Archived: Redannick Residential and Nursing Home

Redannick provides residential care for up to 41 older people most of whom are living with dementia. At the time of the inspection there were 27 people living at the service. The home is situated within a residential area of central Truro. The accommodation is all on one level and there are external garden areas suitable for people to use.

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

The service had introduced a new electronic staff roster to improve the reliability and running of the service. There had been a transition process from paper to the electronic system and some staff had found it confusing using both. However, the service was now only using the electronic roster which staff were now familiar with.

Medicines were stored safely, and staff had the knowledge and skills to administer them safely. Previous errors in missed medicines had been reviewed and action taken to address this. When medicines for use as required were administered there was not always a record to show why they had been given or if they had been effective. We have made a recommendation about this in the report.

All necessary recruitment checks had been completed and there were effective safeguarding systems in place. Staff had a good understanding of what to do to help ensure people were protected from the risk of harm or abuse.

There had been gaps in the delivery of training during the COVID-19 pandemic. However, this was being addressed and staff were updating their training to support them in their role.

Risks were identified, assessed monitored and reviewed. People told us they felt safe.

People were supported to have maximum choice and control of their lives. 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 aware of the organisations guidance on the use of personal protective equipment (PPE) such as masks, gloves and aprons. The service was clean, and we observed housekeeping staff carry out ‘touch point’ cleaning on door handles.

People, their relatives and staff told us management were approachable and they listened to them when they had any concerns or ideas. Regular auditing was used to make continuous improvements to 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 Good (published 18 December 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels, responding to people’s needs and concerns people’s needs were not always being met. A decision was made for us to inspect and examine those risks.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective 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 Redannick 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.

Redannick provides residential care for up to 41 older people most of whom are living with dementia. At the time of the inspection there were 35 people living at the service. The home is situated within a residential area of central Truro. The accommodation is all on one level and there are external garden areas suitable for people to use.

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

People looked relaxed, happy and comfortable with staff, and they interacted well with each other. Staff were caring and spent time chatting with people as they moved around the service.

There were sufficient staff on duty to meet people’s needs. The service used some agency staff, in limited numbers, to cover any shifts.

The service was clean and hygienic, and there were appropriate procedures to ensure any infection control risks were minimised.

Cleaning and infection control procedures had been updated in line with Public Health England (PHE) Covid-19 guidance to help protect people, visitors and staff from the risk of infection. During the summer months some families had met people in the garden. New arrangements were in place for families to meet in the conservatory as this was a designated safe area of the service during the winter months.

The staff were provided with scrubs to change into when coming on shift. The management encouraged staff who did not wear scrubs to wear a different set of clothes once in the building and change out of those clothes before leaving the premises to help with infection risks.

People received their medicines safely and on time. Topical creams where labelled appropriately with clear opening dates and use by dates. Clear procedures were in place and staff received medicines training.

The service had suitable safeguarding systems in place, and staff knew how to recognise, and what to do, if they suspected abuse was occurring.

Care plans included risk assessments and guidance for staff on how to meet people’s support needs. Risk assessment procedures were satisfactory so any risks to people were minimised. Both care plans and risk assessments were regularly updated to include actions needed in the event of an outbreak of Covid-19.

The service was managed effectively. Staff felt supported. There were appropriate audit and quality assurance systems in place.

Rating at last inspection

The last rating for this service was Good (published 18 December 2019).

Why we inspected

We undertook this targeted inspection to check on specific concerns we had about equipment in non-working order, lack of staff training in equipment use, personal care not given in a timely manner, topical medicines, in particular creams, not given as prescribed. Other issues of concern included, staff not wearing appropriate PPE, monitoring charts, for example repositioning charts, not completed and shortages of staff. The overall rating for the service has not changed following this targeted inspection and remains as good.

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.

We found no evidence during this inspection that people were at risk of harm from these concerns.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Redannick 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.

Redannick provides residential care for up to 41 older people most of who are living with dementia. At the time of the inspection there were 38 people living at the service. The home is situated within a residential area of central Truro. The accommodation is all on one level and there are external garden areas suitable for people to use.

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

People told us that they felt happy and safe at the service. People were protected from the risk of abuse. Checks had been completed to help ensure new staff were safe to work with vulnerable adults; however, a full employment history had not always been recorded. We have made a recommendation about completing and monitoring safe recruitment processes.

People and relatives told us they were happy with how staff administered people’s medicines. Medicines were managed safely and staff were appropriately trained. People’s health needs were monitored and staff worked with other professionals to understand and meet people’s needs.

People’s needs were assessed comprehensively before they moved into the service. People and their relatives spoke positively about staff and told us they met their needs. People were empowered to make choices and have as much control as possible. People had a range of activities they could be involved in. People told us they liked the food and were able to make choices about what they had to eat.

People were treated with kindness and compassion by staff. Staff knew people’s individual communication skills, abilities and preferences. They used this knowledge to make sure people’s views and opinions were heard. People told us their privacy and dignity were respected.

People had care plans that clearly explained how they would like to receive their care and support. Staff were passionate about providing high quality holistic care at the end of people’s life. 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.

The registered manager and senior staff had developed a person-centred culture within the staff team. Staff were positive about how the service was run. Relatives told us they would recommend the home to others and were happy with the care their family members received. The service’s relationship with people’s friends and families was valued.

The provider was aware of the importance of forward planning to ensure the quality of service they provided could continue to develop. There was a quality assurance system in place to drive continuous improvement within the service. Most people’s records were detailed and reflected their current needs. However, we did identify small gaps in some people’s records that still required further detail or information. We have made a recommendation about audits and checks of 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 good (published 9 June 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.

Redannick provides residential care for up to 41 older people most living with dementia. At the time of the inspection there were 41 people living at the service. The home is situated within a residential area of central Truro, the town centre and transport network. Car parking is available at the front of the home on a private forecourt. This is a single storey service so accommodation is all on one level. There are external garden areas suitable for people to use.

At the last inspection in June 2015 the service was rated ‘Good’ overall and Outstanding in the domain Responsive. At this inspection we found the service remained ‘Good’ and Outstanding in Responsive.

People and relatives all spoke positively about the service. Relatives told us that people were safe living at the service and that staff were kind, friendly and treated people well. They told us that the registered manager was always available and approachable.

Safeguarding procedures were in place and staff had a good understanding of how to identify and act on any allegations of abuse. Accident and Incidents were logged, investigated and action taken to keep people safe. Risk assessments were in place which were individualised for the person. This was to minimise potential risk of harm to people during the delivery of their care and support. Risk assessment were regularly updated and changes made as necessary so staff were responding to current risk levels.

The premises were safely managed. Recent improvements had been made to the environment to make it more pleasant and homely. Further refurbishment work was taking place when rooms became vacant. All areas were clean and hygienic and a safe place for people to live. Equipment had been serviced and maintained as required.

We found the way medicines were managed was safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with safe arrangements for storage.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. 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.

There were enough staff available to ensure people received prompt and attentive care. Staff had time to chat with people as well as meeting their care and support needs. Recruitment procedures were safe to help ensure staff were of suitable character to work with vulnerable people.

People and relatives told us staff were competent and well trained. Staff had been provided with a range of training relevant to their role and the registered manager had installed a culture where staff sought out new knowledge and shared their knowledge with their peers.

People and relatives spoke positively about the food provided by the home. There was sufficient choice and people received appropriate support where required. We observed regular snacks and drinks throughout the day were provided between meals to make sure people received adequate nutrition and hydration. Comments from people who lived at the home were all positive about the quality of meals provided. One person said, “It’s perfectly OK, I’ve got no complaints about it.”

We found people had access to healthcare professionals and their healthcare needs were met.

There was an extensive range of meaningful activities available to people including regular access to community events. Families were extremely satisfied with the activities available to their relatives and told us the service went, ‘over and above’ what they would expect to be available. Comments included, “Loads of trips, we’re able to join them if we want.” There were activities taking place on at least five days a week at the service. A dedicated activities co coordinator was currently in their 30th year at the home as a carer and activity worker. They were clearly passionate about their role.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered provider had a robust quality assurance process in place to drive improvement in the service location Redannick. These included regular audits of the service, annual surveys, resident meetings and staff meetings to seek the views of people about the quality of care at the service. There was also evidence of the service engaging with external quality assurance organisations which showed the service was open and transparent.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

At the time of the inspection people were safe. Systems were in place to help the manager and staff team 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. Staff showed a good understanding of the care needs of the people they supported.

Redannick alerted the local authority and the Care Quality Commission when notifiable events occurred or they had any concerns regarding people who used the service.

Redannick had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). This helped to ensure that people's needs were met.

Is the service effective?

At the time of the inspection we found the service to be effective. People, or their representatives, were involved in writing or reviewing their plans of care. During our inspection it was clear from our observations and from speaking with staff, and relatives of people who used the service, that staff had a good understanding of people's needs and care plans were up-to-date.

We saw that there was good liaison and communication with other professionals and agencies to ensure people's care needs were met.

Is the service caring?

At the time of the inspection we found the service to be caring. Feedback from a visiting relative was positive, for example, 'it's all fine'. We saw humour in some of the interactions between people and staff. For example, when asked 'How are you this morning?' one person responded with a smile and 'I don't know yet'.

Redannick had regular support from the GPs from the local GP practices and other visiting health professionals. This ensured people received appropriate care in a timely way.

Is the service responsive?

At the time of the inspection we found the service to be responsive to changing care needs and wishes, for example, recent minutes of a resident's meeting showed 'X would like a beer with lunch' and this had been provided and plans had been made for a suggested 'sherry and cake afternoon'. Many people who lived at Redannick had complex health needs and were either not able, or chose not to join in group activities. There was evidence to show that people were routinely offered one-to-one time or group activities. We saw one such activity taking place at the time of the inspection and the people taking part appeared to genuinely enjoy the event.

The service worked well with other agencies and services to make sure people received care in a coherent way.

Is the service well-led?

At the time of the inspection we found the service to be well-led. Redannick had a registered manager. The deputy manager was available on the day of the inspection.

We saw minutes of meetings held with the staff and people who lived at Redannick. This showed the management had consulted with staff and others to gain their views and experiences and improve support for people who lived at the service.

The service had a quality assurance system, and staff were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We saw people's privacy and dignity was respected and staff were helpful. We saw people engaged in activities, and we saw people chatted with each other and with staff. People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People experienced care, treatment and support that met their needs and protected their rights, and people were protected by the home's robust recruitment procedures.

There were enough qualified, skilled and experienced staff to meet people's needs, and we found staff received appropriate professional development.

The provider had an effective system to regularly assess and monitor the quality of service that people received. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

Records were legible, up to date and stored securely.

We used our SOFI (Short Observational Framework for Inspection) tool for approximately one and a half hours in the dining area. The SOFI tool allowed us to spend time watching what was going on and helped us record how people spent their time, the type of support they got and whether they had positive experiences. We saw people's privacy and dignity was respected and staff were helpful. We saw people engaged in activities and we saw people chatted with each other and with staff.

During our inspection, we found people's privacy, dignity and independence were respected and people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People experienced care, treatment and support that met their needs and protected their rights, and people were protected against the risks associated with medicines, because the staff had appropriate arrangements in place to manage medicines.

We found staff received appropriate professional development and supervision.