Archived: Redcotts

Redcotts is a home for up to 18 older people, including people who have dementia. At the time of inspection there were 12 people living at the home. The home has 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.

People who lived at the home were protected from the risk of abuse happening to them. People told us they felt safe and well cared for at the service and they would not be afraid to speak with someone if they had any concerns about their safety or wellbeing. Risk management plans clearly identified what the risk was and provided staff with instructions about how they needed to manage the risk to ensure people received safe care and support whilst enabling them to remain as independent as possible.

There were enough staff on duty to care for people, with a minimum of two care staff per shift during the day and two waking staff at night. Staff had been trained to use specialised equipment, such as hoists, safely.

People told us that they were happy with the care they received and felt their needs had been met. Staff were able to demonstrate good knowledge of people’s needs when they spoke about them and provided care in a safe and caring manner. Staff told us that the aim of the home was to treat people with respect and to care for them as they would a relative of their own. This philosophy was also reflected in the home’s policies and procedures and formed the basis for staff training.

The provider ensured that people’s independence and choice was promoted. People told us that they had been involved in making decisions and there was good communication between staff and themselves. They also confirmed that their consent was asked for before doing anything, such as going somewhere, or receiving medicines.

We saw that people’s health, nutrition, fluids and weight were regularly monitored. There were well established links with GP services offering a single point of access for people.

People told us that the staff were kind and caring towards them. Care records were individual to each person and contained information about people’s life history, their likes and dislikes, cultural and religious preferences. Care records included details such as personal achievements, places visited and family relationships.

We listened to how staff spoke with people and found this was professional, relaxed, and included friendly chit-chat between staff and people who used the service. We saw how people who used the service responded positively to the interaction.

People were able to get up and go to bed at a time that they preferred and were able to enjoy activities and interests that suited them. The home also supported people to maintain relationships with family, relatives and friends.

In order to listen to and learn from people’s experiences the home had an open door policy for relatives and friends as well as occasional meetings where relatives could attend and discuss issues affecting the home and the care provided to people.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to staff supervision and appraisal as well as in relation to systems for quality assuring the care provided at the home.

We saw that staff received supervision but this was intermittent and not regular enough to be effective for staff professional development, with some staff sometimes going several months before a supervision meeting. Annual appraisals, where overall individual performance could be discussed and future goals set were not taking place. We found that quality assurance checks contained insufficient detail as to what was audited, identify shortcomings or how the audits were used to help the provider gain a true understanding of people’s experience of living at the home or evaluate and improve their practice.

You can see what action we told the provider to take at the back of the full version of the report.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although we were informed that no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk. The registered manager set the staff rotas, took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were always met.

Recruitment practice was safe and thorough. No staff had been subject to disciplinary action. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People's needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments.

Visitors confirmed that they were able to see people in private and that visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People and their relatives were complimentary about the way they were helped and supported by the staff team.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly. However, some comments from people indicated that they would like more regular opportunities to make short trips to local shops and the manager was discussing this with the provider.

People knew how to make a complaint if they were unhappy and confirmed that they felt secure in speaking to the manager or staff about any concern.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had a quality assurance system and records seen by us showed that findings from external audits were discussed with the manager and staff team and action plans put in place to address any issues.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We saw that the carers assisted people according to their preferences, spoke with people in a friendly and professional manner and responded promptly to any requests for assistance or drinks. One member of staff we spoke with told us: "you have to treat the residents like you would treat your parents. It is their home and their life".

People told us they were happy with the meals that they took in the home. One person told us: "You can either have what's on the menu or they will do something else for you".

There was evidence that training in safeguarding had been provided and that there was a clear policy and procedure for reporting any concerns.

We saw that staff had received training in infection control and in the control of substances harmful to health. We saw that regular audits were carried out by the management of the home to ensure that adequate infection control procedures were in place.

We saw evidence that the owners of the company made regular visits to the home to carry out audits and checks as part of their quality assurance procedures and that regular management and staff meetings were held. In addition, health and safety audits were carried out as well as reviews of care plans and checks on the safety of equipment.