Raleigh Court is situated close to the centre of the city of Hull, with public transport facilities and local shops within walking distance. The service is registered to provide accommodation and personal care for a maximum of 56 people some of whom may be living with dementia. There are bedrooms, communal sitting rooms, dining rooms, and bathrooms and toilets on both floors. There is an accessible garden and car parking at the front of the building.
We undertook this unannounced inspection on the 16 and 17 December 2015. There were 50 people using the service at the time of the inspection. At the last inspection on 29 October 2013, the registered provider was compliant in the areas we assessed.
The service has 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.
We have made the Responsive domain outstanding. We have done this because we found the registered manager and staff team had developed very creative ways in ensuring people felt part of their local community, which had a positive impact on their wellbeing. People who used the service accessed a comprehensive range of activities and occupations within Raleigh Court but also in the wider community; these provided them with stimulation and a feeling of inclusion.
People who used the service received excellent person-centred care based on their needs, wishes and preferences. We found people and their relatives were fully involved in developing care plans. Relatives told us their family members were cared for in an individual way; they were very happy with the service and had noticed there was a lot going on for people.
A health professional told us about the exceptional progress their patient had made since admission to the service. They said this was due to the way the staff had responded to the person’s individual needs and how they monitored their physical and mental health needs.
We found the environment had been adjusted very well to respond to people’s individual needs. This included making kitchettes safe so people could potter around without harming themselves on very hot water, moving the staff office to enable more effective monitoring of a specific area where people liked to gather in the evening, having a room for people who wished to smoke and making the service ‘dementia friendly’.
We found people were safe within the service. There were good recruitment systems in place and there were sufficient staff on duty on each shift to look after people and ensure their health and wellbeing.
Staff protected people from the risk of harm and abuse. There were policies, procedures and training to guide staff in how to safeguard people from abuse; they knew how to recognise signs of concern and how to report them. We found risk assessments were completed and kept under review. This helped to minimise risk and prevent accidents and incidents from occurring.
We found people received their medicines as prescribed. Staff managed medicines well by obtaining, storing, administering and recording them appropriately.
We observed positive interactions between staff and people who used the service and also their relatives; staff were attentive to people’s needs. We saw people were treated with respect and dignity and their independence was maintained as much as possible. Staff were overheard speaking with people in a kind and caring way.
Staff were aware of people’s health care needs and how to recognise when this was deteriorating. The support they provided helped to maintain people’s health and wellbeing. Staff liaised with health professionals for advice and guidance when required.
We found staff supported people to maintain their nutritional needs. They assisted people to make choices about their meals and to eat them safely when required. The menus provided were varied and offered choices and alternatives.
We found people were supported to make their own decisions as much as possible, for example staff offered visual choices to them. When people were assessed as lacking the capacity to make their own choices, decisions were made in their best interest in line with mental capacity legislation.
We found the environment was safe, clean and appropriate for people’s needs. Equipment used in the service was maintained and regular checks took place to identify any concerns.
Staff told us they received sufficient training to enable them to support people safely and to meet their assessed needs. Records confirmed this. We found staff received guidance, support, supervision and appraisal. This helped them to be confident when supporting people who used the service.
We found there was an organisational structure in place to support and oversee systems and staff, and a value base aimed at person-centred care, improving the quality of life for people and involving them in decisions. Staff told us there was an open culture where they felt able to raise issues with the registered manager and senior management.
We found the service was well-managed. There was a quality monitoring system that ensured people’s views were listened to via meetings, questionnaires and day to day discussions. Audits were completed, complaints were addressed and any shortfalls were actioned. There was an ethos of learning to improve practice and the service provided to people.