 2015 and was unannounced. The last Care Quality Commission (CQC) inspection of the home was carried out on 27 August 2014, where we found the service was meeting all the regulations we looked at.
Ryelands is a care home that can accommodate and provide personal care and support for up to 50 older people. The service consists of two separate units known as Ryelands and Brooklands. Ryelands is located in the main building where up to 32 people can live at any one time and Brooklands is the much smaller 18 bedded unit which specialises in supporting people living with dementia care or receiving end of life care. There were 49 people living in the home at the time of our inspection, approximately three-quarters of whom were living with dementia.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
People told us they were happy with the standard of care provided at Ryelands. We saw staff looked after people in a way which was kind and caring. Our discussions with people using the service and their relatives supported this. People’s rights to privacy and dignity were also respected. When people were nearing the end of their life they received compassionate and supportive care.
People were safe living at the home. Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise and manage these risks in order to keep people safe. The service also managed accidents and incidents appropriately and suitable arrangements were in place to deal with emergencies.
We saw people could move freely around the home. The provider ensured regular maintenance and service checks were carried out at the home to ensure the building was safe.
Staff were suitably trained, well supported and knowledgeable about the individual needs and preferences of people they cared for. Their knowledge and skills were updated through attendance at regular training.
People were supported to maintain social relationships with people who were important to them, such as their relatives. There were no restrictions on visiting times and we saw staff made people’s guests feel welcome.
Staff encouraged people to participate in meaningful social, leisure and recreational activities that interested them. We saw staff actively encouraged and supported people to be as independent as they could and wanted to be.
People were supported to keep healthy and well. Staff ensured people were able to access community based health and social care services quickly when they needed them. Staff also worked closely with other health and social care professionals to ensure people received the care and support they needed. There was a choice of meals, snacks and drinks and staff supported people to stay hydrated and to eat well. People received their medicines as prescribed and staff knew how to manage medicines safely.
There were enough suitably competent staff to care for and support people. The management team continuously reviewed and planned staffing levels to ensure there were enough staff to meet the needs of people using the service.
Staff supported people to make choices about day to day decisions. The management team and other staff were knowledgeable about the Mental Capacity Act (2005) and best interests meetings were held in line with the Act to make decisions on behalf of people who did not have the capacity to make decisions themselves. Deprivation of Liberty Safeguards (DoLS) were in place to protect people’s safety, and the staff were aware of what this meant and how to support people appropriately. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best inters and there is no other way to look after them
The service had a clear management structure in place. We saw the registered manager led by example and was able to demonstrate a good understanding of their role and responsibilities.
The views and ideas of people using the service, their relatives, professional representatives and staff were routinely sought by the provider and used to improve the service they provided. People and their relatives felt comfortable raising any issues they might have about the home with staff. The service had arrangements in place to deal with people’s concerns and complaints appropriately.
There were effective systems in place to monitor the safety and quality of the service provided at the home. The registered manager took action if any shortfalls or issues with this were identified through routine checks and audits. Where improvements were needed, action was taken.
The premises were found to be welcoming and had a number of communal areas for people to use. There was a large dining room, conservatory, activities area and easily accessible gardens.
We saw that staff spoke with people in a kind and courteous manner addressing them politely and using their preferred names. Staff knocked before entering people's bedrooms.
We looked at three records and saw that where it had been possible people had signed the care plans giving consent for their care and other support required. Some had also been signed by people's relatives indicating that they had been consulted about how care and support should be provided.
One person who use the service told us "staff were helpful, kind and welcoming". We observed positive interactions between staff and people who use the service.
Staff told us there were good training opportunities; they enjoyed their work and felt well supported.
We reviewed staff training records and these were up to date - examples included Moving and Handling, Mental Capacity Act, Safeguarding Adults, Equality, Diversity and Inclusion, Infection Control and Fire Safety.
People we spoke with told us that they had been able to visit the accommodation prior to admission and had been able to bring in items of their own furniture and personal effects. People also told us that the provider was able to meet the needs of their relatives who had been diagnosed with dementia and that communication between themselves and the provider was timely and effective. People told us the food was very good, that the staff were helpful and prepared to be flexible. We found evidence that the staff had appropriate training in relation to safeguarding adults and that the provider had systems in place to regularly assess and monitor the quality of services provided.
They told us 'we are looked after very well, its very nice here'.
They told us that staff ask their views about how they would like to be supported and they could tell them if they had any problems.
They said that they liked the food that was served "there is always a choice" and "its always well cooked".
Other residents told us about the activities that are arranged for them," there's things to do, but you go if you want to, no one forces you'. They particularly liked the films and musical entertainment.