Archived: Russell Churcher Court

Russell Churcher is a care home that does not provide nursing. It provides support for up to 44 older people, some of whom are living with dementia. At the time of our inspection there were 44 people living at the home. Accommodation is over two floors and lifts were available.

A registered manager was in place. 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.

Medicines were not managed safely as records did not show how to administer covert medicines and records did not always reflect how much medicines had been given.

People’s care had been appropriately assessed however, plans had not consistently been developed to ensure that staff met people’s needs consistently and reduced and identified risks.

People confirmed they felt safe and that staff involved them in making decisions and staff knew people well.

Observation demonstrated people’s consent was sought before staff provided care.

People described staff as lovely and caring. Staff treated people with respect and recognised the importance of promoting independence, dignity and privacy.

Staff demonstrated a good understanding of safeguarding people at risk. They were confident any concerns raised would be acted upon by management and knew what action to take if they were not. However, they were unsure about the Mental Capacity Act and Deprivation of Liberty Safeguards. The manager told us that they had yet to make ten DoLS assessments for people where it was felt they were at risk of being deprived of their liberty. We have asked that we be informed on when they have made their assessments.

Recruitment checks were carried out and the provider ensured there were enough staff on duty to meet people’s needs. Staff received an induction when they first started work which helped them to understand their roles and responsibilities. They felt supported through supervision and training.

People and their relatives knew how to make a complaint and these were managed in line with the provider’s policy. Systems were in place to gather people’s views and assess and monitor the quality of the service. Records were not appropriately maintained in a number of areas including care plans and risk assessments.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People are treated with respect and dignity by the staff. People told us they felt safe.

Systems were in place to make sure that managers and staff learn 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 place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although 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 appropriate measures had been taken to ensure people were safe.

The service was clean and hygienic. Equipment was well maintained and serviced regularly therefore people were not put at unnecessary risk.

The registered manager set the staff rotas, they took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required of staff. This meant there were sufficient staff with appropriate skills and experience to meet the needs of people.

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support.

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 said that they had been involved in writing their care plans and these reflected their current needs. Care plans were reviewed monthly and people and their relatives were involved in this process.

To detect declines in a person's health, the management had records such as daily food and fluid charts, turn charts, monthly weight monitoring, monthly nutrition assessments, skin/pressure area assessments and warfarin and medication reviews. Staff were able to explain why it was important to complete these records. One person we spoke with told us they felt their health was closely monitored. They told us it felt a bit overwhelming at times but staff always explained why they needed to do these assessments.

Is the service caring?

People were supported by kind and attentive staff. People who used the service spoke with us about their care and were complementary about the staff. They told us the staff were caring and respectful and were always happy to speak with them about anything. We observed staff interact with people in a respectful and caring manner. Staff were noted to adapt their approach according to people's individual needs. One person told us 'The staff are very busy but they never make me feel like a nuisance'. We observed staff spoke with people to get their views on the care provided for them and if there was anything they would like to change.

Before people received any care they were asked for their consent and the provider acted in accordance with their wishes. For those who did not have the capacity to consent, the provider had acted in accordance with the legal requirements.

People who used 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 inside and outside of the home regularly. There were weekly and monthly timetables of activities for people to participate in. A recent survey showed people had been asked their opinions in activities available and these had been acted on.

We looked at the incident and accident file and noted the high incidence of falls. The home manager had a separate file to monitor and investigate the incidence of falls. Forms had been completed accurately with details of the incident, any injuries and actions taken to reduce the risk of it happening again. Referrals had been made to appropriate services such as physiotherapy, General Practitioner (GP) for a medication review and the wheelchair service. Accident and incident forms were reviewed monthly by the manager. We saw incidents had been documented in the person's notes and risk assessments amended accordingly.

Is the service well-led?

The service has a quality assurance system in place to monitor the quality of the service provided to people. Records we saw identified any concerns were addressed promptly. As a result the quality of the service was continuingly improving.

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 which were in place. This helped to ensure that people received a good quality service at all times.

People who used the service told us they were well cared for by staff and trusted them to react if they saw any deterioration in their health. Relatives told us the home was proactive in identifying concerns and implementing strategies to address these

People we spoke with told us their choices are respected and supported. We saw that people were asked for their consent prior to support starting and we saw that where a person lacked capacity to make a decision, formal mental capacity assessments were carried out with relevant people.

We found that care needs were assessed and people we spoke with told us that the staff knew them well. One person told us 'They are marvellous, they are always cheerful and they look after us brilliantly'. Another told us 'The staff are marvellous, they do their best for me, they are really helpful, I'm very content'.

We found that people were cared for in a clean and hygienic environment by suitably qualified, skilled and experienced staff.

Staff we spoke to told us they felt supported and that the management 'really care'.

We found that the provider had effective systems in place to monitor the quality of the service and found that people's views were taken into account and acted upon.

We found that the provider had an effective complaints system in place and any complaints were responded to appropriately.