CQC report explained · a residential care home
What the CQC found at Ryde House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, robust risk assessments, suitable safeguarding procedures and safe medicines management. Some areas in two units were not clean, but these issues were addressed during the inspection.
- Effective?
- Good
- Staff had induction, regular training and specialist training for people's needs. People had access to food, drink, health checks and relevant health professionals.
- Caring?
- Good
- Staff were kind, respectful and compassionate. They supported communication, choice, privacy, dignity and independence.
- Responsive?
- Good
- Care plans were detailed and personalised. People were supported with activities, community life and complaints, and staff responded when needs or behaviours changed.
- Well-led?
- Good
- Inspectors found a clearer management structure, supportive managers and strong auditing systems. Managers and staff worked with health and social care professionals to coordinate care.
What inspectors found, January 2019
Ryde House was rated Good; inspectors found safe, kind and personalised care, with cleanliness issues in two units dealt with during the inspection.
This was an unannounced inspection over three days in September 2018. Inspectors visited all five units, spoke with people, relatives, staff and health professionals, and checked care records, safeguarding information, training, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines systems, detailed risk assessments and care plans, and good access to health professionals.
Staff knew people well and supported their choices, independence and community activities. People were treated with dignity and respect. The inspectors did find some unclean areas in two units, but these were addressed immediately.
The previous inspection in 2017 rated the home Requires improvement and found no breaches. This inspection found that improvements had been made, including clearer management oversight and more consistent systems across the five units.
Managing individual risks
Risk assessments were detailed and gave staff clear instructions. Staff supported people to take positive risks while helping them stay safe.
“Individual risk assessments identified risks to people, providing clear guidance to staff on how risks should be managed and mitigated.” from the report
Kind and respectful staff
Staff knew people well and built positive relationships. Inspectors saw people being treated with dignity and respect.
“Staff developed caring relationships with people and treated them with dignity and respect.” from the report
Personalised care
Care plans included people's histories, preferences, health needs and communication styles. Staff used this information to provide individual support.
“People's care plans were person centred and staff had the information they needed to support them as individuals.” from the report
Activities and independence
People were supported to learn skills, make choices and take part in activities they enjoyed, including community activities, work and education.
“People were actively involved in accessing their community and participating in activities they chose.” from the report
Improved management oversight
Since the previous inspection, the provider had reviewed its management structure and introduced more consistent oversight across the five units.
“The directors of the provider's company had considered the management structure and the previous lack of consistency across the five units.” from the report
Cleanliness in two units
needs fixingInspectors found an unclean area in the main house and a bathroom in another unit needing maintenance so cleaning could be done properly. Managers acted immediately, but families should check that standards remain consistent.
“Three of the five units were clean, however we found areas in two of the units that could pose an infection control risk to people.” from the report
Accommodation size and registration guidance
minorEach unit accommodated more people than the best-practice guidance for supporting people with learning disabilities recommends. The report says the home followed the values behind the guidance in other ways.
“Although, they do not meet the requirement of registering the right support because each unit accommodates more people than Registering the Right Support guidance advises.” from the report
Management registration during the inspection
minorThe two senior managers were still awaiting registration with the CQC during the inspection. The report says their registration was completed after the inspection.
“Although the two senior managers had not yet been registered with the Care Quality Commission (CQC), they understood their responsibilities and had notified CQC about all incidents, safeguarding concerns and events that were required.” from the report
- 01What checks are now in place to keep all five units clean, including the areas identified during this inspection?
- 02How is the current management structure organised, and who has final accountability for the unit where my relative would live?
- 03How do you make sure practice and care standards are consistent across all five units?
- 04How will my relative's end-of-life wishes be recorded, given that an advance care planning tool was still being created at the time of the inspection?
- 05How would you support my relative to take part in community activities while managing their individual risks?
The unannounced inspection covered all five units, the overall quality of the service and all five CQC questions. This explanation was written from the published report of 18 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.
What inspectors found, August 2017
Rated Requires Improvement; inspectors found kind and effective care, but gaps in risk records, care plans and leadership oversight.
Inspectors made an unannounced visit on 24 and 25 May 2017 and 1 June 2017. They spoke with people living in the home, families, staff and health professionals. They also observed care and checked care plans, medicines, staffing, complaints and management records.
The home was rated Good for Effective and Caring. People were supported by trained staff, received their medicines safely, had access to health professionals and were treated with kindness, dignity and respect. Staff supported people to make choices, stay independent and take part in activities.
The home was rated Requires Improvement for Safe, Responsive and Well-led. In two units, some risks were not properly assessed or managed. Care plans in two units were not always personal or accurate, and quality checks in one unit were not strong enough to identify problems.
The overall rating Requires Improvement means the home was not consistently meeting the expected standard in some important areas. A previous breach about infection control and a previous breach about consent and capacity had been put right by this inspection.
Enough trained staff
There were enough staff to meet people's needs. Staff had induction, ongoing training, supervision and relevant specialist training.
“Staff received an appropriate induction, on-going training and support to enable them to meet the needs of people using the service.” from the report
Activities and independence
People were supported to take part in activities they enjoyed, use the community and keep their life skills and relationships.
“People were provided with appropriate mental and physical stimulation.” from the report
Medicines and infection control
Medicines were stored and given safely. The previous infection control problem had been put right, and the home was clean and well maintained.
“There was no longer a breach of this regulation and the home was clean, well maintained and appropriate risk assessments in respect of infection control had been completed.” from the report
Some risks were not properly managed
seriousIn Silver Birch, one person who spent long periods in bed had no call bell or other way to summon urgent help. Their checks were not recorded, and the hoist risk assessment did not include osteoporosis. Beech House also lacked a risk assessment for transporting and managing controlled medicines outside the unit.
“they did not have access to a call bell or other means of alerting staff if they needed urgent assistance.” from the report
Care plans lacked personal detail
needs fixingSome Silver Birch care plans did not explain what signs such as being unsettled or in pain looked like for the individual, or what support should be tried first. A Sycamore House plan did not explain how staff should support a person with weight and healthy living.
“information in people's care plans was generic and did not focus on people's individual's needs.” from the report
Records were not always accurate
needs fixingSome Silver Birch keyworker reviews repeated the same wording for several months. They did not accurately show current health changes or activities.
“some of the keyworkers in Silver Birch had 'cut and pasted' the same review over a period of months” from the report
Weak oversight in one unit
needs fixingQuality checks in Silver Birch were less formal and less robust, so some problems were not identified. Senior roles also overlapped, making accountability less clear.
“This provided the potential for confusion, with overlapping responsibilities leading to a lack of clear accountability and ownership of issues.” from the report
Expired liberty safeguard
seriousIn Silver Birch, one person's legal authorisation had expired and no renewal application had been made. The manager took action after inspectors raised it.
“the DoLS authorisation for one person had expired in June 2016 and no renewal application had been made.” from the report
- 01What risk assessments are in place for my relative in the specific unit they would live in, and how often are they reviewed?
- 02How will staff recognise my relative's signs of pain, anxiety or distress, and what support will they try before giving as-required medicine?
- 03How do you check that keyworker reviews are current and have not been copied from earlier months?
- 04How do you make sure any Deprivation of Liberty Safeguards authorisation is renewed before it expires?
- 05Who is accountable for fixing problems found in the unit, and what quality checks are now carried out there?
This was an unannounced inspection of all five questions across the five units, including care, staffing, records and management systems. This explanation was written from the published report of 24 August 2017 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Ryde House
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- January 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015
Registered with the Care Quality Commission on 30 June 2015.
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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Most charge £1,010 to £1,230 a week. 68 can care for a couple. 11 years' experience on average.
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