Redcot Residential Care Home

We found the following examples of good practice:

People were well supported by staff to have telephone and internet contact with their family and friends. The service facilitated in-person visits in a manner which minimised the risk of infection spread, such as garden and window visits. An internal visitor’s pod had been created for people to meet. More recently, face to face visits with a designated visitor had been introduced.

The service ensured that all visitors were carefully screened so that they did not present a risk to people in the home. Visitors were asked a series of screening questions, had their temperature checked on arrival and were subject to rapid lateral flow testing. Personal protective equipment (PPE) including face masks and aprons were provided for visitors before entering the home.

Staff had received training on how to keep people safe during the COVID-19 pandemic and staff and people using the service were regularly tested for COVID-19. The building was clean and free from clutter.

Plans were in place to isolate people if required, to minimise the risk of Covid-19 transmission, such as when people returned from a stay in hospital. One to one care and support arrangements were provided to those people required to isolate within their rooms.

Staff carried out additional cleaning of all areas and completed monthly audits of IPC processes. The service had utilised a National Care Forum Compliance Assessment Tool to ensure effective infection prevention processes were in place.

The service had good supplies of PPE which were readily available throughout the service. Staff carried notebooks to support communication with people who struggled to hear them through a mask.

Effective welfare review processes were in place to monitor and support staff. A staff well-being file, located in the staff room, provided additional well-being support and guidance.

Managers spoke positively about the commitment and dedication staff had shown in supporting people's emotional and social wellbeing during the pandemic.

Redcot Residential Care Home is a residential care home providing personal care to 21 people aged 65 and over at the time of the inspection. The care home can accommodate up to 32 people in one adapted building across three floors. The Ground floor is comprised of three lounge areas, a dining room, two office spaces as well as bedrooms, the second and third floor house the remaining bedrooms.

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

People who lived at the home continued to receive good care and some of the aspects of the support they received to establish their own routines and their activities of interest were well managed. We saw people were treated with dignity and respect by trained staff.

People told us they felt safe living at Redcot Residential Care Home. Staff understood how to protect people from the risk of harm and understood potential signs of abuse. Potential risks to people’s safety were assessed to keep them safe.

People received their medicines safely and as prescribed. People were supported to access healthcare services as needed and staff responded promptly to people’s change in care needs. Staff followed good food hygiene and infection control practices to protect people from the risk of infections.

Other aspects of safety, including fire safety and issues of personal safety, were well managed in the home. Routine checks and audits were conducted to ensure that all aspects of the service were being delivered safely as planned.

People were provided with good nutrition and hydration. People had personalised care plans which provided staff with information to support people living in the home and detailed people’s preferences which staff followed, reviewed and updated, liaising with other departments when necessary.

Accidents and incidents were effectively monitored to identify and address any patterns or themes. Lessons were learnt, and systems were improved, and staff were kept informed.

People could choose where they wanted to spend their time and had access to all floors and a garden area. People were supported and encouraged to maintain their independence as much as possible and were given the freedom to make their own choices.

People were not isolated, and staff encouraged people to be involved in activities both within the home and on day trips. Staff were able to have meaningful conversations with people as they had a clear understanding of people’s hobbies and interests.

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.

People spoke positively about the management and leadership of the service as being open and transparent. People knew how to raise any concerns or complaints and their feedback was used to make improvements to the service. Staff were encouraged to share ideas about how to develop the service. The provider worked in partnership with external agencies to ensure people achieved the best possible outcomes.

Quality audits were carried out on all aspects of the service and used to drive continuous improvement.

Staff had good relationships with external agencies which supported people to live a healthy life. Statutory notifications had been completed to inform us of events and incidents, this helped us monitor the action the provider had taken.

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 14 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.

Redcot Residential Care Home is a residential home providing support to older people, some of whom are living with dementia. The home is registered to provide care for up to 32 people. At the time of our inspection there were 23 people living at the home.

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 about how the service is run.

People were kept safe from abuse as staff understood their role in safeguarding people. Risks to people were assessed and plans were in place to minimise risks to people. Where incident had occurred, measures were taken to prevent a reoccurrence.

There were enough staff present to meet everybody’s needs. We did receive feedback that at weekends staff were sometimes stretched. We have recommended that the provider reviews their deployment of staff. Staff had undergone checks to ensure that they were appropriate for their roles.

People were supported by staff who knew them well. Staff provided support in a way that promoted people’s independence, privacy and dignity. Care plans were person centred and people’s needs were reviewed regularly to identify any changes.

People lived in an inclusive atmosphere in which they were consulted on issues that may affect them. People were encouraged to make their own choices and decisions. Where people were not able to make decisions, their rights were protected as staff worked in accordance with the Mental Capacity Act 2005.

People had access to a wide range of activities. People were provided with a choice of food that matched their dietary requirements.

People’s medicines were administered safely by trained staff. Staff worked alongside healthcare professionals to ensure that people’s healthcare needs were met.

The provider asked for people’s feedback in order to identify improvements that they could make. There were a number of audits in place to improve the quality of the care that people received. People had a good relationship with management and were aware of how to raise a complaint.

Staff had input into the running of the home and told us that they felt supported by management. Staff received regular supervision and appraisals and told us that they had access to the training that they needed in order to ensure that they were effective in their roles.

Systems were in place to reduce the risk of fire and to ensure people’s health and safety. A plan was in place to ensure that people’s needs would continue to be met in the event of an emergency.

If you wish to see the testament that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. Domestic staff worked daily and used guidance in the form of checklists which ensured all areas within the service were cleaned regularly. Equipment used to care for people had been serviced within the last twelve months and there were sufficient quantities available to meet the needs of people. The deputy manager told us about a person who had been diagnosed with an infective illness and we saw they were in the process of "deep cleaning" their room during our visit. They told us they had been promoting their infection control policies with staff by providing extra training and were "pleased" that no other resident had complained of any symptoms.

We reviewed the staffing rota and saw that there were enough staff on duty to meet the needs of people. The manager identified challenges within the size of the building which impacted on the care they provided for people and told us about their intention to improve the call bell system and increase minimum staffing levels. This meant people could have access to staff more often. Staff told us they worked as "doubles and singles" during the day which ensured people who required two care staff to support their needs did not wait long periods for care to commence.

We spoke with four members of staff who told us they had received mandatory training within the last year in line with the providers training policy. The manager told us fifty per cent of staff had received their mandatory training within the last year. They told us they had recently started using a new format to deliver training which meant not all the staff were up to date. A plan had been put in place which meant staff would receive the training over the coming months.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had been submitted, proper policies and procedures were in place to protect people against unlawful restraint.

Is the service effective?

People told us they were happy with the care they received and felt their needs were met. People told us the staff were "extremely kind" and "wonderful". They told us they felt staff enabled them to remain "independent" and "don't get impatient" with them

We observed the staff caring for people and saw that they were knowledgeable about people's treatment. We observed a member of staff who had a discussion with a person about their health needs. They encouraged them to rest as they had been advised by the local GP and demonstrated good knowledge of their prescribed medication. People's on-going health needs were documented in the care plan and staff ensured treatment had been given according to the direction of external professionals.

Is the service caring?

Staff who supported people were kind and caring. We observed staff caring for people and saw they spoke to them kindly and respectfully. People were offered choices about their care and staff told us they "knew people well". People we spoke with confirmed this and told us "it feels like home". The building had an area for people of religious faiths to gather and people from external organisations were encouraged to visit. People told us the staff were "very attentive" and they were given choices about their daily routines. They told us they could change aspects of their care if they wanted to and the staff supported them well.

Is the service responsive?

People's needs were assessed before they moved into the service. We reviewed the care plans for three people and saw a wide variety of assessments were completed which identified people's needs. Care plans were individualised and consideration had been given to people's wishes. Care had been reviewed regularly which ensured people were given choices about their on-going care.

People had access to a variety of activities and told us they felt it enabled them to stay "independent". They told us they were supported to access activities out of the home if they wanted to and family and friends were encouraged to visit. People's records confirmed people's interests and preferences

Is the service well-led?

The acting manager told us they had been in post for two weeks but had transferred from another service owned by the provider. Staff we spoke to had a good understanding of the ethos of the service and quality assurance processes were in place. People were able to provide feedback and used a variety of methods including: comments books, resident survey's and meetings. We could see changes had happened as a result of feedback from people as a "date board" had been displayed in the main lobby and changes had been made to the menu. Comments books were visibly available for people and staff wrote comments alongside which detailed actions that had happened as a result of feedback.

Staff we spoke with were clear about their roles and responsibilities and were able to tell us about how they escalated concerns and learnt about changes to the service. There was a clear management structure within the service and staff were supported by senior care staff everyday. They told us training was provided which ensured they could care for people's needs and "team building exercises" were offered which they felt had been a good way of "getting to know" their colleagues. Staff meetings were held regularly and staff told us they felt the management team "listened" to their ideas and "changes happened" as a result of these meetings.

We spoke with three relatives. They also expressed their satisfaction with the home and the care provided.

We spoke with four members of staff, including the deputy manager. They told us that they had a good and stable team and that they enjoyed working at the home. One carer said, 'I really like the work here. We get so much support from our seniors and we are taught whatever we want to know'. Another told us, 'Everyone is pleasant and willing to learn more'.

We found that the home was spacious and bright and that people looked well cared for. People's rights with regard to consent were being promoted by the service and staff understood how people's capacity should be considered. Staff were welcoming and we saw that they supported people with kindness and respect. People told us that they could approach staff or the manager if they were unhappy or had ideas to discuss.

During our observation we saw that staff interacted well with people when they were supporting them. We saw that staff were knowledgeable about people's needs and preferences. We found staff were respectful and maintained people's dignity, privacy and independence. For example staff knocked on people's door before entering and they checked on how they wanted their care to be provided before doing so. We saw that activities were altered to suit individual needs.

We were shown examples of person centred care records which were well organised into separate sections. This provided clarity for staff. These had been developed for each individual and documented their wishes and preferences in relation to how their care was provided. A relative's assistance was sought with this where the person was unable to fully contribute themselves.

Equality and diversity had been considered in the service by looking at each individual's needs. Any equipment or adaptations needed were provided.