CQC report explained · a nursing home
What the CQC found at Ryland View Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2021
Requires Improvement; inspectors found staffing shortages and weak management systems, although medicines and safeguarding arrangements were generally effective.
This was an unannounced focused inspection. Inspectors visited on 24 and 29 June 2021, spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
There were not always enough staff to support people promptly. Some people waited for personal care or help to use the toilet. Staff were mainly focused on tasks and had little time for conversation or activities. This breached Regulation 18 on staffing.
People generally received their medicines when needed and systems were in place to protect them from abuse. However, some risk assessments lacked important detail, infection risks were found in worn equipment, and management systems did not always identify or deal with problems promptly.
The overall rating fell from Good at the previous inspection in 2018 to Requires Improvement. The inspection only assessed Safe and Well-led. Ratings for the other areas were carried forward from the earlier comprehensive inspection.
Medicines usually given as prescribed
Most people said they received their medicines when needed. Electronic records showed medicines had been administered as prescribed, and staff had medicine training and competency checks.
“The electronic records confirmed medicines had been administered to people as prescribed.” from the report
Safeguarding systems
People said they felt safe, and staff knew how to recognise and report possible abuse. Relatives spoken with did not raise safety concerns.
“Staff we spoke with confirmed they had received training in relation to safeguarding people from abuse and knew the procedures to follow.” from the report
Recruitment checks
The recruitment records checked showed that required checks had been completed before staff started work.
“These demonstrated all the required recruitment checks had been completed before the staff members commenced working in the service.” from the report
Partnership working
The home worked with health and care professionals to support people's healthcare needs. A visiting professional said staff followed recommendations and people's conditions generally improved.
“Staff follow any recommendations shared and people's condition generally improves in response to the partnership working and intervention.” from the report
Not enough staff
seriousStaffing was not sufficient to meet people's wider needs promptly. Inspectors saw delays with medicines and personal care, and had to intervene when a person at risk of falling could not get staff support.
“Sufficient numbers of suitably qualified, competent skilled and experienced staff were not deployed to meet people's holistic needs.” from the report
Limited time and activities
needs fixingStaff were mainly task focused and people had few opportunities for conversation or meaningful activity. Some people living with dementia were observed without activities or objects to occupy them.
“We observed staff were busy and mainly task focused during our inspection visits meeting peoples core care needs.” from the report
Incomplete risk information
needs fixingSome risk assessments did not explain clearly what support was needed or when tasks should be completed. This could make it harder for new or agency staff to provide consistent care.
“We found for some people these lacked detail to provide staff with clear direction and information.” from the report
Management instability
needs fixingThere was no registered manager at the time of the inspection, and staff reported low morale. Some audits did not clearly show what action had been taken to fix identified problems.
“There has been a period of instability with the management of the service.” from the report
Infection and fire risks
needs fixingWorn and ripped equipment was found on three units and presented an infection risk. One fire-safety action had not been completed promptly, although temporary steps had been taken.
“We observed on three of the units equipment and furniture where the integrity had been compromised as they were worn and ripped.” from the report
- 01How many staff are now working on each unit at different times of day, and how do you check this is enough for people's needs?
- 02What has changed since the inspection to prevent people waiting for personal care, toilet support or help when they are at risk of falling?
- 03Has the new manager been registered with CQC, and what has been done to improve staff morale and respond to staff concerns?
- 04What action has been completed on the fire-safety work and the worn or damaged equipment?
- 05How are meaningful activities now provided, especially for people living with dementia?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 21 August 2021 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 2018
Rated Good overall, but inspectors found activities were uneven across units and rated the home Requires Improvement for responsiveness.
Inspectors visited the home without warning on 04 and 05 July 2018. They spoke with people, relatives, staff and managers, observed care, and checked care, medicines, recruitment, complaints and quality records.
They found people were generally safe. Staff managed risks, medicines and infection control appropriately. Staffing levels were considered sufficient, and staff had the required recruitment checks.
Care was kind and respectful. People received support with meals, health appointments and communication. Care records were personalised and updated when needs changed.
The main shortfall was activities. What was available varied between units, so some people had more meaningful experiences than others. The home was rated Good overall, with Safe, Effective, Caring and Well-led rated Good, and Responsive rated Requires Improvement.
Safe staffing
Inspectors found enough staff across the units and saw people receive support promptly. Staffing was planned using a dependency tool, with arrangements to cover sickness.
“Our observations across all units indicated there were enough staff to keep people safe” from the report
Kind and respectful care
Staff built positive relationships with people, offered choices and respected privacy and dignity.
“We saw examples across all five units of positive relationships being developed between people and the staff supporting them.” from the report
Personalised care
Care records included people's preferences and were updated when their needs changed. Staff knew people's needs and life histories.
“We found that care records were updated where people's needs had changed and that people's preferences with regards to their care had been considered.” from the report
Health and nutrition support
People received help with meals and drinks and were supported to see health professionals. Staff monitored weight loss and made referrals when needed.
“People had access to healthcare services to support their health and well-being.” from the report
Learning from incidents
The registered manager reviewed accidents and changed staffing times after identifying more incidents in the evening.
“The registered manager showed a willingness and openness to learning from incidents to improve the safety of the service.” from the report
Uneven activities
needs fixingActivities were more readily available on some units than others. Inspectors also heard that some events had limited spaces or may not have been accessible to people needing wheelchair support.
“We found that the availability of activities varied across each unit.” from the report
Moving and handling practice
needs fixingOn one unit, staff supported people to stand in a way that could have increased their risk of falling. The manager had identified this and arranged specialist advice and further training.
“Staff supported people by holding their hands while they stood, rather than encouraging them to push themselves up using the arms of the chair.” from the report
Uneven DoLS knowledge
needs fixingSome staff could not recall who had a Deprivation of Liberty Safeguards authorisation or what it meant. Inspectors could not be sure people were always supported in line with those authorisations.
“Without this knowledge of who has a DoLS authorisation and any associated conditions on these, we could not be sure that people were always supported in line with the authorisations” from the report
Training updates
minorNot all staff had completed the required training updates. The manager had identified the gap and was arranging the outstanding training.
“Records we looked at showed that while training was being completed, not all staff had completed the required courses.” from the report
- 01What activities are available every day on the unit my relative would live in?
- 02How do you make sure people who use wheelchairs or need help to move can take part in outings and events?
- 03What moving and handling training has been completed since the inspection?
- 04How do staff know which people have a Deprivation of Liberty Safeguards authorisation and what conditions apply?
- 05Have all required staff training updates now been completed?
This was an unannounced inspection covering all five key questions and the overall service, and it was the first inspection since registration under a new provider in December 2017. This explanation was written from the published report of 31 August 2018 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 Ryland View Care Home
2 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- August 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2018GoodSafe: GoodWell-led: Good
- November 2017
Registered with the Care Quality Commission on 30 November 2017.
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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