Ryde House

This inspection was unannounced and took place on 10,11 and 13 September 2018. Ryde House provides personal care and accommodation for people with a learning disability and Autism, including people who have behaviours that can place themselves and others at risk.

Ryde House is registered to accommodate up to 64 people. At the time of the inspection there were 55 people living at the service. The service is a group of individual units set within one location. There are five units which are registered as one service, Ryde House (main house), and four separate purpose-built buildings; Maple Tree, Sycamore House, Beech House and Silver Birch. Each unit had their own staff team including unit managers, deputy managers and senior staff. All five units were looked at as part of this inspection.

Since the last inspection in 2017, the provider had reviewed their registration, in line with best practice guidance 'Registering the Right Support' for people with a learning disability. Although, they do not meet the requirement of registering the right support because each unit accommodates more people than Registering the Right Support guidance advises. Nonetheless, the service had been developed and was in line with the values and other aspects that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

We last inspected the service in May 2017 when we did not identify any breaches of regulation, but rated the service as 'Requires improvement'. At this inspection, we found improvements had been made.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The registered manager was supported by a manager in each of the five units.

The registered manager for Ryde House was also one of the directors of the provider's company and the unit manager for Silver Birch unit. At the last inspection in May 2017, we found that the director held different roles at different levels within the organisation with overlapping responsibilities, which created a lack of clarity and clear accountability. At this inspection a review of the management team had taken place and there were two senior managers who were awaiting registration with Care Quality Commission to become the joint registered managers for the service. Following the inspection, their registration was completed. The two senior managers were working to ensure there was a consistent approach across the service, with a clear process for accountability and the previous registered manager was in the process of de-registering.

Accommodation in the Ryde House unit, in the main house, was arranged over two floors which could be accessed by a staircase. There was a large lounge and a dining room, with smaller quieter rooms available for people and a large garden. The other four units were purpose built and each had a lounge, dining room and quiet areas. Most bedrooms in the purpose-built units had en-suite facilities. Each unit had its own garden and people across all five units had access to large communal grounds which included a private beach.

Staff knew how to identify, prevent and report abuse. Safeguarding investigations were completed and actions were taken in a timely way when safeguarding concerns were raised with the service.

There were sufficient staff employed to meet people's needs, keep them safe and provide them with person centred support. Recruitment procedures were robust and ensured that suitable staff were employed.

Individual and environmental risks to people were managed effectively. Risk assessments were reviewed as and when needed. Individual risk assessments identified risks to people, providing clear guidance to staff on how risks should be managed and mitigated.

Medicines were managed safely in all five units. People received their medicines as prescribed and there was a consistent system in place, with all the units using the same pharmacy.

Three of the units were clean and staff followed best practice guidance to control the risk and spread of infection. Two units had areas that were not clean. However, these were immediately addressed when brought to the attention of the senior managers.

Staff knew people well and had developed positive relationships with them. People were treated with dignity and respect and staff protected people's privacy.

People were supported to participate in activities of daily living within the home. Independence was promoted, with people being supported to maintain and learn new skills that would enable them to make choices about their own lives.

People received effective care from staff who were competent, suitably trained and supported in their roles. Staff acted in the best interests of people and followed legislation designed to protect people's rights and freedom.

Care plans contained detailed information to enable staff to provide care and support in a personalised way. People were empowered to make choices about all aspects of their lives. They had access to a range of activities suited to their individual interests.

Staff understood people's health needs and people had access to health professionals and other specialists when required. Procedures were in place to help ensure that people received consistent support when they moved between services.

The management team and staff worked collaboratively with other health and social care professionals to help ensure people received additional support when needed and there was a co-ordinated approach to their care and support.

There were robust auditing and quality assurance processes in place to review systems and allow ongoing learning and development.

The five questions we ask about services and what we found