We carried out a review of the data available to us about Ravenstone Care and Rehabilitation Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ravenstone Care and Rehabilitation Home, you can give feedback on this service.
We found the following examples of good practice:
All staff and essential visitors used appropriate personal protective equipment (PPE).
The home had sufficient supplies of appropriate PPE which was stored hygienically and kept safe.
Staff were provided with separate areas to put on and take off and dispose of PPE safely.
Staff supported people's social and emotional wellbeing. Where people required additional support, they were referred to appropriate services.
The provider explained the quality systems they had in place to check the service was providing safe care.
Deep cleaning of all areas of the home was completed and recorded.
All staff, including catering and housekeeping staff had undertaken training in infection prevention and control. This included putting on and taking off PPE, hand hygiene and other Covid-19 related training.
The provider's infection outbreak plan required further development.
Further information is in the detailed findings below.
Ravenstone Care and Rehabilitation Home is a residential care home providing personal care for up to 14 people, some of whom are living with mental health or dementia needs. There were 13 people living at the home at the time of this inspection.
People’s experience of using this service and what we found
People said they liked living at this home and the staff were friendly. They said their independence was encouraged. Relatives said it was “small and personalised” and had a welcoming atmosphere.
All the people and relatives we spoke with felt the home was safe and comfortable.
There had been improvements to the way medicines were managed and a commitment to checking these continued to improve. Risks to people’s health and safety were assessed and minimised.
People said there were enough staff to support them when they needed it. Safe recruitment practices had been used to make sure new staff were suitable. Staff had practical training in infection control. They followed national guidelines to prevent the spread of infection and to make sure the home was hygienically clean.
People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible and in their best interests; the policies and systems in the service upheld this practice.
People and relatives said the home was well-run and described the registered manager as open and approachable.
Due to the pandemic, quality assurance checks and audits had not progressed as much as intended. Further work was needed but the provider and registered manager were committed to continuous improvement. We have made a recommendation about this.
Staff had mixed views about the way the home was managed. The provider was aware of this and was taking steps to address this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 7 April 2020) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations. However, further action was needed with regards to the auditing of the service to ensure that the improvements which were being made were sustained.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 11 November 2019. Breaches of legal requirements were found. The provider completed an action plan after that inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ravenstone Care and Rehabilitation Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Ravenstone Care and Rehabilitation Home is a residential care home registered to provide personal care for 14 people living with dementia or a mental health condition. At the time of the inspection 14 people lived at the home. The care home accommodates 14 people in one adapted building.
People’s experience of using this service and what we found
Risk assessments did not always fully address risk. Medicines were not always managed in line with good practice. People and staff told us staffing levels were appropriate to people’s needs. Staff had received training in reporting and responding to abuse and were confident they could report any concerns. However, we found processes had not been consistently implemented. We have made a recommendation about this.
Auditing systems for managing risk were sometimes ineffective as they had failed to identify concerns we found. We received conflicting evidence about staff morale and teamwork within the home. The registered manager was aware of their role and responsibilities and the importance of continuous improvement. Staff turnover was low. We saw evidence of multi-disciplinary working to make sure care was delivered in line with good practice.
People had access to kitchen facilities to make snacks and drinks. We received positive feedback about the choice and quality of food provided. People told us they had access to health professionals when needed. Good practice guidance was considered.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, documentation did not always show the provider was working within the principles of the Mental Capacity Act (MCA). We have made a recommendation about following good practice guidance related to the MCA.
People and relatives told us on the whole staff were kind and caring. Observations made during the inspection confirmed people were treated with dignity and respect. We observed staff enquiring about people’s comfort and welfare throughout the visit. There was a focus on developing independence and people who lived at the home experienced positive outcomes.
People were supported by staff who knew them well. End of life care had not been formally addressed within care records, but staff understood the importance of multi-disciplinary working at the end of a person’s life. There was an emphasis on providing activities to keep people occupied and combat isolation. Concerns were proactively addressed by the registered manager. People told us the service met their needs and described the care as “spot-on.”
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 this service was good (published 25 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment and good governance. Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Ravenstone Care and Rehabilitation Home (Ravenstone) provides care and accommodation for up to 13 people with mental health needs. The building has three storeys that have been adapted for use as a residential care home. Each person had their own room and there are lounge and dining facilities on the ground floor.
Ravenstone was flooded in December 2015. At the time the people who lived there had to be found temporary accommodation. Ravenstone staff and the registered manager continued to provide support to people while they awaited significant rebuilding and refurbishment works to be completed. The service lost much of its paper records in the flood. When we inspected the home had just re-opened and was accommodating six of its former residents.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The service managed medicines appropriately. They were correctly stored, monitored and administered in accordance with the prescription. People were supported to maintain their health and to access health services if needed. People who required support with eating and drinking received it and had their nutrition and hydration support needs regularly assessed.
There were sufficient staff to meet people’s needs. They were trained to an appropriate standard and received regular supervision and appraisal. As part of their recruitment process the service carried out background checks on new staff.
Where people were not able to make important decisions about their lives the principles of the Mental Capacity Act 2005 were followed to protect their rights. Staff were aware of how to identify and report abuse. There were also policies in place that outlined what to do if staff had concerns about the practice of a colleague.
Care plans were subject to regular review to ensure they met people’s changing needs. They were easy to read, based on assessment and reflected the needs of people. Risk assessments were carried out and plans were put in place to reduce risks to people’s safety and welfare.
Staff had developed good relationships with people and communicated in a kind and friendly manner. They were aware of how to treat people with dignity and respect. Policies were in place that outlined acceptable standards in this area.
There was a complaints procedure in place that outlined how to make a complaint and how long it would take to deal with. People were aware of how to raise a complaint and who to speak to about any concerns they had. There were no outstanding complaints in the service.
The home was well led by a registered manager who had a vision for the future of the service. A quality assurance system was in place that was utilised to improve the service.
Overall summary Ravenstone Care and Rehabilitation Home provided care and accommodation for up to 13 people with mental health needs. The building was three storeys that had been adapted for use as a residential care home. Each person had their own room and there were lounge and dining facilities on the ground floor.
People told us they were happy with the care they received and "could come and go as they pleased".
We found there was a very inclusive atmosphere in the home where people decided themselves how they spent their time.
Staff knew those that lived in the home very well as most had lived in Ravenstone for a number of years. There was a very stable staff team with a low turnover and because of this the interaction and communication throughout our visit was warm and friendly.
Each person had an up to date plan of care that gave staff sufficient information to ensure appropriate care and support was provided. Risk assessments were in place to safeguard people when they were in the home or out in the community.
Staffing levels were sufficient to meet the needs of people who used this service and they told us there was always someone around if they needed anything.
All new staff completed a full induction programme provided by an external training company. We looked at staff training records and found the training programme included all mandatory subjects and other subjects appropriate to caring for people with mental health needs.
The registered manager was on leave at the time of the inspection and as a result of this the deputy manager assisted with our inspection visit. The staff we spoke to were very appreciative of the support they received from the manager. Staff supervision was up to date and staff meetings were held monthly.
There were minor issues with the maintenance of the building and we were assured the handyman would put these right. The home was clean.
'I am very happy here and the staff are very helpful'.
"I have no complaints at all about this place. I have been here a long time'.
We saw that staff treated people with dignity and respect and that support was provided in a relaxed manner.
We found that people's care and support needs had been assessed and kept under regular review to help ensure people received the care they needed. We saw that people had access to health and social care professionals.
We found that there was a sufficient number of staff to provide an appropriate level of care and support.
We found there was a procedure for dealing with complaints and concerns and people knew any concerns they had would be dealt with immediately.
"Honestly we are well looked after".
"They're always there to listen".
"Feels like home".
"I am quite happy where I am".
We found that staff had good relationships with the residents of the home. They were well trained and understood the needs of the residents. The owner of the home and the manager supported their staff to deliver good quality care and kept up to date, relevant records.