This inspection took place on 24 and 26 October 2017 and the first day was unannounced.

Ryland Residential Home was last inspected in September 2015 and was rated Good. At this inspection, the service remained Good.

The provider is registered to provide accommodation for up to 17 older people in the service over two floors. There were 16 people using the service at the time of our inspection.

A registered manager was in post and was available throughout the inspection. 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.

Risks were not always managed so people were fully protected from avoidable harm. Sufficient staff were not always deployed to meet people’s needs and medicines management practices required improvement.

Staff knew how to keep people safe and understood their responsibility to protect people from the risk of abuse. Staff were recruited through safe recruitment practices. The service was clean and staff followed correct infection control practices.

Staff received induction and training. Staff had not received individual supervision and appraisal recently but had received group supervisions and did feel supported. People’s rights were protected under the Mental Capacity Act 2005.

People received sufficient to eat and drink. External professionals were involved in people’s care as appropriate and adaptations had been made to the design of the home to better support people living with dementia.

Staff were kind and knew people well. People and their relatives were involved in decisions about their care. Advocacy information was made available to people.

People received care that respected their privacy and dignity and promoted their independence. People could receive visitors without unnecessary restriction.

People received personalised care that was responsive to their needs. Care records contained sufficient information to support staff to meet people’s individual needs. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising concerns with the management team and appropriate action would be taken.

The registered manager and provider were meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided. New more detailed audit tools were to be introduced to further improve monitoring of the quality of the service.

We spoke with two relatives about the standards of care within the home. Both of them told us they were very happy with the care their relative received.

We spoke with four people about the care and support they received from staff. All four of them were happy and they told us the staff were very kind and supportive and they were looked after well.

Everyone we spoke with felt safe living at the home.

We spoke with two people about their medicines. Both of them told us that the staff looked after their medicines for them and they got these when they needed them.

There had been on-going environmental improvements and people were living in a well maintained and safe environment.

We spoke with four people about the staffing levels. They all told us they felt there were sufficient staff available to meet their needs and they did not have to wait for assistance. However two people did express anxiety about there only being one member of staff awake during the night and one person told us they sometimes had to wait for assistance during the night. We discussed this with the manager and the manager told us they would speak with people and reassure them about the arrangements.

We spoke with four people using the service to establish their views and experiences.

We also spoke with the manager and assistant manager and consulted with two members of staff in respect of their job roles and the support they offered to people using the service.

People told us they were happy and settled living at the home. They told us they had been involved in the care planning process and any decisions that were made about their care and treatment. They all felt that their needs were met and staff were kind and caring towards them. One person said, “I feel involved in my care, I can do things for myself and maintain my independence but the staff help me if I need it.” Another person said, “The staff are very caring, they look after me as I like and I am very happy here.”

People told us the staff looked after their medicines and they received these as needed.

People told us they felt the staff were well trained and good at their jobs.

No one expressed any concerns and they felt staff would listen to them if they did. One person said, “I have no complaints, if I did I know who to speak with and I know they would listen.” Another person said, “It is very good care here, I have no complaints at all.”

We carried out this responsive inspection because we had concerns that this service had not been visited since 11 September 2009.

We spoke with four of the 17 people living at the service when we visited on 29 February 2012. We spent a period of time, sitting with a group of people in a communal area. During this time we carried out a ‘Short Observational Framework for Inspection’ (SOFI). This framework offers a formal way to observe people and understand how their needs were supported. We were also able to observe people’s experiences of living in the home and their interactions with each other and the staff.

Our observations showed that people had a positive experience at the home, the atmosphere was calm and friendly and the staff were attentive to the needs of the people living there.

We were told, “I am very happy here, I would recommend it, we are well looked after.” And “I am settled and comfortable, it is like this everyday, as the staff are kind and caring.”

We were also told, “I enjoy the peace and quiet, I like it here, it is very clean and I have always been kept clean.” And “Staff listen to what I have to say but there is nothing that needs changing at all as it just seems to flow.”

Three people said they had been involved in the care planning process and regular reviews took place to make sure their needs were met. They also said they could make their own choices about how they spent their time.

People using services said they could have a say and provide feedback about the service they received. One person said they felt safe with the staff and living at the home.

This inspection took place on 23 and 24 September 2015 and was unannounced.

Accommodation for up to 17 people is provided in the home over two floors. There were 17 people using the service on the day of our inspection. The service is designed to meet the needs of older people.

There is a registered manager but she was not available during the inspection. The deputy manager was available throughout the inspection. 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.

People felt safe in the home and staff knew how to identify potential signs of abuse. Systems were in place for staff to identify and manage risks and respond to accidents and incidents. The

premises were well maintained. Sufficient staff were on duty to meet people’s needs and they were recruited through safe recruitment practices. Medicines were safely managed.

People’s rights were not always protected under the Mental Capacity Act 2005 as a Deprivation of Liberty Safeguards application had not been made for a person who used the service. Staff received appropriate induction, training and supervision. People received sufficient to eat and drink. External professionals were involved in people’s care as appropriate.

Staff were caring and treated people with dignity and respect. People and their relatives were involved in decisions about their care.

People’s needs were promptly responded to. Care records provided sufficient information for staff to provide personalised care. Activities were available in the home and plans were in place to improve them further. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising any concerns with the management and that the registered manager would take action. There were systems in place to monitor and improve the quality of the service provided.