Ranvilles Nursing & Residential Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The provider’s governance and quality assurance systems did not always drive enough improvement in a timely way to ensure people always received high-quality care. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Processes did not always support staff to provide person-centred and meaningful care and support. The management team were open and honest throughout the assessment process and were keen to ensure people received safe and high-quality care. Staff told us the service was well-led, they were well supported and treated equally regardless of any protected characteristics. Partners were positive about their working relationship with staff at Ranvilles and felt the joined-up approach ensured good outcomes for people’s health.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us there was a positive culture in the service and were committed to delivering high-quality, person-centred care for people. They enjoyed working at Ranvilles and felt valued for the work they did. Staff were not always aware of the providers core values but felt their contribution to the service was important and understood the importance of supporting people in a person-centred, caring and compassionate way. Staff also told us they worked well as a team and were complimentary about each other.

The provider had processes in place to ensure there was an open and honest culture. The management team had an open-door policy and all of the staff we spoke with confirmed this policy to be accurately in place at Ranvilles. Systems did not always support staff to provide person-centred and meaningful care and support. However, all staff were observed to be kind and caring in their approach. The provider had processes in place to share information with staff. Staff had the opportunity to regularly attend staff meetings or share information in their supervision. Handovers were in place to share information about people using the service.

The registered manager told us they were well supported by the directors and the nursing officer of the organisation, and they also sought support from external professionals and local registered manager groups. Staff were positive about the leadership of the service and told us it was well-led. Staff described being well supported by the registered manager and deputy manager. Comments included, “I would say it is well-led here. I have worked at other nursing homes previously and this one is a lot better. We are always able to speak to the manager, there are things in place to support us all, it’s the small things that make a difference here.” and “I would say the leaders are capable and compassionate, yes.” Staff told us there was mostly good delegation of tasks although some said the nurses had too much to do and it was hard for the nurses to focus on the people who needed support and complete everything that was required of them when they also had a lot of organising and management tasks to complete. During our visit the management team were receptive to our feedback and acted to ensure people received safe care and support.

The management team were established and had worked at the service for a long time, they knew people and staff well. The provider had systems in place to support the leadership of the home. Quality leads and consultants, internal and external to the service supported the management team with the day to day running of the service. Despite this, the service had not always complied with the standards set out in the quality statements or associated regulation.

The nominated individual told us, “I have regular meetings once a quarter with nurses and carers. I’m encouraging staff to voice their opinions. When I first started, there was a lot of silence, it’s got a lot better. The last few carers’ meetings have been much more vocal. I say there are no repercussions for voicing anything, we’ll make the changes together.” Most staff were confident to speak up, for example, 1 staff member said, “The [registered] manager has an open-door policy so we can always go in there and raise any concerns. She’s always happy to listen, discuss anything and give feedback. A lot of the staff here are from different ethnicities, when we enter the home, we are all one team. This is a second home to us, and we are all here to support the residents. We are always encouraged to speak up, especially in staff meetings where all departments are involved.” Some staff members told us they were more comfortable to speak to the deputy manager and 1 said it would be beneficial to have a speak up champion as on occasion some suggestions “got lost” if it was a particularly busy time or the focus was elsewhere.

The provider had a policy in place for Whistleblowing. This provided staff with information to support them to make a disclosure should they have any concerns regarding the home, staff or management including concerns regarding abuse of people using the service. The provider had ensured that staff had the opportunity to speak up in a range of forums such as supervisions, team meetings and surveys.

Staff working within the home were from diverse backgrounds and told us they were included and accepted. Staff felt supported and described being treated fairly and equally regardless of any protected characteristics such as race, religion, gender or sexual orientation. Some staff told us they would like more opportunities to celebrate cultural differences. For example, 1 staff member said, “There’s not much coming from the home, I wouldn’t say cultural differences are celebrated here.” The registered manager told us they were in the process of arranging multi-cultural events in the home to enhance inclusivity.

There were policies in place to ensure the provider met their legal obligations to staff and work towards a fair and inclusive culture. Staff were supported to complete equality and diversity training.

Staff had confidence in the providers governance. Staff also told us there were regular checks to ensure they were working in line with expectations and training. Staff were clear about their roles and responsibilities. The nominated individual, registered manager and deputy manager displayed positive attitudes to the assessment process and were responsive to feedback.

The provider had a range of quality assurance processes in place. These included audits and checks by staff members who worked at the service and external staff members or partners. Although some of the concerns identified by us during our assessment had also been identified by the provider using their quality assurance processes, improvements had not been embedded to ensure people always received high-quality care. For example, although the provider's quality assurance systems had identified improvements were needed with activities, records and mealtimes we found these shortfalls remained at the time of our assessment. We also identified concerns with the quality of 1:1 support for people and the training to support people with their complex needs. Other audits had prompted improvement, and the provider had an action plan in place. There was a clear staffing structure at the service, with each role understanding their position and responsibilities. Information was shared as needed with other agencies. This included statutory notifications as required by CQC.

Relatives told us they had a good relationship with staff in the home and were always welcome. They described working in partnership to support good outcomes for people. For example, a relative said, “Staff always phone to inform us if my mum required care by the GP or hospital and let me know when she has returned safely to them after a hospital stay”. Relatives also provided positive feedback about how the home worked with partners, for example, 1 relative told us, “Ranvilles seem to have a very good relationships with all professionals involved with dad, whether it be doctors, nurses, chiropodist, or even entertainers and hairdressers”.

Staff and managers gave us numerous examples of working with other healthcare professionals to improve people’s outcomes. This included, GP’s, community nurses and chiropodists. Staff described a good working relationship with these partners.

Partners told us how staff at Ranvilles worked well with them to support good care provision. For example, 1 partner said, “They [staff] recently managed a patient who was displaying extremely challenging behaviours, and I was really pleased and proud of how we worked together to try and manage that individual within the home environment in order to prevent the patient from being admitted to hospital which is always a last resort. They utilised some very safe and therapeutic skills to minimise this individual’s distress and maintain a safe environment for everyone in a least restrictive manner”. Another partner said, “Ranvilles staff work closely with the immediate and wider care team to ensure that care recommendations and processes are clearly communicated to all relevant parties e.g. social workers, personal assistants. This allows effective facilitation of shared goals. For example, sharing personalised swallow recommendations to allow an individual to access a community café”.

Systems and process in place meant referrals were made to other professionals when needed. When professionals provided advice and guidance this was followed by staff. Processes such as handovers meant staff understood people’s changing care needs. The provider had organised a weekly ward from a GP who worked closely with the home. This was effective in supporting people’s medical needs.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.