Ravenlea

Updated 7 March 2019

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 and to provide a rating for the service under the Care Act 2014.

We undertook an unannounced inspection of this service on 16 January 2019. The inspection was undertaken by one inspector, this was because the service was small and it was considered additional inspection staff could be intrusive to people’s daily routine.

Before the inspection we reviewed the information about the service the provider had sent us in the Provider Information Return. This is information we require providers to send us at least once a year to give some key information about the service, what the service does well and improvements they plan to make. We looked at notifications about important events that had taken place in the service, which the provider is required to tell us by law and spoke with some local authority care commissioners who had placed people at the service. We used all this information to plan our inspection.

During the inspection we reviewed a range of records. These included two care plans and associated risk assessment information as well as parts of other care plans. We looked at recruitment information for four staff, including those who were more recently appointed; their training and supervision records in addition to the training record for the whole staff team. We viewed records of accidents/incidents, complaints information and records of some equipment, servicing information and maintenance records. We also viewed policies and procedures, medicine records and quality monitoring audits undertaken by the registered manager and provider.

We met each person living at Ravenlea and spoke with four of them. We also spoke to two staff as well as the deputy and registered manager. As some people were not to speak with us directly, to help us further understand their experiences, we observed their responses to the daily events going on around them, their interaction with each other and with staff.

To help us collect evidence about the experience of people who were not able to fully describe their experiences of the service for themselves because of cognitive or other problems, we used a Short Observational Framework for Inspection (SOFI) to observe people’s responses to daily events, their interaction with each other and with staff.

Updated 7 March 2019

The inspection took place on 16 January 2019. The inspection was unannounced.

Ravenlea is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Ravenlea accommodates up to seven people who have learning disabilities or autistic spectrum disorder. Some people had additional health concerns such as epilepsy and diabetes. There were six people living at the service when we inspected.

The care service has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had 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.

This service was last inspected in September 2017 and we found two breaches of regulations and improvement was required. The breaches concerned not responding promptly to concerns about people’s safety and a failure to notify CQC of events which was legally required. This inspection found required improvement had been made and the previous concerns were addressed.

People's medicines were well managed and stored safely; there was clear guidance for staff on how to support people to take their medicines.

Risks to people were individually assessed and there was comprehensive guidance for staff. People were kept safe from avoidable harm and could raise any concerns with the registered manager.

There was enough suitably trained and safely recruited staff to meet people’s needs. Staff had the right induction, training and on-going support to do their job. People were supported to eat and drink enough to maintain a balanced diet and were given choice with their meals.

People’s needs and rights to equality had been assessed and care plans were kept up to date when needs changed. People were protected from any environmental risks in a clean and well-maintained home. Lessons were learnt from accidents and incidents.

Health and social care professionals were involved in people’s care and support and people accessed the healthcare they needed. Staff worked closely with other organisations to meet people’s individual needs.

People’s needs were met by the facilities provided at Ravenlea. They 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.

Staff were caring, the management team ensured there was a culture which promoted treating people with kindness, respect and compassion. Staff were attentive to people. The service had received positive feedback and people were involved in their care as much as possible. Staff protected people’s privacy and dignity and people were encouraged to be as independent as possible. Visitors were made welcome.

Personalised care met people’s needs, care plans were person centred and up to date. Where known, people’s wishes about their end of life care were recorded. People were encouraged to take part in activities they enjoyed. There had not been any complaints but people could raise any concerns they had with the registered manager. The provider sought feedback from people and their relatives which was recorded and reviewed.

People were happy with the management of the service and staff understood the vision and values of the service promoted by the provider and staff. There was a positive, person centred and professional culture. The registered manager had good oversight of the quality and safety of the service, and risks were clearly understood and managed. This was supported by good record keeping, good communication and working in partnership with other health professionals. The management team promoted continuous learning by reviewing audits, feedback and incidents and making changes as a result.

Further information is in the detailed findings below.