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We are carrying out a review of quality at Russell House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 14 September 2018

This inspection took place on the 25 and 26 June 2018 and was unannounced. At the previous inspection the service was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities 2014). At this inspection we found there was a continued breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities 2014). This was because records were not suitably maintained, accurate and up to date and the governance of the service failed to bring about the improvements required for them to become compliant with this regulation.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective and well –led to at least good. The provider sent us an action plan telling us what improvements they intended to make. At this inspection we found the improvements were not sustained and the service was again rated requires improvement. This is the third inspection where the service has been rated “Requires Improvement.”

Russell house is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Russell house accommodates 20 people across four separate units, each of which have their own facilities. At the time of this inspection there was nineteen people living in the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service was required to have a registered manager. 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. In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time. The registered manager had recently left the organisation and the provider was actively recruiting into the position.

Relatives were complimentary of the permanent staff and felt they were skilled, kind and caring. However, the service had a high number of staff vacancies which meant a high use of bank and agency staff were used to cover shifts. Relatives felt those staff did not always have required skills and training and the use of agency staff led to inconsistent care for their family members.

Whilst the required staffing levels were maintained on each unit staff were not deployed appropriately which meant some units had a high number of agency staff on shift. This put a lot of pressure and responsibilities on the permanent staff members who felt they were working under extreme pressure. They were expected to be drivers, administer medicine, act as shift leaders as well as providing personal care and support to people. The provider confirmed after the inspection they had moved staff around to provide a better skill mix of experienced staff across all the units. They were continuing to recruit into vacancies and they were currently consulting on a pay review which they hoped would help with the retention of staff.

Staff were not suitably inducted, skilled, trained and supported in their roles. The agency staff were not appropriately trained in that they did not have training such as epilepsy awareness and learning disabilities which the provider considered was mandatory for th

Inspection areas

Safe

Requires improvement

Updated 14 September 2018

The service was not always safe.

People did not receive consistent care due to the high use of agency staff used within the service.

People’s risks were identified but the reliance on agency staff had the potential for risks not to be consistently managed.

People were safeguarded from the risk of potential abuse.

People were supported by staff who were suitably recruited.

Effective

Requires improvement

Updated 14 September 2018

The service was not always effective.

People were not supported by staff who were suitably inducted, trained, skilled and supported in their roles.

People were consented on their day to day but staff did not work to the principles of the Mental Capacity Act 2005.

People had access to a range of health professionals to meet their needs. Some aspects of their health and nutritional needs were not always addressed.

Caring

Requires improvement

Updated 14 September 2018

The service was not always caring.

People were supported by staff who were kind and caring however, some staff did not always show people respect and promote their privacy and dignity.

People had their own bedrooms and en- suite bathrooms.

People were provided with information on advocates to support them.

Responsive

Requires improvement

Updated 14 September 2018

The service was not always responsive.

People had care plans in place which outlined their needs and support required. They lacked details around the management of behaviours that challenged.

People’s communication needs were identified but staff did not consistently use aids and pictures to promote people’s involvement in the service.

People had access to activities but community access was limited due to the lack of drivers within the service.

People’s end of life needs were identified and the service had positively supported a person on end of life care to remain at the home.

Well-led

Requires improvement

Updated 14 September 2018

The service was not always well led

People’s records were not suitably maintained and accurate.

People were not supported by a service that was suitably monitored to bring about improvements.