CQC report explained · a residential care home
What the CQC found at Ryeview Manor Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found suitable risk assessments, enough planned staff, safe recruitment, safe medicines systems and clean communal areas.
- Effective?
- Good
- Staff were trained and considered competent. People were supported with food, drink, healthcare, legal decision-making and care based on recognised guidance.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People and relatives said staff knew people well, involved them in decisions and promoted independence.
- Responsive?
- Good
- Care plans reflected people's needs, preferences and routines and were updated when needs changed. People had flexible activities, support with communication and a complaints process.
- Well-led?
- Good
- The home had a clear management structure, an open culture and improved quality checks. Staff, people and relatives had opportunities to give feedback.
What inspectors found, March 2020
Ryeview Manor Care Home was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection on 4 February 2020. The inspection team observed care, spoke with 16 people, seven relatives, nine staff and a visiting professional, and checked care, medicines, recruitment and management records.
All five areas were rated Good. Inspectors found that people were protected from abuse, risks were assessed, staffing levels were met and medicines were given as prescribed. Staff were described as skilled, caring and respectful.
People had personalised care plans, suitable activities and support to maintain relationships. The home also supported people's health, nutrition, communication needs and end of life care.
The previous rating was Requires Improvement, with three breaches of regulations. Inspectors found that improvements had been made and that the home was no longer in breach. The report includes one contradictory summary sentence saying the service was not always effective, although the effective rating and detailed findings were Good.
Safe staffing and medicines
Planned staffing levels were being achieved and staff responded promptly. Medicines were administered as prescribed and records were accurate.
“We observed staff administering medicines to people in line with their prescriptions. There was accurate recording of the administration of medicines.” from the report
Personalised care
Care plans had become more detailed and gave staff clear guidance about people's individual needs, preferences and routines.
“Since our last inspection the provider had reviewed care plans and updated them, we observed the level of detail about people's personalised needs had improved” from the report
Kind and respectful staff
People and relatives spoke positively about the care. Staff supported people's choices, privacy, dignity and independence.
“We saw staff checked with people before providing support and encouraged them to express their views and wishes.” from the report
Activities and relationships
People could take part in flexible activities that matched their interests and were supported to maintain important relationships.
“There was a wide range of activities offered, and throughout the day we observed people engaged with staff and enjoying what they wanted to do” from the report
End of life care review
minorThe manager was reviewing the way people were supported at the end of life. Ask what this review concluded and what changes were made.
“The registered manager was currently reviewing the way people were supported at end of life care” from the report
- 01What changes were made after the review of end of life care?
- 02How are care plans checked and updated when a person's needs or preferences change?
- 03How do you make sure planned staffing levels are still being achieved on every unit and shift?
- 04How are medicines records checked for accuracy and how often are staff competency checks repeated?
- 05How do people and relatives give feedback, and what changes have been made in response?
This was an unannounced inspection covering all five CQC questions, including care, premises, records, staffing and management systems. This explanation was written from the published report of 14 March 2020 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, February 2019
Rated Requires Improvement; inspectors found safe and effective care, but concerns about personalised support, responding to distress and quality checks.
This was an unannounced inspection on 27 November and 4 December 2018. Inspectors spoke with people living in the home, relatives and staff. They reviewed care plans, medicine records, staff records, audits and other documents, and observed care.
The home was rated Good for safe and effective care. Staff were trained, there were enough staff, medicines systems were generally in place, and people had access to food, drink and health professionals.
The ratings for caring, responsive and well-led were Requires Improvement. Inspectors saw people left for long periods with little interaction, including someone who appeared distressed. Some care plans used negative language or did not give enough detail about how to support people.
The overall rating fell from Good in all areas at the previous inspection in August 2016 to Requires Improvement. The report identified breaches of Regulations 9 and 17 and said the provider had to send an action plan.
Safeguarding
Staff had safeguarding training and knew how to recognise and report abuse. The report says concerns were investigated and resolved promptly.
“People were protected from the risk of harm and abuse by staff who had completed the required training.” from the report
Staffing and training
Inspectors found enough staff to meet people's needs and keep them safe. Staff received induction, training, supervision and competency checks.
“People were supported by staff who had completed the appropriate training.” from the report
Health and nutrition
People were supported to eat and drink enough and to access healthcare professionals. Staff used assessments to identify risks such as malnutrition and pressure ulcers.
“People were supported to have sufficient amounts to eat and drink.” from the report
Activities and involvement
The home offered activities and involved people, relatives and staff in decisions. This included a dementia café, visits from a local nursery and opportunities for feedback.
“The provider sought feedback from people and their relatives using written and verbal methods.” from the report
People left without enough support
seriousInspectors saw people sitting with very little interaction for more than two hours. A person who appeared distressed called out for a relative but staff did not respond.
“There were several missed opportunities which staff could have taken to provide emotional support, reassurance and have meaningful interactions with people during this period.” from the report
Care plans were not always personalised
seriousSome care plans used negative language and did not explain what might trigger anxiety or what staff should do to reduce distress. This was a breach of Regulation 9.
“This meant the person's emotional needs were not being met, as staff did not have sufficient guidance to refer to when the person needed support in periods of anxiety or distress.” from the report
Medicine audits did not prove errors were fixed
seriousAudits identified gaps in medicine records, but did not contain enough detail to show how errors were corrected or whether actions were completed. Repeated mistakes were found, and this was a breach of Regulation 17.
“These audits indicated actions staff had taken to correct errors had not been effective as mistakes were repeated.” from the report
Limited end of life detail
needs fixingSome end of life wishes were recorded, but the report found too little detail about the care and treatment people preferred and needed in their last days.
“There was also information about people's preferred funeral arrangements and which relatives to contact in case of an emergency.” from the report
- 01What has changed to make sure staff respond promptly when residents show distress or call out?
- 02How do you involve residents and families in writing and reviewing care plans?
- 03How do care plans now explain triggers and effective ways to support someone who becomes anxious or distressed?
- 04What checks now show that medicine record gaps and other medicine errors are corrected and do not recur?
- 05How are residents' detailed wishes for end of life care recorded and kept up to date?
This was an unannounced inspection covering all five CQC questions, and it looked at both the accommodation and the care provided. This explanation was written from the published report of 22 February 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 Ryeview Manor Care Home
3 rated inspections over 4 years: the service has held its Good rating throughout.
- March 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- July 2013
Registered with the Care Quality Commission on 23 July 2013.
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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