Archived: Rippleside Rest Home

Updated 26 August 2016

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 2, 3 and 9 June 2016 and was unannounced. The inspection team consisted of two inspectors and an inspection manager. Before the inspection we checked the information that we held about the service and the service provider. The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We met with all of the people who use the service and were able to speak with five people, three care workers, the registered manager, and a director of the provider’s limited company. We observed staff providing care and support to people. We spoke with two relatives and a health care professional by telephone.

We reviewed four people’s care plans and associated risk assessments, the recruitment and training records for three members of staff, quality monitoring audits and other records relating to the management of the home.

Updated 26 August 2016

This inspection took place on 2, 3 and 9 June 2016 and was unannounced. Rippleside Rest Home provides care and support for up to eight people with mental health needs who may also have a diagnosis of early stage dementia. Each person had their own private bedroom. There were six people with an age range of 68 to 85 years living in the home at the time of our inspection.

The home had 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.

The service was not always safe. Risks to individuals, and environmental risks, such as fire and legionella, were not well managed, although required maintenance for gas, electrical and fire systems had been completed. Staff did not have a good understanding of the importance of managing risk properly, to keep people as safe as possible.

Staff knew how to recognise the signs of abuse and what they should do to keep people safe, by either reporting concerns to the registered manager or the local authority. Recruitment practices were safe and there were enough staff to meet people’s needs. Medicines were managed safely and people were given their medicines as prescribed.

The registered manager did not have a good understanding of the Mental Capacity Act (2005) or who had the legal right to make decisions on behalf of a person using the service. Capacity assessments had not been completed for people who may have needed them.

People were supported to maintain good health and had access to health care services when they needed it. People had their food and hydration nutritional needs met, and feedback about the food was positive. However, people’s choices and preferences were not well understood and they were not well supported to express their views or make decisions about their care.

Staff were concerned for people’s welfare, and were kind and caring. Feedback from people about staff and the care they experienced was positive. Although there were enough staff on duty to meet people’s basic care needs and keep them safe, staff were not given the time they needed to make sure the care people experienced was person centred and not task focused.

The service was not responsive. People were not supported to be involved in the assessment and planning of their care. People’s care needs were not regularly reviewed and the registered manager and staff did not make sure people experienced care that was individual to them. People were not always supported to do the things that were important to them.

The provider did not have robust quality monitoring processes in place and did not understand the importance of good quality monitoring. Areas for improvement were not always identified. Complaints and concerns were not well managed and the registered manager and provider did not properly seek feedback from people, relatives or staff.

The registered manager did not have a good understanding of their role and responsibilities and ensured that staff understood what was expected of them. Not all of our registration requirements were met and accurate and up to date records were not kept.

Leadership was not visible from the provider or registered manager. They did not understand their responsibilities and quality monitoring was poor. Many of the issues highlighted at this inspection had not been identified by the registered manager or provider. Incidents and accidents were well reported but not properly analysed so staff and the registered manager could learn from them. Records were inaccurate and not always kept securely. Not all of the relevant notifications had been sent to CQC as required by law.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 You can see what action we told the provider to take at the back of the full version of this report.