Archived: Rippleside Rest Home

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.

We found that care and support focused on promoting people's independence and that staff treated people in a respectful manner. Care plans were personalised and took into account the choices and decisions of people who used the service. We examined the systems and processes in place for the safe management of medicines and found these to be safe and effective. We saw that the service had systems in place to gather information about the safety and quality of the service.

We saw people talking freely with staff. One person who was going out was discussing their forthcoming outing with staff.

We saw that the care plans were personalised and reflected the needs of the individual. People were encouraged to maintain their own independence as far as possible.

People received a choice of healthy and nutritious meals. One person told us they were looking forward to their lunch, they told us, 'the food is good here.'

We saw that people who were responsible for partially funding their own care costs did not receive the appropriate statement as required by the Care Quality Commission (Registration) Regulations 2009. We have asked the provider to address this.