CQC report explained · a nursing home
What the CQC found at The Rylands Nursing and Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, medicines, staffing, recruitment and infection control were managed safely. They noted improvement since the previous inspection.
- Effective?
- Good
- People's needs were assessed and care plans reflected their needs and choices. Staff worked with health professionals and supported eating, drinking, treatment and legal decision-making.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in choices about their daily lives and care.
- Responsive?
- Good
- Care was personalised and updated when people's needs changed. People and relatives could raise concerns, and the home recorded actions taken in response.
- Well-led?
- Good
- Managers had improved quality monitoring, risk management and medicines systems. Staff said managers were approachable and supported them to raise concerns.
What inspectors found, May 2019
The Rylands Nursing and Residential Home was rated Good; inspectors found safe, kind care and improvements since the previous inspection.
Inspectors visited on 2 and 3 May 2019. They spoke with people living at the home, relatives, staff and health professionals. They observed care and checked care records, medicines, recruitment, training, complaints and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that medicines, staffing, risk management and infection control had improved since the previous inspection.
People said staff were kind, respectful and knew them well. The home supported choice, personal care needs, healthcare and involvement in decisions. The overall Good rating means the service met legal requirements and inspectors found consistently good care at this inspection.
Medicines were managed safely
People received medicines when they needed them. This included time-sensitive medicines, and staff competency was checked.
“People received their medicines when they needed them and from staff who were competent in their role.” from the report
Enough staff
Inspectors found sufficient staff to support people safely and meet their needs. There was a staff presence in all areas during the inspection.
“People were safely supported by sufficient numbers of staff.” from the report
Kind and respectful care
Staff knew people well and supported their dignity, privacy, choices and relationships. Inspectors observed positive interactions during the visit.
“Throughout the inspection we observed positive and thoughtful interactions between staff and people.” from the report
Improved oversight
The home had improved its audits and monitoring systems. Checks were linked to action plans and evidence of positive outcomes.
“All audits were supported by action plans and evidence of positive outcomes.” from the report
Care plans still needed improvement
needs fixingManagers said some care plans were not yet wholly person-centred. This was an identified area for further improvement.
“The registered and deputy manager told us they were aware of some improvement still needed such as, further improvements to people's care plans, to ensure they were wholly person centred.” from the report
Some delays with call bells
minorSome people said they had occasionally waited when they called for assistance. The manager planned to monitor response times more closely.
“some people had commented that they were, on occasion, kept waiting when they rang for assistance.” from the report
- 01How have you made care plans more fully person-centred since this inspection?
- 02How do you monitor call-bell response times, and what happens if people wait too long?
- 03How do you make sure time-sensitive medicines are given on time?
- 04How do you check that staffing levels continue to meet people's nursing and personal care needs?
- 05How are people and relatives involved when care needs or end-of-life wishes change?
This was a planned inspection covering all five CQC questions, including the premises and care provided, to check improvements since the previous inspection. This explanation was written from the published report of 31 May 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, June 2018
Rated Requires Improvement; inspectors found kind and responsive care, but staffing, medicines guidance and management checks were not reliable enough.
This was an unannounced inspection on 6 April 2018. Inspectors spoke with people living at the home, staff and a visiting health professional. They observed care, reviewed seven care records and checked medicines, staff files, complaints, accidents and quality checks.
The home was rated Good for Effective, Caring and Responsive. People were treated with dignity, offered choices and supported to stay independent. Staff knew people well, activities were available, and people could access food, drinks and other health professionals.
The home was rated Requires Improvement for Safe and Well-led. There were sometimes not enough staff to respond promptly. Some guidance for medicines given 'when required' was unclear, and some risk and wound care records were not kept up to date. Management systems did not always identify these problems.
Kind and respectful care
People were treated with dignity. Staff explained what they were doing and helped people make choices about their care.
“People were treated with dignity and respect.” from the report
Staff knew people well
Staff could describe people's needs, health conditions, life histories and preferences. Care plans were reviewed and changed when needed.
“Staff we spoke with knew people well and were able to tell us about people's needs, their life histories and their preferences.” from the report
Choice and independence
People were offered choices about food and where to spend their time. Staff encouraged people to do things for themselves where possible.
“We observed a member of staff encourage a person to try and eat independently which they then did.” from the report
Medicines guidance
seriousSome medicines to be given when needed did not have clear written instructions. The home added more detailed guidance after the inspection, but inspectors said further improvement was needed.
“This meant there was a risk that people may not receive their 'as and when required' medicine when they needed it as staff did not have guidance to follow.” from the report
Out-of-date risk records
seriousSome care and risk plans did not reflect changed needs. A wound plan and monitoring records were not clear or complete, which could lead to inconsistent care.
“This posed a risk as the person may not receive consistent care if their plan was not up to date and the wound was not always being effectively monitored.” from the report
Quality checks
needs fixingThe home's monitoring systems did not always find problems quickly. Medicines audits had not identified missing guidance, and some actions from previous incidents were not fully embedded.
“This meant we could not be assured that systems currently in place were effectively at identifying and resolved all concerns in a timely manner in order to protect people.” from the report
Staff training updates
minorStaff had training, but the training records showed some gaps. Inspectors recommended that all necessary training should be kept up to date.
“We recommend staff continue to receive updated training so all necessary training is up to date.” from the report
- 01How many staff are on duty on each shift, especially in the mornings, and how do you adjust this when people's needs change?
- 02How quickly are call bells normally answered, and how do you make sure communal areas are staffed?
- 03What written instructions are now in place for every medicine given 'as and when required'?
- 04How are wounds, falls and other changing risks recorded, measured and reviewed?
- 05Which staff training courses are still outstanding, and when will they be completed?
This was an unannounced inspection covering all five key questions; it did not examine the circumstances of a person's death, which was subject to a local authority investigation. This explanation was written from the published report of 22 June 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 The Rylands Nursing and Residential Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Rylands Nursing and Residential Home →
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at The Rylands Nursing and Residential Home →
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
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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