CQC report explained · a residential care home
What the CQC found at Ruddington View
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were found to be safe, with better management of incidents, safer support during distress and fewer behavioural incidents. Staffing levels, recruitment, medicines and infection control were also judged safe.
- Effective?
- Good
- People received suitable support with health, food, communication and daily choices. Staff had received additional training and worked with health and social care professionals.
- Caring?
- Good
- People and relatives spoke positively about staff, who were described as kind, caring and respectful. Staff supported choice, independence and relationships.
- Responsive?
- Good
- People had more personalised support and opportunities for activities, and were involved in care decisions. However, some support plans, activity records and guidance were incomplete or needed further development.
- Well-led?
- Good
- Inspectors found stronger leadership, better oversight and more effective quality checks. The home had an action plan, but inspectors said more time was needed to show that improvements would last as occupancy increased.
What inspectors found, June 2019
Rated Good; major improvements mean the home is no longer in Special Measures, although some care records still needed more detail.
Inspectors carried out an unannounced comprehensive inspection on 8 April 2019. They spoke with people living there, a relative, managers and staff. They reviewed care records, medicines records, recruitment files, audits and other records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found safer support for people whose anxiety affected their behaviour, better staff training, fewer agency workers and improved medicines systems.
Inspectors also found some care plans and activity records were not detailed or complete. The home had improved significantly since its previous Inadequate rating, but inspectors said more time was needed for the new systems to become fully established.
Safer support during distress
Staff had better training and guidance for supporting people during anxiety or challenging behaviour. Inspectors found more consistent and less restrictive support, with fewer incidents.
“Improvements had been made to how incidents were managed.” from the report
More consistent staff team
The use of agency staff had reduced, so people were more often supported by regular staff. This helped people build positive relationships with those caring for them.
“The use of agency staff had reduced and was only used to cover short notice absenteeism.” from the report
Kind and respectful care
People and relatives were positive about staff. Inspectors saw staff promoting choice, independence and personal space.
“People were positive about the staff who supported them, who showed great care, understanding and compassion.” from the report
Safer medicines arrangements
People received medicines when they should, and there was better guidance for medicines prescribed only when needed.
“Medicines systems were organised and people were receiving their medicines when they should.” from the report
Some care plans lacked detail
needs fixingInspectors found missing or incomplete guidance about exercise, a community treatment order and possible pain. Information was provided after the inspection, but the records needed to be more complete at the time.
“further time was required to ensure information was sufficiently detailed to enable staff to be responsive to people's needs.” from the report
Activity records were not always reliable
needs fixingSome activity plans did not match daily records, or were blank. The manager identified a need for further staff training in record keeping.
“From reviewing a sample of activity plans and people's daily records, we found instances where they did not match or were blank.” from the report
One person could not access the garden independently
minorOne person did not have a key fob after an earlier incident. A replacement had been ordered, but had not arrived during the inspection.
“However, one person did not have a key fob because of an incident that had occurred on 14 March 2019.” from the report
One medicines record missed a photograph
minorOne person’s medicines record did not contain a photograph. The manager knew about this and was taking action, and inspectors judged the impact on safety to be low.
“On reviewing people's medicine records, we noted one person did not have a photograph, despite being at the service since February 2019.” from the report
- 01How do you check that each person’s care plan contains complete and current guidance about their health, behaviour and risks?
- 02How are activity plans and daily records checked so they match and are not left blank?
- 03Has the replacement garden key fob been provided, and can people now access the garden as independently as planned?
- 04What evidence can you show that the improvements made after the previous Inadequate rating have continued?
- 05How do you make sure staff understand any community treatment orders or support needed for pain?
This was an unannounced comprehensive inspection covering the overall service, including care and the premises, and all five CQC questions. This explanation was written from the published report of 1 June 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2019
Rated Inadequate and placed in special measures; inspectors found serious safety, staffing, rights and management problems.
This was an unannounced inspection on 15 November 2018. Inspectors spoke with people living at the home, relatives and staff. They reviewed care records, risk assessments, medicines records, staff files and training records, and observed care.
Inspectors found serious risks linked to people's behaviour were not managed safely. Staff did not always have the right guidance, skills or numbers to keep people safe. Restrictive interventions were used, medicines for anxiety and agitation were not always properly justified, and incidents were not used effectively to prevent repeat problems.
People's legal rights and choices were not always protected. Care plans were out of date, support was inconsistent, activities were not well planned, and privacy was not always respected. Inspectors also found some positive care, including kind staff, clean premises, enough food and drink, and support that helped prevent some hospital admissions.
The overall rating was Inadequate. Safe and well-led were rated Inadequate, while Effective, Caring and Responsive required improvement. This was the first inspection since the home registered, and the home was placed in special measures.
Kind interactions
People and relatives described staff as kind and caring. Inspectors observed patient and friendly interactions.
“Overall, people told us they were supported by staff who were kind and caring in their approach.” from the report
Clean environment
The home was generally clean and hygienic, with infection control measures in place.
“Overall, the home was clean and hygienic and effective infection control and prevention measures were in place.” from the report
Food and drink
People had enough to eat and drink, with choices available. People were also supported to help prepare food where possible.
“People had a choice about what they ate and were supported to get involved in food preparation where possible.” from the report
Preventing hospital admission
The short-term unplanned care service had helped some people through periods of crisis and prevented a hospital admission.
“The 'unplanned care' part of the service had been effective in preventing hospital admission.” from the report
Unsafe behaviour support
seriousSome behaviour risks had not been assessed and support plans lacked clear instructions. This left people and staff at risk of harm.
“Risks associated with people's behaviours were not always managed safely. Risks had not always been assessed and there was a lack of guidance about how to manage some people's behaviours.” from the report
Restrictive interventions
seriousPeople were sometimes restricted in ways that did not respect their rights. Staff were not always given safe alternatives or clear guidance.
“People were subject to restrictive interventions that did not respect their rights.” from the report
Rights and consent
seriousMental capacity assessments had not been completed when required. Staff made some decisions for people without the legal authority to do so.
“People's rights under the MCA were not protected as the Act had not been applied to ensure decisions were made in people's best interests.” from the report
Staffing and skills
seriousThere were not always enough suitably qualified staff. Agency staff did not always know people well or have the necessary training.
“There were not always enough suitability qualified staff available to meet people's need and ensure their safety.” from the report
Out-of-date care plans
seriousCare plans did not always reflect people's current needs or changes after incidents. This increased the risk of inconsistent support.
“Support plans were not always up to date and did not reflect people's needs.” from the report
Weak oversight
seriousManagement checks failed to identify or address some serious issues. Records and incident reviews were not reliable enough to show that people received the support they needed.
“There had been a failure to identify and address some serious issues at Ruddington View.” from the report
- 01How many permanent and agency staff are normally on each shift now, and what training do agency staff have in learning disability, mental health and MAPA?
- 02Have every person's behaviour support plan and risk assessment been reviewed after incidents, and how are staff told what to do in a crisis?
- 03Have mental capacity assessments and best-interest decisions now been completed for all decisions where consent is in doubt?
- 04How do you check that as-required medicines for anxiety or agitation are only used as a last resort and are properly recorded?
- 05What actions from the provider's improvement plan have been completed, and what evidence can you show that they are working?
This was the first inspection since registration and covered all five key questions, with observations, discussions and reviews of care, medicines, staffing and management records. This explanation was written from the published report of 17 January 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Ruddington View
2 rated inspections over a year: the service has improved, from Inadequate to Good.
- June 2019Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2018
Registered with the Care Quality Commission on 13 February 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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