The Care Quality Commission
  • Care Home
  • Care home

Archived: Rapkyns Nursing Home

Guildford Road, Broadbridge Heath, Horsham, West Sussex, RH12 3PQ (01403) 265096

Provided and run by:
Dr Shafik Hussien Sachedina

All Inspections

3 February 2014

During an inspection looking at part of the service

During this inspection we spent time observing how people were cared for in both the main building and in Sycamore Lodge. These are two separate buildings that formed part of this location. We spoke with six people who lived in the main building and three people who lived in Sycamore Lodge. In addition, we also spoke with the manager, three representatives of the provider, two nurses and seven other members of staff who were on duty in both buildings that formed the location.

In the main, people told us that they were happy with the service they received. For example, one person described the home as, 'Lovely' and also said, 'Very nice staff'. Another person said, 'It's nice, nice food, nice staff and nice people".

Since our last inspection we found that improvements had been made in relation to the management of people's nursing needs, staffing levels and record keeping. This was also confirmed by people that we spoke with. For example, one member of staff said, 'It's getting better now we've got new staff coming in'.

People who lived in Sycamore Lodge told us that the care they received was good and that they were offered choices with regard to activities they could participate in. They also told us that they received lots of support to maintain their independence and to access the local community. For example, one person told us, 'They asked me what I'd like to do and I said voluntary work. I'm going to start tomorrow to help out at the reception desk at the nursing home. I have done admin work before". The evidence we gained during the inspection supported the comments made by people who lived in Sycamore Lodge.

People who lived in the main building that formed part of this location told us that they could participate in activities but that they had very limited access to community based facilities. Our evidence supported the views of people who lived in the main building. We found that people were not provided with opportunities and support to promote their community involvement.

19 September 2013

During a routine inspection

People we were able to speak with told us they received acceptable care at Rapkyns Nursing Home. The said that staff were kind and gentle, describing them as, "Lovely". Some people said the food was good and that they had plenty of choice.

However, we also found that people were not always getting the care they needed or wanted. People said they would like more activities and outings and that life in the home was, 'Boring". We saw that this issue had been raised some time ago at a resident's meeting but that nothing had been done to increase the number of opportunities people had to use their local community.

Staff worked hard as a close knit team but there were not enough staff to ensure that the, often very complex, needs of people living at the home were fully met. The most vulnerable people being cared for in isolation in their rooms were at greatest risk of not having their needs fully met. People were left unable to summon help with no call bells and with staff downstairs helping others. Staff also had to 'double up' by providing one to one care at the same time as being deployed to care for other people around the home. There was only one person on duty to clean the house and do all the laundry, which was insufficient to meet the needs of people living at the home.

Record keeping was chaotic. People's files were not up to date, there was missing information and inaccuracies. Staff told us they simply didn't have time to maintain the records properly.

14 March 2013

During an inspection looking at part of the service

We were only able to speak with two of the 38 people who lived at the service due to people's complex needs which meant they were unable to tell us their experiences. We gathered evidence of people's experiences by looking at the care three people received, two of whom were identified as having capacity issues in relation to consent. This process included reviewing their records, talking with two nurses who were on duty and observing how care was delivered. We also talked to manager's who were representing the provider. We found that the views of people and their representatives had been obtained and were being respected in relation to their illness if it progressed and their choices and wishes were known with regard to end of life care. Staff understood these and the importance of obtaining and respecting people's wishes. As one person told us, "We have the right information to care for people at all stages of their lives. This helps us provide good care based on what the individual wants".

We also found that systems had been introduced to ensure information was shared appropriately if a person transferred between services. Again staff understood the importance of this.

18 February 2013

During an inspection looking at part of the service

We were only able to speak with two of the 39 people at the service due to people's complex needs which meant they were unable to tell us their experiences. We gathered evidence of people's experiences by looking at the care four people received, three of whom were identified as having capacity issues in relation to consent. This process included reviewing their records, talking to four members of staff and observing how care was delivered. We also talked to managers who were representing the provider. We found that people's rights with regard to consent were being met by staff who understood how people's capacity should be considered. Where people lacked capacity, best interest meetings were held with people who knew and understood the person. Capacity and consent procedures were followed in practice and monitored for people who were unable to give, or chose to withhold, consent to care and support.

People were cared for by staff who were supported to deliver care and treatment safely, and to an appropriate standard. Staff told us that the training and support offered to them was good. One member of staff told us, "We get offered so much training. It really helps me to do my job".

People who lived at the service did not talk to us about the quality of service they received. However by talking to staff and looking at records we found that the provider had a system to regularly assess and monitor the quality of service that people received.

1, 23 November 2012

During an inspection in response to concerns

We were only able to speak to one of the 38 people at the service because people had complex needs which meant they were unable to tell us their experiences. We gathered evidence of people's experiences by tracking the care of four people who lived at the service, all of whom the manager identified as having capacity issues in relation to consent. This process included reviewing their health and care records, talking to six nurses on duty about how they ensured people's needs were managed safely and observing how care was delivered. We talked to the manager, the area manager and an activities coordinator. We spent time observing how other people were cared for to help us understand the experience of people who could not talk with us. We found that when people became unwell appropriate medical advice was sought. Staff had a good understanding of when to contact a doctor for advice. However, people's rights with regard to consent were not being met by the service and staff were not provided with training relating to consent. This resulted in staff not understanding how people's capacity should be considered. They did not ensure when people lacked capacity, that best interest meetings were held with people who knew and understood the person. Capacity and consent procedures were not followed in practice and monitored for people who were unable to give, or chose to withhold, consent to care and support. This did not meet the requirements of the Mental Capacity Act 2005.

11 October 2011

During a routine inspection

People told us that they received excellent care at Rapkyns Nursing Home. They said that staff were very friendly and looked after them well. People said that they were able to make choices about all aspects of their care. Some people told us that the communal areas of the home were noisy so they mostly stayed in their rooms.