• Care Home
  • Care home

Rushymead Residential Care Home

Overall: Inadequate read more about inspection ratings

Tower Road, Coleshill, Amersham, Buckinghamshire, HP7 0LA (01494) 727738

Provided and run by:
Michael Batt Charitable Trust

Important: We are carrying out a review of quality at Rushymead Residential Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Latest inspection summary

On this page

Background to this inspection

Updated 5 January 2024

The inspection

We carried out this focused inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors, a regulatory co-ordinator joined the inspectors on day two. An Expert by Experience made telephone calls to people and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care.

Service and service type

Rushymead Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Rushymead Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post, however they were absent from the home. The home was being supported by an interim manager and existing senior staff.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and consider evidence we found on a direct monitoring activity. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the interim manager, care team supervisor, general assistant, 2 team leaders and 5 care staff. We reviewed a range of records. This included 6 care plan records and 2 medicine recording charts. We looked at safeguarding records, training, complaints and 3 staff recruitment files. A variety of records relating to the management of the service, including policies and procedures were requested from the provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We sought feedback from staff and community professionals by email.

Overall inspection

Inadequate

Updated 5 January 2024

About the service

Rushymead Residential Care Home is a residential care home providing personal care to up to 28 people. The service provides support to older people some of whom are living with dementia. At the time of our inspection there were 22 people living at the service.

The care home is located in a large three storey building. The building is located in extensive grounds in a rural part of Buckinghamshire. People’s bedrooms were located on each floor, each floor had a small lounge and kitchenette area. People had access to two large ground floor rooms where group activities could take place.

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

People were not routinely protected from risk of injury or avoidable harm. Risks associated with fire were not always identified by the registered people or acted upon when they were made aware. Fire risks identified by the provider’s own fire risk assessment in March 2023 and by Buckinghamshire Fire and Rescue Service had not been actioned by the provider in a timely manner.

People were left at risk of potential abuse. Staff did not always recognise when abuse had occurred. For instance, people had been physically assaulted, intimidated and had other residents enter their room without permission. These had not always been referred to the safeguarding authority or investigated by the registered manager or provider to prevent a reoccurrence.

People were put at risk by poor recruitment processes and systems. The registered manager and provider did not ensure all the required pre-employment checks were completed before staff worked with people.

People were at risk of infections due to poor hygiene and a lack of preventative measures to stop or prevent the spread of infections.

People were put at risk of harm as the registered manager and provider failed to ensure all accidents and incidents were recorded, investigated, and analysed to identify trends.

The service was not well led. Both the registered manager and provider failed to ensure they maintained compliance with the regulations. We did not always receive the required legal notifications of certain events, like safeguarding and serious injury.

We found the care records within the home to be disorganised, unclear, not complete or accurate. For instance, some records showed a lack of hydration and personal care offered to people. We found confidential records relating to staff and the home management were easily accessible to unauthorised people.

We have made a recommendation about ensuring guidance for staff on how to give liquid medicines support other risk assessments. For instance, when people require thickened fluids, we found some medicine records contradicted other risk assessments for how medicine should be given and how they should be thickened.

We have made a recommendation about ensuring people are referred to external healthcare professionals in a timely manner to prevent a deterioration in their health.

People told us staff were kind and responded to them when they pressed the call bell. Relatives gave us mixed feedback. Comments included “They really do a wonderful job there,” “Staff know us and always acknowledge our visit,” “All the staff we have seen seem happy in their work,” “They are certainly always busy” and “The carers are all very nice.”

Negative comments from relatives included “I feel it would be better for residents if all carers wore name badges. Especially as some of the weekend staff wear a different uniform,” “There did seem to be activities at first, but they have definitely dropped off now,” “I don’t think that Rushymead is a dementia care home from what I can see,” “The home haven’t really been keeping me posted about what is happening with mum, but then they have a high turnover of staff” and “Sometimes we find him unshaved and his hair has got a bit long.”

People were not always supported to have maximum choice and control of their lives, however, staff supported them in the least restrictive way possible and in their best interests. We found improvements were required in the policies and systems at the service to ensure when people's movements were restricted, legal authorisations were in place.

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 4 April 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We received concerns in relation to good governance and safeguarding people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rushymead Residential Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to risk management, safeguarding people from abuse, safe recruitment and staffing. We have also identified concerns about infection prevention and control, leadership and governance. The registered manager and provider were unable to demonstrate an understanding of their legal responsibilities to notify the Care Quality Commission of certain events.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.