Increased Ralphs Close staffing levels have ‘greatly enhanced’ care: RQIA

Priscilla Clayton, a care inspector with the Regulation and Quality Improvement Authority (RQIA) spoke to staff at Ralphs Close on February 12, 2014, and was told that increased staffing levels had greatly enhanced the provision of care by enabling greater time for staff to spend with individual residents.

After an anonymous whistleblower wrote to the health authorities in July 24, 2012, alleging mistreatment of vulnerable adults in the facility a series of inspections found - amongst other things - that a manager had complained to the Trust about inadequate staffing levels but that the required staff complement had not been achieved.

But the recent unannounced inspection has reported significant improvements at the home over the past year-and-a-half.

Ms Clayton was following up on progress against seven requirements and four recommendations made during a RQIA inspection in May last year.

During the visit Ms Clayton found the Acting Manager of the 16-bed facility, Mr Desy Carton “readily available for discussion and clarification” throughout.

According to her report, between 10.15am and 5.15pm on February 12, the inspector met with residents and staff, discreetly observed care practices, examined records and carried out a general inspection of the home environment.

Her report states: “Several residents had attended day care on the morning of the inspection and on their return they were attended by staff in a respectful professional manner.

“Residents were appropriately dressed and presented indicating that time and attention had been afforded to their personal care needs.”

She also described the atmosphere as warm, friendly and welcoming and noted that all areas were appropriately furnished and comfortably heated.

“Residents’ bedrooms were personalised with items of memorabilia displayed. Fire safety and environmental improvement issues identified at the previous inspection, had been fully addressed,” she added.

Issues relating to the availability of food for patients had also been addressed.

“Catering arrangements within the home had been reviewed. Daily menus were displayed in pictorial format to enhance residents’ understanding. Two weekly rotating menus had been established. Mid-morning and afternoon snacks/drinks were also provided,” she wrote.

Meanwhile, a random selection of residents’ care records also returned a positive report.

“Three care records randomly selected were inspected and were found to be comprehensive reflecting there were multi-professional collaboration in planned care, robust risk assessments and person centred care plans in place. It is pleasing to see the transition from a clinical/medical model to a social care model,” she stated.

Significantly, the report found staff morale to have been good.

Ms Clayton reported that increased staffing levels had improved care at the home.

She stated: “The current staffing levels had greatly enhanced the provision of care by enabling greater time for staff to spend with individual residents. It also facilitated closer supervision of residents, on-going training and early identification of triggers to prevent episodes of challenging behaviours.”

In conclusion she wrote: “The ‘acting’ manager and staff are to be recommended on the overall improvements made in Ralphs Close. The inspector wishes to thank residents, staff and the manager on their warm welcome and open discussions throughout this inspection.”

Ultimately, the facility complied with the seven requirements imposed after the inspection of May 2013.

These related to fire risks, maintenance issues, training on safeguarding vulnerable adults, fire training, food and snacks, personal records, and records of day care arrangements.

It also complied with four recommendations imposed last year.

These related to the staff duty roster indicating when shifts started and ended; rosters scheduling time for change of shift handover reports; record-keeping for all staff training; and registered advocates being put in place.