All inspections: Lower Ridge Home for Older People

We carried out an inspection of Lower Ridge Home for Older People on 18 and 19 May 2016. The first day was unannounced.

Lower Ridge Home for Older People is registered to provide accommodation and personal care for up to 35 older people. The home is located close to Burnley town centre and is set in its own grounds. Accommodation is provided on three floors linked by a passenger lift and stairs. At the time of the inspection there were 19 people accommodated in the home.

The service was managed by 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.

At the last inspection on 24 and 26 November 2014, we asked the provider to make improvements to the arrangements in place to manage medicines, the recruitment of new staff, staff supervision and appraisal and the quality assurance systems. Following the inspection the provider sent us an action plan which set out what action they intended to take to improve the service.

During this inspection, we found the necessary improvements had been made. However, we found there was a breach of one regulation relating to the timely notification of specific events and incidents which had occurred in the home. You can see what action we told the provider to take at the back of the full version of the report. We also sent a letter reminding the registered person of their responsibility to notify the Commission of events as outlined within regulations. We made one recommendation in respect of the temperature in the medicine storage room.

People living in the home said they felt safe and staff treated them well. Appropriate recruitment checks took place before staff started work. There were enough staff on duty and deployed throughout the home to meet people's care and support needs. Safeguarding adults’ procedures were robust and staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to. People's medicines were managed appropriately and people received their medicines as prescribed by health care professionals. However we noted the temperature in the room used to store medicines was in excess of 25°C. This meant there was the potential risk to the effectiveness and potency of the medicines.

Staff had completed an induction when they started work and they were up to date with the provider's mandatory training. The registered manager and staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation. There were appropriate arrangements in place to ensure that people were receiving the food and fluids as recorded in their support plans. People had access to a GP and other health care professionals when they needed them.

Staff treated people in a respectful and dignified manner and people's privacy was respected. People living in the home and their relatives, where appropriate, had been consulted about their care and support needs. Support plans and risk assessments provided guidance for staff on how to meet people’s needs. There was a range of appropriate activities available for people to enjoy. People and their relatives knew about the home's complaints procedure and said they were confident any complaints would be fully investigated and action taken if necessary.

All people, their relatives and staff told us the home was well managed and operated smoothly.

The registered manager took into account the views of people and their relatives about the quality of care provided through consultation, meetings and surveys. The registered manager used the feedback to make improvements.

We carried out an inspection of Lower Ridge Home for Older People on 24 and 26 November 2014. The first day was unannounced. We last inspected Lower Ridge on 25 October 2013 and found the service was meeting the current regulations. However, during this inspection we found the care home provider required to make improvements in the following areas: the management of medication, the recruitment and supervision of staff and the quality assurance systems. We also recommended improvements in the implementation and use of the Mental Capacity Act 2005, the dining arrangements for people living in the home and the provision of activities.

Lower Ridge is registered to provide personal care and accommodation for up to 35 older people including people with a dementia. The property is a three storey building set back off a main road and on a bus route to Burnley. Accommodation is offered in single bedrooms and there are several communal rooms including a conservatory. At the time of the inspection there were 24 people accommodated in the home plus an additional person in hospital.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People living in the home made positive comments about the home and told us they felt safe and well looked after. All staff spoken with were aware of the procedures in place to safeguard people from harm. We observed staff were kind and considerate in their interactions with people throughout the inspection.

As Lower Ridge is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. At time of the inspection two people had an authorised DoLS. However, we found one person’s care plan documentation did not provide sufficient guidance for staff on the implementation of the DoLS as part of daily care practice. We also found people’s mental capacity to make decisions for themselves had not been reviewed following admission to the home.

Whilst there were systems in place to handle medication in the home we found prescribed creams were not well managed. This is important to protect the health and well-being of people living in home.

People were provided with a varied diet of food and all people spoken with told us they enjoyed the meals provided. However, we found people had to wait a long time for their breakfast in the morning.

Each person had an individual care plan. The care plans were well presented and contained information about people’s personal preferences and any risks to their well-being. However, we found people had not always been involved in the care planning process. This is important so people can have direct input into the delivery of their care.

People had meetings where they had a chance to say what they thought about the service and were also asked to fill in questionnaires about the quality of the service. However, we found there had been no feedback given about any action taken in response to their concerns. As a consequence people had raised the same issues on more than one occasion.

There were procedures in place for the recruitment of new staff, however, we found there were gaps in some information provided by applicants and there was no record to demonstrate this had been explored further at interview. We also noted that although all staff spoken with told us there were good arrangements in place for training, they had not received individual supervisions in the last few months. These are important so staff can discuss their experiences of working in the home and identify future training needs.

Our findings demonstrated a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

People using the service told us they liked living at Lower Ridge and received the care and support they needed. One person said, 'The staff are lovely and very patient.'

All the people asked said they enjoyed the meals. People's weight was monitored and when necessary advice was sought from other healthcare professionals.

We found that the home was clean, warm and well ventilated. One person said, 'My room's always clean and I've got my own things.'

We noted that all members of staff received the training they needed in order to provide safe and effective care for people using the service.

We saw that systems were in place to monitor the quality of the service provided. There was evidence to demonstrate that people were regularly consulted about the care and facilities provided at the home.

People using the service told us they liked living at Lower Ridge and were satisfied with the care provided. Members of staff explained what they were doing before they carried out care tasks so that people could give their consent. One person said, 'The staff are very nice, they have manners.' Another person said, 'I'm happy here.'

We found that members of staff had a good understanding of safeguarding procedures and told us they would report any concerns immediately.

Members of staff told us they received the training they needed in order to provide safe and appropriate care for people using the service.

We saw that appropriate and accurate records were kept for people using the service and the overall effective management of the home.

People told us they were treated with respect and were happy living at Lower Ridge. One person said, 'I wouldn't go anywhere else, the food is good and the staff are marvellous.'

All the people we asked said the food was good and they had a choice of menu for all meals.

People told us about the leisure activities they had enjoyed. These included arts and crafts, games and visits to local attractions. One person said, 'There's activities organised every afternoon.'

We were told that visitors were welcomed into the home at anytime and offered refreshments.

People explained that the daily routine was flexible and they could choose when to get up and go to bed. One person said, 'You can do what you want.'

Arrangements were in place to ensure that people using the service and their relatives were involved in planning and reviewing their care.

Archived: Lower Ridge Home for Older People

All Inspections

18 May 2016

During a routine inspection

24 & 26 November 2014

During a routine inspection

28 October 2013

During a routine inspection

24 January 2013

During a routine inspection

16 December 2011

During a routine inspection