Archived: Ridgewood

Updated 3 January 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.

This inspection took place on 3 and 5 December 2018. The first day was unannounced. The inspection was conducted by one adult social care inspector.

Before the inspection we reviewed previous inspection reports and other information we held about the home including any notifications. A notification is information about important events which the service is required to send us by law. We also reviewed the Provider Information Record (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make.

We looked around the premises and observed staff interactions with people. We spoke with three people living at the service, the manager, two members of staff. Following the inspection, we spoke with one relative. We looked at care records for two people, staff training records, staff files and other records relating to the running of the service. We also contacted two external professionals to hear their views of the service.

Updated 3 January 2019

We carried out an unannounced inspection of Ridgewood on 3 & 5 December 2018. The service is registered to support up to 12 people with complex needs who have a learning disability and/or mental health conditions. At the time of the inspection there were 6 people using the service.

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

Ridgewood is a detached house in a residential area of Camborne. It has two floors and 12 individual rooms. Refurbishment work was underway on the first day of the inspection. This was to improve kitchen, communal bathing and en suite facilities. On completion of the work the service will have 5 rooms with en suite facilities. There were bathing facilities on each floor. A wet room had been added to a bathroom as well as a separate shower facility in another bathroom. There was a lounge and separate conservatory. A previous quiet lounge had been converted to a kitchen preparation area as well as a main kitchen used to cook meals. There was a rear garden area.

A manager was in post, and had applied to be registered with the Care Quality Commission. The manager was responsible for the day-to-day running of the service. 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.

As part of this comprehensive inspection we checked to see if the provider had made the required improvements identified at the inspection of 19 October 2017. In October 2017 we found governance systems were not effective and did not demonstrate clear oversight of the service. Incident reporting was not always happening when it should. For example, there was no evidence of how an incident might have occurred and action to prevent it occurring again. Medicine systems were not being managed effectively. A cream had not been dated when opened to ensure staff knew when the cream would remain effective to use. There were three gaps in administration records for when the cream was applied. Stock control was not always accurate. We made a recommendation for the service to improve the medicine audit system. People’s risks were not always being managed effectively because assessment for a person living at the service had not been completed. The staffing rota was not an accurate record which could be relied upon. Staffing levels supported people to have choices in activities during the week. However, during weekends this could be limited because of staffing levels in the service.

At this inspection we found improvements had been made in all the areas identified at the previous inspection. This meant the service had met all the outstanding legal requirements from the last inspection and is now rated as Good.

Since the previous inspection the Nominated Person [A person who has overall responsibility for supervising the management of the regulated activity] had changed. They had introduced new recording and management systems and reviewed all operational systems for the governance of the service. This had been carried out with the manager who had experience of working at a senior level. New governance systems had been put in place including reporting of accidents and incidents. Audit systems relating to accidents and incidents were in place so the manager could identify any patterns or trends to mitigate the possibility of it occurring again.

Medicine administration systems had been reviewed. Weekly auditing processes meant any omissions and stock control issues were being identified and managed more effectively. Staff understood the importance of dating creams when opening them and records to record the application was being maintained.

Risk assessments included details of identifying the risk to the person and how this was going to be managed. Risk assessments were in place for people living at Ridgewood. People’s individual care needs had been assessed for risks related to aspects of daily living and these were reviewed regularly.

Staffing levels had been reviewed and changes to shift patterns meant there was more flexibility in how the service was staffed. There were sufficient numbers of staff deployed to meet people’s needs. This meant people were supported to take part in activities when they wanted to.

The service learned from accidents and incidents. An additional night staff post had been put in place following a review after an incident. It was identified that one member of staff had found it difficult to alert an on-call staff member due to the presenting situation. By creating an additional post, it meant accidents and incidents could be responded to more effectively.

People told us that they felt safe with the support they received from staff at Ridgewood. There were safeguarding policies and procedures in place. Staff were knowledgeable about what action they should take if they suspected abuse.

Staff records showed the recruitment process was robust and staff had been safely recruited. Training was up to date, and the staff team were supported through supervision and appraisal sessions.

The care service was established before the development of the CQC policy, 'Registering the Right Support' and other current best practice guidance. This guidance includes the promotion of values including choice, independence and inclusion. The service was working with people with learning disabilities that used the service to support them to live as ordinary a life as any citizen. For example, people’s bedrooms offered space and privacy. There was access to activities both at the service and in the community.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. Where restrictions were in place to keep people safe the best interest process had been followed to check restrictions were necessary, proportionate and the least restrictive practice.

The service was undergoing a refurbishment programme to improve the environment.

There were effective quality assurance systems in place. People, staff and relatives had opportunities to make suggestions about how the service could be improved. Staff described the management team as approachable and supportive.