Background to this inspection
Updated
8 July 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Two inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. We visited the service on 15 June 2023 and 20 June 2023. The Expert by Experience made phone calls to relatives on 16 June 2023.
Service and service type
Ridgeway Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ridgeway Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 8 people living in the service and 9 relatives about their experience of the care provided. We spoke 15 staff. This included the registered manager, area director, deputy manager, senior clinical lead, senior care staff and care staff. We also spoke with activities, kitchen, domestic and maintenance staff. We spoke with 1 visiting health professional.
We looked at aspects of 7 people's care records and multiple medication records. We reviewed recruitment records for 3 staff. We looked at a range of other records including quality assurance checks, meeting minutes and training records.
Updated
8 July 2023
About the service
Ridgeway Lodge is a residential care home providing personal and nursing care to up to 61 people. The service provides support primarily to older people, some of whom are living with dementia. At the time of our inspection there were 42 people using the service.
People’s experience of using this service and what we found
Since the last inspection improvements had been made to all areas of previous concern, particularly in relation to the poor quality of dementia care.
There were consistently enough staff to meet people's needs. More permanent staff had been recruited and staff were getting to know people and their needs well.
People living with dementia who may show behaviour indicating distress were appropriately and safely supported. Improvements were found in care records including assessments of risk and support plans setting out how to provide safe and personalised care. Processes to learn lessons and for these to be shared with the staff team had been implemented. Incident recording and reporting processes continued to be embedded into practice.
People received person-centred care. Improvements were found in the planning and delivery of person-centred care, particularly for people living with dementia and those who may show behaviour indicating distress. The management team were embedding good practice at all levels so people and their needs were better understood by staff. People were supported to spend time in the way they preferred and doing things they enjoyed.
The provider acknowledged the failings found at the last inspection. A new registered manager started soon afterwards and worked with the provider and staff team to identify, implement and embed improvements in all areas. The registered manager was well regarded. They worked openly and transparently and welcomed the inspection process. They were committed to driving continuous improvements and embedding an open and learning culture in the service.
People were cared for safely and protected from the risk of abuse. People were supported with their medicines and good infection control practices were in place.
People's needs were assessed, monitored and reviewed. Care plans included consideration of people's individual needs under the Equality Act 2010. Since the last inspection staff had received refresher and additional training to upskill their knowledge and practice. Competency checks took place to strengthen this further.
People were supported with their nutrition and hydration needs. Improvements were found in the dining experience since the last inspection, which we observed to be relaxed and enjoyable. People were supported to promptly access health care services when needed.
People received support from caring staff. Staff enjoyed working in the service, valued people as individuals and had positive relationships with people and their relatives. People were treated with respect. Staff maintained people's dignity and privacy. Consent was sought before care was delivered.
People and their relatives knew how to make a complaint, and felt they could raise any issues with the registered manager. Staff felt able to raise concerns if they needed to.
Quality assurance systems were effective. A range of meetings took place with people, relatives and staff. Staff were supported through one to one supervisions, competency checks and team meetings. The management team had an open door policy to encourage staff, people and their relatives to talk to them about anything.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 22 December 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this inspection to review the breaches of regulation found at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ridgeway Lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.