Archived: Read House

Read House is registered to provide accommodation and personal care for up to 40 older people who are blind or visually impaired or older people with a physical disability. The service does not provide nursing care. At the time of our inspection there were 32 people using the service.

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

Improvements had been made to Infection Prevention and Control (IPC) practices since the last inspection on 16 October 2020. Staff at different levels of seniority had become involved in this process, sharing learning and providing input into changes and improvements made. People living at Read House and their relatives were kept up to date about the impact of COVID-19 on the service by the management team, and relevant policies and procedures were in place.

A registered manager was in post, supported by a wider management and administrative team. We reviewed records to check management oversight of other areas of health and safety systems and governance processes at the service. This was not always robust. We discussed these findings with the management team who told us they would put an action plan in place to mitigate possible risk and demonstrate quality assurance.

We made a recommendation on following best practice guidance for managing the risk of Legionella.

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 25 June 2018).

The service was inspected but not rated as part of an Infection Prevention and Control (IPC) thematic review (published 17 November 2020).

Why we inspected

During the thematic review on 16 October 2020, we identified some concerns about IPC measures at the service. Following the inspection the provider submitted an action plan outlining the improvements they would make as a result.

We undertook a further targeted inspection on 20 November 2020 to check improvements had been made in line with the provider’s action plan, that IPC practice was safe, and the service was compliant with IPC measures. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will follow up with professionals to check support is in place for the service, including additional training on safe working practices during the COVID-19 pandemic. We will follow up with the service on the progress of their action plan. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

People were supported to meet with family members and friends in a COVID-19 secure area. The registered manager had created a separate area of the home where families could meet with people safely. This involved dividing and sealing a meeting room into two using clear plastic and speakers to allow people to talk with each other. Visitors are provided with a separate door into the room and have their temperature taken and recorded when they arrive.

People were supported by the service to access foot care from medical professionals. A separate room at the rear of the service, with its own entrance from outside, had been transformed into a clinical area for chiropodists to continue to see people. People accessed the room in appropriate PPE and a privacy screen was used to prevent face to face contact with people however, their feet could be placed underneath and treated appropriately.

Further information is in the detailed findings below.

Read House is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Read House is registered to provide accommodation and personal care for up to 40 older people who are blind or visually impaired or older people with physical disability. The service does not provide nursing care. At the time of our inspection there were 32 people using the service.

At the last inspection in 2016, the service was rated good. At this inspection, we found the service had maintained good.

The service had 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 were safe because staff supported them to understand how to keep safe and staff knew how to manage risk effectively. Staff that had been trained and assessed as competent to administer medicines managed medicines safely and there were sufficient numbers of care staff with the correct skills and knowledge to safely meet people’s needs.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act.

People had sufficient amounts to eat and drink to ensure their dietary nutritional needs were met. The service worked well with other professionals to ensure that people’s health needs were met. People’s care records showed that, where appropriate, support and guidance was sought from healthcare professionals.

Staff had good relationships with people who used the service and were attentive to their needs. People’s privacy and dignity was respected at all times.

People were encouraged to follow their interests and hobbies and to engage in meaningful person centred activities. They were supported to keep in contact with their family and friends. People’s care plans were individual and contained information about people’s needs, likes and dislikes and their ability to make decisions.

The service was brightly decorated and stimulating for the people living there. The communal areas were decorated to a high standard were clean and furnished giving an overall homely feel. The outside area had accessible gardens with benches and easy access for people with limited mobility.

People received support that was personalised and tailored to their needs. They were aware of how to complain and there were a number of opportunities available for people to give their feedback about the service.

There was an open culture and the management team encouraged and supported staff to provide care that was centred on the individual.

The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.

Read House provides accommodation and personal care for up to 40 older people who are blind or visually impaired or older people with physical disability. The service does not provide nursing care. At the time of our inspection there were 32 people using the service.

There was a registered manager in post at the service. 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 were safe because the management team and staff understood their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs.

There were sufficient staff who had been recruited safely and who had the skills and knowledge to provide care and support in ways that people preferred.

The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.

People’s health and social needs were managed effectively with input from relevant health care professionals and people had sufficient food and drink that met their individual needs.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider was following the MCA code of practice.

People were treated with kindness and respect by staff who knew them well.

Staff respected people’s choices and took their preferences into account when providing support. People were encouraged to enjoy pastimes and interests of their choice and were supported to maintain relationships with friends and family so that they were not socially isolated.

There was an open culture and the management team encouraged and supported staff to provide care that was centred on the individual.

The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. The people we spoke with told us that staff made sure they were in agreement when they were receiving support or personal care. We noted staff interactions with people to be friendly and consultative when people were asked about something.

We reviewed the care records of five people. All care records we looked at had been reviewed in the last month. This meant that the risk of people receiving unsafe or inappropriate care was reduced as people's needs were kept under regular review.

We spoke with people living at Read House about the food, all of whom were complimentary. People could choose from a good variety of home cooked food. We noted that people always had drinks available which reduced any risks to their health posed by dehydration.

The service ensured that staff recruited were screened to ensure they were suitable to work with vulnerable adults.

An effective complaints procedure was in operation.

We had conversations with five people living in the home and one relative during our inspection. All the people and the relative we spoke with were very complimentary about the staff and the care provided. They described staff as, 'very kind', 'excellent' and 'absolutely wonderful'.

There was a wide range of activities that provided stimulation for people, helped them to retain their abilities and improved their quality of life. People were happy with the standard of the food and the variety on the menu. One person told us, 'The food is excellent. There are plenty of choices.'