The Red House

About the service

The Red House is a residential care home providing personal care to 7 people at the time of the inspection. The service can support up to 7 people. The care home is an adapted and extended domestic style building.

People’s experience of using this service and what we found

Right Support

People were not always supported to make important choices about their money. Best interest decision processes were not always in place. For example, there was no evidence that people, or their appointees, had consented to pay the provider a weekly charge in respect of the care home vehicle.

Some aspects of people’s living environment were not always safe and the provider’s quality monitoring processes were not always effective at spotting those issues and rectifying them in a timely way. Staff supported people in the least restrictive way. They supported people to be as independent as possible. People were supported by staff to pursue their interests and work towards achieving their aspirations and goals. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist healthcare support in the community. Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care

Staff understood and responded to people’s individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People’s support plans reflected their range of needs, and this promoted their wellbeing and enjoyment of life.

Right Culture

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments, or sensitivities people with a learning disability and/or autistic people may have. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. Staff placed people’s wishes, needs, and rights at the heart of everything they did. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 17 March 2018).

Why we inspected

We undertook this focused inspection to check whether the previous rating was still accurate, given the length of time since the last inspection. We reviewed the key questions of Safe, Effective, and Well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed to Requires Improvement, based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Red House on our website at www.cqc.org.uk.

Enforcement

At this inspection, we have identified a breach of regulation in relation to the provider's quality monitoring and governance processes. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This inspection visit took place on 20 February 2018 and was unannounced. The inspection was completed by one inspector. The Red House is a care service. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The Red House is located in Ilkeston. The accommodation is in a large Victorian house close to shops and amenities and has a secure garden. Each person has a large room with an ensuite facility. There are shared spaces which include the lounge, a dining room and a quite area. The home is registered for seven people. At the time of our inspection seven people were being living in the home.

People continued to receive safe care. There was a consistent staff group and people could request staff to support them with their individual activities or pass times. Risk assessments had been completed to reflect any area of concern and we saw guidance for staff was provided to reduce any risks. Medicines had been managed safety and when necessary medicine reviews had been completed to reduce any unnecessary medicine for people’s wellbeing. The risk of infection had been managed and lessons had been learnt from events which had occurred to drive improvements.

The care that people received continued to be effective. People had been supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff had received training for their role and the registered manager was proactive in seeking additional training when people’s needs changed. People were involved in the choice of meals and guidance was provided to support their nutritional needs or long term conditions. People could personalise their space and they had been involved in the decoration of the communal spaces in the home. Health professionals had been involved in the development of peoples care and guidance was provided and followed.

People continued to have positive relationships with the staff who were caring and treated people with respect and kindness. Staff knew people well and were able to balance this knowledge to consider the level of support people required. This reflected people’s personal space and levels of independence.

The home continued to provide a responsive approach to people’s needs. People were able to access activities of their choice and some to develop life skills. The care plans were detailed and covered all aspects of the persons care needs history and preferences. Information was available in different formats to people. Relatives were aware of how to raise a concern.

The management of the home remains good. People felt at home and enjoyed living with the people they shared their home with. The registered manager used audits and information about the home to drive improvements and safety. People’s views had been considered and used to develop any areas of change. The registered manager understood their registration and sent us information about the home. They had conspicuously displayed their rating at the home and on their website.

Further information is in the detailed findings below

The home offers accommodation in a period house close to the town centre of Ilkeston. This provided good access to local shops and services. There was a registered manager in post. 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 who used the service told us they felt safe and well cared for. There were always plenty of staff on duty to meet the needs of the people and they were able to be flexible to meet people’s needs. Staff told us they received a broad range of training to support them in their role. The provider had a robust recruitment policy and this was followed.

We found staff were considerate in the way they spoke and supported people. They were respectful of people’s choices in relation to privacy and space and understood the importance of protecting people’s information. .

People were able to choose the meals they wish to eat and alternatives were provided. Healthy eating and lifestyle was promoted. We saw that medicines were managed safely and administered in line with people’s prescriptions Health needs had been considered and referrals or appointment had been made to the relevant professionals when required. .

Staff used their extensive knowledge of people who used the service as the basis for their care planning, reviews of their care plans and risk assessments. Peoples care plans were personalised and they had been encouraged to be involved if they wished so that their own wishes and words would be reflected.

Staff continued to look for new opportunities and hobbies which they thought would be interesting to people, based on their personality and observations of similar experiences which they had enjoyed and benefited from. Any complaints had been addressed and resolved in a timely manner.

People told us they found the service to be warm and welcoming, like a family home. We found the management of the service was very visible, open and approachable. Staff felt supported by the management and there was a clear process in place to cascade information about the service and the needs of people. There was a clear procedure for audits and continuous improvements.