We carried out a review of the data available to us about Redcote Residential 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 Redcote Residential Home, you can give feedback on this service.
Redcote Residential Home is a residential care home providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. The service can support up to 28 people.
People’s experience of using this service and what we found
People felt safe using the service and staff understood their responsibilities to protect people from harm. Risks associated with people’s care had been identified and mitigated. Measures were in place to reduce the risk of infection. There we enough staff to meet people’s needs. People received their prescribed medicines. Accidents and incidents were reviewed.
People told us staff treated them well. Relatives told us staff were kind and caring. People were supported to follow their chosen faith.
There was a robust and clear system in place to monitor the quality of the service. Quality audits were conducted, and the registered manager and provider had oversight of the service. People, staff, relatives and visiting professionals were encouraged to share their feedback regularly. The management team of the service were continually highly commended. People’s suggestions were acted upon.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 07 December 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 12 November 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve relating to safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Redcote Residential Home on our website at www.cqc.org.uk.
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.
Redcote Residential Home is located in Gainsborough and provides care and support for up to 28 people aged over 65. The service is set over two floors. At the time of inspection there were 27 people using the service.
People’s experience of using this service and what we found
The registered manager had implemented systems to enable them to have clear oversight of accidents and incidents which took place in the service. This included an investigation of each incident reported and identifying trends. Action taken to reduce the risk of re-occurrence was clear.
Medicated creams which had been prescribed by the GP had clear guidance for staff to enable them to apply this safely and effectively. Information relating to medicine where people were prescribed ‘one to two’ tablets was clear and documented on the MAR chart (Medication Administration Record).
The provider had sought support and guidance from a Care Improvement Associate (CIA) to implement effective quality monitoring processes in the service. The registered manager monitored quality in all aspects of the service and where short falls were found, action plans were in place. The provider had oversight of achievements and shortfalls in the service.
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 requires improvement (published 06 December 2019).
Why we inspected
We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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.
Redcote Residential Home is located in Gainsborough and provides care and support for up to 28 people aged over 65. The service is set over two floors. At the time of inspection there was 27 people using the service.
People’s experience of using this service and what we found
There were quality assurance processes which were in place, however, they did not identify shortfalls in the service and audits were not consistent. There was a lack of oversight and direction from the registered provider, who visited the service but did not identify improvement which needed to be made. The registered manager was open but had not followed parts of the duty of candour. People, staff and relatives felt the registered manager was approachable. There was a culture to improve in the home but lacked direction to do so. The service worked in partnership with others.
There was a lack of monitoring of accidents and incidents, this indicated that not all safeguarding concerns had been identified. People received their medicines, however documentation and prescription labels on some medicine needing clarifying. People were supported by enough staff. The registered provider carried out sufficient pre-employment checks on staff but did not always have correct information about the selection and suitability of staff for their role. People felt safe using the service. Infection control measures were taken to protect people from infection.
People’s capacity had been assessed where required and best interest meetings had taken place, however, these needed to be more decision specific. People had their needs assed prior to admission. Staff received on going training. Staff supported people to have a well-balanced diet and their nutritional needs met. Staff worked collaboratively with others to ensure timely on-going health care support for people. People had their oral health needs assessed and had access to dentists. The premises were fit for purpose and people were able to personalise their bedrooms.
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.
Staff were caring and interacted positively with people. People felt they were well treated and supported with their care.
People had care plans in place, individual to them. There were no formal complaints in the service, however, informal concerns were documented. People were given information in different ways to enable them to have information that they will understand. People were encouraged to join in activities and follow their chosen faith. People had end of life care plans in place and staff had received training in relation to this.
Rating at last inspection
The last rating for this service was requires improvement (published 12th June 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made/ sustained and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
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 alongside the provider and local authority to monitor progress.
Enforcement
We found the provider continued to be in breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued a warning notice instructing the registered provider they needed to improve the management systems in the service by 21st February 2020.
Redcote Residential Home is registered to accommodate up to 28 older people in one building. Some of these people were living with dementia. At the time of the inspection, 26 people were using the service.
A registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
During the home’s previous inspection on 20 August 2015, we rated the home overall as ‘Good’ although the service was rated as ‘Requires Improvement’ for the question, ‘Is the service safe?’ During this inspection, we found some areas of concern and the overall rating has now changed to ‘Requires Improvement’. The details of the reasons why are explained in the summary below and in the body of the main report.
People felt safe living at the home. Staff understood the processes for protecting people from avoidable harm. People’s medicines were managed safely however, protocols for the consistent administration of ‘as needed medicines’ were not always in place. The risks to people’s safety had been assessed and care plans were in place to support people safely. There were enough staff to keep people safe, however the staff were not always deployed appropriately, which could place people at risk. Accidents and incidents were regularly reviewed, assessed and investigated by the registered manager. The home was clean and tidy.
People’s physical, mental health and social needs were assessed and provided in line with current legislation and best practice guidelines, although guidance for some conditions such as Parkinson’s disease was needed. People were supported by trained staff who had their performance regularly assessed. However, few staff had received an annual appraisal of their work. Staff felt supported by the registered manager. People spoke positively about the food; however, the lunchtime experienced was unorganised with some people waiting longer for their meals than others.
The registered manager had built effective relationships with external health and social care organisations and people’s health was regularly monitored. However, information for people within the home about their health conditions was limited. The environment had been adapted to ensure people who had mental or physical disabilities were able to lead fulfilling lives. However, more directional signage was needed to support people living with dementia to orientate themselves independently around the home. 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 supported this practice, although some assessments of people’s capacity to make decisions required more detail.
People and relatives liked the staff and found them to be kind, caring and respectful. Staff treated people with dignity and respected their privacy. People felt able to make decisions about their care and felt the staff respected those decisions. People were encouraged to lead as independent a life as possible. People were provided with access to an independent advocate if they needed one, although information about how to do so independently was not available.
People’s care records were person centred and guidance was provided for staff on how each person would like to be cared for. Some records required older information to be removed to avoid conflicting information. People felt their personal preferences and choices were respected. People were cared for without discrimination and systems were in place to support people who had communication needs. People were encouraged to take part in group activities and activities that were important to them. People felt able to make a complaint and were confident it would be dealt with appropriately. End of life care was not currently provided, however, systems were in place to support people with this if they needed it.
The home was led by a caring registered manager who was well liked by all. However, the quality assurance processes that were in place to continually assess the quality of the service people received were not always effective. They had not identified the concerns raised during this inspection. Input from the provider was limited and the performance of the registered manager was not formally assessed. People felt able to give their views about the service. Staff felt valued and able to give their views although formal team meetings were not in place. The registered manager was keen to develop the role and skills of the deputy manager. Staff were not always held accountable for their actions.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the back of this report
This inspection took place on 20 August 2015 and was unannounced. Redcote Residential Home provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 28 people who require personal and nursing care. At the time of our inspection there were 27 people living at the home.
At the time of our inspection there was a registered manager in post. 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
On the day of our inspection we found that staff interacted well with people and people were cared for safely. People and their relatives told us that they felt safe and well cared for. Staff were able to tell us about how to keep people safe. The provider had systems and processes in place to keep people safe.
The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.
We found that people’s health care needs were assessed and care planned and delivered
to meet those needs. People had access to other healthcare professionals such as a dietician and GP and were supported to eat enough to keep them healthy. People had access to drinks and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.
There were usually sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support and people had their privacy and dignity considered.
Staff had a good understanding of people’s needs and were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received regular supervision, however they had not received appraisals.
We saw that staff obtained people’s consent before providing care to them. People had access to activities and community facilities.
Staff felt able to raise concerns and issues with management. Relatives were clear about the process for raising concerns and were confident that they would be listened to. The complaints process was on display.
Regular audits were carried out and action plans put in place to address any issues which were identified. Audits were in place for areas such as medicines, health and safety and infection control. There were cross infection issues which had not been identified by the infection control audit.
Accidents and incidents were recorded. The provider had informed us of incidents as required by law. Notifications are events which have happened in the service that the provider is required to tell us about.
We talked with five of the 27 people using the service and three relatives. We looked at five people's care records and observed care being provided. We talked with three care staff, the cook, two housekeepers and the manager. We examined four staff records and the documentation related to quality audits.
This helped us to answer the questions below:
Is the service safe?
We found there were appropriate standards of hygiene and cleanliness and staff were conversant in procedures necessary for the prevention and control of infection.
Safe procedures were in place for the ordering, storage and administration of medicines.
Is the service effective?
Care was planned in conjunction with the person using the service or their relatives. Care plans had been reviewed regularly and updated as necessary. Care plans were therefore accurate and reflected people's needs.
Specialist equipment needs had been identified and required equipment was in place.
Visitors we talked with confirmed they were able to visit at any time and could see their relative in private if they wished.
Is the service caring?
All the people we talked with told us all the staff were kind and caring. A relative of a person using the service said, "They try their hardest to encourage (the person) to eat and will prepare anything (the person) fancies even though they eat very little of it."
People's preferences had been recorded and care and support was provided in accordance with their wishes.
Is the service responsive?
People were encouraged to provide feedback on the care provided and issues identified were addressed.
People told us staff listened to them and said, "If you want anything at all, you only have to ask. The carers will do anything for you."
The service cooperated and collaborated with other care professionals to ensure people had access to specialist support when required.
Is the service well led?
People using the service and the staff told us the manager was always available for them to talk to and acted on issues raised.
There were a range of quality audits in place to assess and monitor the quality of the service provided.
Care records and staff records were maintained and stored appropriately.