Archived: Rearsby Home Limited

Rearsby Home Ltd is a residential care home providing personal care to 23 people at the time of the inspection. The service operates within a purpose-built building and can support up to 27 people.

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

People were protected from the risk of abuse. Care staff had received safeguarding training and the provider had safeguarding policies and procedures in place.

People lived in an environment which was regularly checked, by the provider, to ensure that it was safe. The registered manager told us they would arrange for some minor repairs to be carried out in some bedrooms and would ensure shower hot water temperatures were controlled to remove any potential for scalding.

People were supported by enough care staff to meet their care and support needs. The provider carried out checks to ensure that the care staff employed were safe to work with vulnerable people.

People were given their prescribed medications safely, by senior care staff who had been appropriately trained.

People lived in an environment that was clean and tidy. Care staff understood how to reduce the potential for infections and wore disposable gloves and aprons when carrying out personal care tasks with people.

People had care plans in place which care staff followed to ensure people’s support needs were met.

People were supported by care staff who had received the necessary training. Arrangements were in place to ensure that effective handovers took place between care staff shifts.

People told us they enjoyed the food, and people were supported to eat and drink enough to maintain a balanced diet.

People were supported to access healthcare when they needed it, and the care staff worked in partnership with health care professionals to ensure people were appropriately supported.

The care home was purpose-built and met the needs of the people living there. There were different rooms available for people to spend time in during the day, so they could follow their interests.

People were treated with kindness and compassion by the care staff. The provider ensured that people’s equality and diversity needs were met.

People were involved in creating their own care plans, where they were able to.

People’s privacy, dignity and independence were respected and maintained by the care staff.

People’s communication needs were understood, and the registered manager ensured information was provided in ways that people could understand.

People were supported to maintain links with their families and friends. The provider encouraged people to avoid visiting the care home during meal times and after 8pm due to people’s support needs.

People were enabled to plan for the end of their life, where they chose to, and were supported with kindness by care staff.

The registered manager ensured that the person’s relatives were informed when any incidents occurred. The registered manager understood their responsibility to be open and honest with people when something goes wrong.

People were supported by managers and care staff who understood their roles and the need to provide a quality service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 18 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

Rearsby Home Limited is located in the small rural village of Rearsby, near Melton Mowbray in Leicestershire. The service provides care and accommodation for up to 27 older people with age related needs, including mental health needs, dementia and physical disability. On the day of our inspection there were 24 people living at the service.

People told us the meals served at Rearsby Home Limited were good. Their nutritional and dietary requirements had been identified and a balanced diet was being provided. However, people’s dining experience varied, with some people enjoying a more positive and inclusive experience than others. This was because the staff team did not always interact well with those they were supporting. We also observed care workers supporting two people to eat their meal at the same time. This did not promote either person’s dignity.

People told us they felt safe living at Rearsby Home Limited. Relatives we spoke with agreed and told us and that they felt their relation was safe with the staff team who supported them.

The staff team had received training on how to keep people staff and knew the procedure to follow if they were concerned that someone was at risk of abuse or avoidable harm.

People’s needs had been identified and the risks associated with their care and support had been assessed. These assessments provided the registered manager with the opportunity to reduce and properly manage the risks presented to both the people using the service and the staff team.

Plans of care had been developed when people had moved into the service. These provided the staff team with the information they needed to enable them to support the people using the service in a way they preferred.

Appropriate checks had been carried out when new members of staff had started working at the service. This was to see that they were suitable and safe to work there.

People were supported by a staff team with the right skills and knowledge. Staff members were supported through Induction, training and supervision and were aware of their responsibilities under the Mental Capacity Act 2005.

People felt there were currently enough members of staff on duty each day because their care and support needs were being met. The registered manager monitored staffing levels to make sure appropriate numbers of staff were deployed.

People had been involved in making day to day decisions about their care and support. Where people lacked the capacity to make their own decisions, these had been made for them in their best interest and in consultation with others. The staff team understood their responsibilities with regard to gaining people’s consent, though this was not always observed.

People received their medicines as prescribed by their doctor. Medicines were being appropriately stored and the necessary records were being kept. There were systems in place to audit the management of medicines and medicines were only administered by staff members who were competent and appropriately trained.

People using the service had access to the required healthcare services and they received on-going healthcare support.

People told us the staff team were kind and caring. Relatives we spoke with agreed with this and told us that the staff team treated their relative with kindness and respect. This was observed on the whole, with the staff team treating people with respect and when supporting them, doing so in a kind and friendly manner.

A complaints process was in place and a copy of this was displayed for people's information. Although not everyone we spoke with had seen this, they knew who to talk to if they had a concern of any kind.

People had the opportunity to be involved in how the service was run. They were asked for their opinions of the service on a regular basis. This was through daily dialogue and through the use of surveys.

The registered manager monitored the service being provided on an on-going basis. Audits on the

documentation held had been completed and checks on the environment and equipment used to maintain people's safety had been carried out.

People told us the service was well managed and they felt able to discuss any issues with the registered manager. The registered manager was aware of their registration responsibilities including notifying CQC of significant incidents that occurred at the service.

During our inspection we spoke with the registered manager, deputy manager and two care staff. We looked at some of the records held in the service, including the care files for three people who used the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask. This is a summary of what we found.

Is the service safe?

People told us that they felt safe and that staff supported them appropriately.

We saw the provider had internal systems and processes in place that monitored the quality and safety of the service. This reduced the risks to people and enabled the service to continually improve.

We saw people had received a pre-assessment, and care plans and risk assessments were in place and reviewed regularly. This meant risks that had been identified, had measures in place to reduce risks and keep people safe.

People had their dependency needs assessed which informed the level of staff required to meet people's needs and keep people safe. We saw the staff roster showed there was sufficient staff employed and deployed appropriately.

We, the Care Quality Commission (CQC) monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to nursing and care homes. This means that when people have their liberty deprived in order to keep them safe, this was only done following a best interest assessment carried out by the local authority DoLS team. We saw an authorisation was in place for one person. This showed the provider had acted appropriately and within the legislation.

Is the service effective?

We saw people's preferences, routines, health and welfare needs had been assessed. We saw examples of referrals and joint working with health professionals in meeting people's needs. This showed person centred approaches to care delivery.

People who used the service were provided with information about the service. The provider had sought information about local advocacy services and had made this available for people. People were supported to know what their rights, choices and options were.

Staff received appropriate training, development and support to enable them to do their job effectively.

People received balanced and nutritional meals that met their dietary requirements. People received sufficient food and fluid that kept them hydrated.

Is the service responsive?

We saw activities were provided by the staff and external entertainers visited the home. Daily newspapers were provided for people to read. One person told us how they had been encouraged and supported to organise a fund raising activity.

The provider had a complaints policy and procedure that supported people to know their rights, and what action to take should they wish to complain about the service.

Is the service caring?

We found staff knowledgeable about people's needs, preferences and routines.

We found staff were kind and attentive. We observed people who used the service appeared relaxed and at ease with the staff supporting them.

Is the service well-led?

Staff were aware of their roles and responsibilities, this showed good leadership and accountability.

We saw the provider had quality assurance processes in place to monitor the quality of services provided to people.

We observed staff talking with people this was done with their privacy and dignity in mind and showed the staffs' awareness of peoples individual support needs. We also looked at how people's individual care, support and dietary needs are organised planned. We looked at how staff compile care and other supporting records and documents, and how the staff were supported with training on both an individual and group basis.

We also looked at how complaints and compliments are handled by the staff. We found that the provider included a clear commitment to dealing with complaints in their Statement of Purpose and had a 'Comments Box' available for the use of relatives and visitors. The provider had also issued a quality assurance which they call a 'Family Questionnaire' we saw evidence where the provider dealt with a concern which had been raised by a relative.