17 October 2023
During a routine inspection
Ryland Residential Home is a residential care home providing personal care for up to 17 people. The service provides support to older adults. At the time of our inspection there were 16 people using the service.
People’s experience of the service and what we found:
The provider failed to have sufficient systems and processes to assess, monitor and mitigate the health, safety and quality of the service. Their quality assurance systems failed to identify people were at risk of harm from lack of risk assessments, plans to mitigate risks and lack of adherence to policies and procedures.
People were at risk of infection and harm from a service which was unclean and required repair and refurbishment.
The provider, registered manager and staff did not understand their roles in safeguarding people. Incidents of alleged abuse were not recorded or reported to the local safeguarding authority. Medicines were not managed in line with best practice. Staffing levels were not safe and left people at risk of falls and social isolation.
People’s specialised diets were not followed or planned effectively. The provider did not work well with professional agencies to mitigate risk and improve outcomes. Staff had not received relevant training to support them to be competent in their roles.
Care was not person-centred and was task oriented. People were not always treated respectfully or with dignity. People did not receive personalised activities and were left at risk of social isolation.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. The policies and systems in the service did not support people to live in the least restrictive way possible.
People were supported to have contact and visits from relatives. Staff recruitment was safe. Some staff showed a caring and compassionate attitude. Relatives told us they felt the service was safe, person-centred, and meals were of good quality. Relatives felt the registered manager was friendly and approachable.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service under the previous provider was Good (published 17 November 2017).
Why we inspected
The inspection was prompted in part due to concerns received about medicines management, staffing levels and the environment. A decision was made for us to inspect and examine those risks. We made a decision to complete a comprehensive inspection due to the change of service provider since the last inspection.
Enforcement
We have identified breaches in relation to safety, safeguarding, person centred care, staffing and training.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow Up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.