We carried out a review of the data available to us about Rusthall Lodge Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rusthall Lodge Care Home, you can give feedback on this service.
Rusthall Lodge Care Home provides residential and nursing care and accommodation for up to 69 older people. It also offers respite care services for short stays. At the time of our inspection there were 65 people living at the service. The home is spread over three floors and is situated within quiet rural grounds in Kent.
People’s experience of using this service
People and their relatives spoke positively about the service and said staff were kind, caring and supportive. Throughout our inspection we observed staff interacted positively with people and had formed respectful relationships with them and their relatives.
The service had safeguarding and whistleblowing policies and procedures in place and staff had a clear understanding of these procedures and how to keep people safe. People's needs, and preferences were assessed and risks were identified with plans in place to manage risks safely. Medicines were administered and managed safely and staff followed infection control practices to prevent the spread of infections. Robust recruitment checks were in place and there were sufficient staff available to meet people's needs promptly. Staff had the skills, knowledge and experience to support people appropriately. Staff were appropriately supported through induction, training and supervision.
People were supported to maintain a healthy balanced diet that met their cultural and dietary preferences. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were involved in and consulted about their care and support needs. People had access to health and social care professionals as required. People were supported to participate in activities of their choosing that met their needs and interests. Staff worked with people to promote their rights and understood the Equality Act 2010 supporting people appropriately addressing any protected characteristics.
There were effective systems in place to assess and monitor the quality of the service. The service worked in partnership with health and social care professionals to plan and deliver an effective service. The service took people’s and staff’s views into account to help drive service improvements.
Rating at last inspection: Good (Published 9 May 2017).
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received, we may inspect the service sooner.
For more details, please see the full report which is on the website at www.cqc.org.uk
At the last inspection, the service was rated Good. At this inspection we found the service remained Good and met all relevant fundamental standards.
Why the service is rated Good
Staff knew how to recognise and respond to the signs of abuse. Risks to individuals’ safety and wellbeing were assessed and minimised. We made a recommendation about improving risk assessments and care plans for people with epilepsy and diabetes. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Medicines were managed safely.
There was a sufficient number of staff deployed to meet people’s needs. Nursing and care staff received the training and support they needed to meet people’s individual needs. Robust recruitment procedures were followed to ensure staff were of suitable character to carry out their role.
Staff knew each person well and understood how to meet their needs. Staff communicated effectively with people and treated them with kindness and respect. People were supported to make their own decisions and remain as independent as possible. Staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.
People had enough to eat and meals were in sufficient quantity. People told us they enjoyed the food. Staff knew about and provided for people’s dietary preferences and restrictions. People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. These records helped staff deliver personalised care.
The registered manager and the provider were open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was a system of monitoring checks and audits to identify any improvements that needed to be made. Action had been taken as a result of these checks to improve the quality of the service and care. The majority of records were maintained accurately, but we made a recommendation about the completion of repositioning charts.
Further information is in the detailed findings below
The inspection took place on 12 November 2014 and it was unannounced, which meant that the provider did not know that we were coming.
Rusthall Lodge Care Home is a residential home providing personal and nursing care with accommodation for up to sixty seven older people, some of who were living with dementia. At the time of our inspection, sixty one people lived at the home.
The management team at Rusthall Lodge included the general manager who was in the process of applying for registration with CQC at the time of our inspection. There was a registered manager at the home. The deputy general manager was the registered manager with CQC at the time we inspected the home. 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.
We carried out this inspection in response to some concerns raised through Healthwatch Kent speak out forum completed at an event in Tunbridge Wells on 09 October 2014. A local Healthwatch organisation is a statutory body set up across a local authority area to champion the views and experiences of local people about their health and social care services. The areas of concerns centred around the delivery of care to people and lack of skilled staff including staff support.
The provider had systems in place to manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies, such as the local authority safeguarding team, in a timely manner. All of the people who were able to converse with us said that they felt safe in the home; and said that if they had any concerns they were confident these would be quickly addressed by the registered general nurse (RGN) in the first instance, or by the general manager who was applying to be the registered manager at the time we visited.
The home had risk assessments in place to identify risks that may be involved when meeting people’s needs. The risk assessments showed ways that these risks could be reduced. We found risk assessments on various areas of care such as falls, mobility, bed rails and diabetes. These risk assessments were reviewed in November 2014. We saw that accident records were kept and audited monthly to look for trends. This enabled the staff to take immediate action to minimise or prevent accidents.
There were two passenger lifts with access to all floors. We checked the two lifts and found them to be in good working order. There was a maintenance contract plan in place. The home had well-proportioned bathrooms; wet rooms and toilets. There were several communal lounges and dining areas which were pleasant and offered people choices about where they wanted to eat or sit.
There were no indications that staffing levels were too low to meet people’s needs. Staff were not hurried or rushed and when people requested their care or support, this was delivered quickly. The provider operated safe recruitment procedures. All nurses’ registration (PIN) numbers were regularly checked to ensure that the nurses were on the active register of the Nursing and Midwifery Council (NMC).
Medicines were stored and administered safely. Nursing staff administered medication. Clear and accurate medicines records were maintained.
People said, “Staff were well trained and knew what they were doing”. Staff knew each person well and had a good knowledge of the needs of people who lived at the home. Training records showed that staff had completed training in a range of areas that reflected their job role. Staff told us that they had received supervision and appraisals were on-going.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests. We found the home to be meeting the requirements of Deprivation of liberty safeguards.
People said that the food was good. The menus offered variety and choice. It provided people with nutritious and a well-balanced diet. People had a choice of hot foods and sandwiches each day; and a choice of two main meals and desserts at lunch times.
People and their relatives told us that they were involved in their care planning, and that staff supported people with health care appointments and visits from health care professionals. Care plans were amended immediately to show any changes, and care plans were routinely reviewed every three months to check they were up to date.
People told us they were always treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed. Staff had suitable training and experience to meet people’s assessed needs; staff encouraged people to make their own choices and promoted their independence.
People’s needs were fully assessed with them before they moved to the home to make sure that the home could meet their needs. Assessments were reviewed with the person and their relatives. People were encouraged to take part in activities and leisure pursuits of their choice, and to go out into the community as they wished.
People knew how to make a complaint if they were unhappy. One relative said, “If I need to complain, I will go to the manager. She is very approachable”.
People spoke positively about the way the home was run. The provider had a clear set of vision and values, which we observed that both the management team and staff followed. The management team and staff understood their respective roles and responsibilities. Members of staff told us that the general manager was very approachable and understanding. They said they were encouraged to raise issues or make suggestions and felt they were listened to.
The home had a system to monitor and review the quality of service they provided. The way the home was run had been regularly reviewed. Prompt action had been taken to improve the home and put right any shortfalls they had found. Information from the analysis of accidents and incidents had been used to identify changes and improvements to minimise the risk of them happening again.
Care plans gave staff guidance about how to support each person with their personal, social and health care needs.
The manager was knowledgeable about how to refer to and work with the safeguarding authority about concerns or allegations of abuse. There was a system in place that supported people with their financial affairs.
People benefitted from safe and comfortable accommodation, which was suitably designed and maintained to meet their needs. One person told us 'I love my room. This is my bedsit. I like to look out of the window.' People's health and safety was protected from risks associated with the environment in which they lived.
People who used the service were supported by enough skilled staff who knew how to meet people's needs.
People who used the service and their relatives and/or representatives were asked for their views about the service provided. We saw that people were able to communicate their wishes to staff, who listened and took action. People who used the service told us '[Staff] are very good. I've got no complaints.'
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.
The welfare of people who used the service was promoted by the provision of social activities. '[My relative is] happy being here ' [they] like the company.' Care and treatment was planned and delivered in a way that ensured people's safety and welfare. One family member told us '[One member of staff] in particular is very good with [my relative] and managing [their] behaviour.'
Staff received training and support, which helped them to meet the needs of people who used the service. One person told us 'Staff are friendly and good.' The manager told us they had scheduled courses for all gaps in necessary staff training, which would be completed during the first half of 2013.
The provider had taken steps to identify the possibility of abuse, which aimed to prevent abuse from happening. During the course of the inspection, we were informed of safeguarding matters, which were currently being looked into by the local authority safeguarding team.
People explained how they were able make day to day choices about their lives and plans for the future and described how staff supported them to do this.
People told us the staff were kind and caring. People described how staff helped them.
People said that they felt safe and were well cared for by staff. People explained that they could speak with staff if they had a problem or were worried about anything. People told us that they were asked for their views about the support they received.