Ruddington View

Updated 1 June 2019

The inspection:

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, to look at concerns we received about the safety of the service and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was undertaken by two inspectors, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

Ruddington View 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, and both were looked at during this inspection.

Ruddington View is a new model of care that aims to enable people with learning disabilities to live and remain in their local community. Although the size of the service exceeds the maximum of six people as specified in the CQC policy, Registering the Right Support. It had been developed in line with the Registering the Right Support values of choice, independence and inclusion. Ruddington View was developed in response to the national 'Transforming Care' agenda, which aims to improve health and social care services so that more people with a learning disability can live in the community. Within Ruddington View there are two short term 'unplanned care' apartments, offering support to people who may be in a period of crisis and require additional support to remain in the community. The remaining six places are 'step down', these are for people who have been in long term hospital placements who require support to enable them to move into the community. Ruddington View is staffed by support workers with specialist input from a behaviour therapist.

Since the last inspection, the registered manager had left the organisation and a new registered manager had been appointed. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This comprehensive inspection was unannounced.

What we did:

Before our inspection, we reviewed information we held about the service. This included the last inspection report, information received from local health and social care organisations and statutory notifications. A notification is information about important events, which the provider is required to send us by law, such as, allegations of abuse and serious injuries. We also contacted commissioners of the service and asked them for their views. We used this information to help us to plan the inspection. At the time of this inspection the provider had not been asked to submit a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. However, we reviewed the provider’s action plan they submitted after the last inspection and during the inspection, we gave the management team the opportunity to share any other additional information they wished to share.

During our inspection visit, we spoke with two people who lived at the service and one person’s relative. We also spoke the registered manager of the service, another manager who was supporting the service, the deputy manager, the regional operations manager and six support workers. To help us assess how people's care needs were being met we reviewed all, or part of, three people's care records and other information, for example their risk assessments. We also looked at the medicines records of three people, three staff recruitment fil

Updated 1 June 2019

About the service:

We conducted an unannounced inspection at Ruddington View on 8 April 2019. Ruddington View accommodates up to eight people in one building. On the day of our inspection, three people were using the service, all were people living with a learning disability.

People’s experience of using this service:

People received safe care and support. Improvements had been made to how incidents were managed. This included more robust ways of involving people and staff, with an emphasis on how lessons could be learnt. Staff had received additional training in positive behavioural support and improved support and communication had impacted on people experiencing positive outcomes. Least restrictive practice in the care and support people received had greatly improved. Staff were very positive about the support and leadership of the service. This had resulted in them gaining a greater awareness, understanding and confidence in meeting people’s complex needs.

The use of agency staff had reduced and was only used to cover short notice absenteeism. This meant people were supported by a consistent staff team whom they could develop positive relationships with. Safe staff recruitment procedures were used to appoint new staff. Staff received a structured and supportive induction, ongoing training and regular opportunities to discuss their work, training and development needs.

People received their prescribed medicines safely and when they needed. Improvements had been made to guidance on medicines used ‘as required’ and national best practice guidance was followed.

The environment met people’s needs and safety. Improvements had been made to safety and access to outdoor space. The service was clean and infection control practice was understood and followed.

People received sufficient to eat and drink. People were involved in menu planning and independence was promoted. People are 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 with any health conditions and accessed health services to maintain their health needs.

People were positive about the staff who supported them, who showed great care, understanding and compassion. Positive engagement was seen between staff and people who used the service, where independence and choice were promoted, encouraged and respected.

Support plans that provided staff with guidance of how to meet people’s needs had improved. However, further time was required to ensure information was sufficiently detailed to enable staff to be responsive to people’s needs. People received opportunities to pursue interests and hobbies and social activities an inclusion was being further developed. People were involved in discussions and decisions about their care as fully as possible.

Staff were clear about their roles and responsibilities and improvements had been made to the systems and processes that monitored safety and quality. The provider had an ongoing action plan that confirmed what action had been completed to make improvements with targets for future work.

The service met the characteristics of Good. The inspection found significant improvements and the breaches in legal requirements had been met. Further time was required for improved systems and procceses to be fully embedded and sustained.

Rating at last inspection:

At the last inspection the service was rated Inadequate. (The report was published 17 January 2019). For more details, please see the full report which is on the CQC website at ww.cqc.org.uk

Why we inspected:

This was a planned inspection based on the rating of the last inspection. This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. Following this inspection, the service will no longer be in Special Measures.

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.