This was an unannounced comprehensive inspection which took place on 8 and 9 September 2015.
We had previously carried out a scheduled inspection on 2 July 2014 when we found the service had not complied with all the regulations we reviewed. We found breaches in the regulations relating to the management of medicines and assessing and monitoring the quality of service provision. We returned to the service on 28 August 2014 and found that action had been taken to achieve compliance with the regulations in both areas.
In August 2015 we received concerns that medicines were not being administered and monitored effectively.
Reinbek provides residential care for up to 44 people. The home is a large extended, two storey, detached
property set in mature grounds in the Stockport area. The home is divided into four units, named Blueberry, Lemon Tree, Greenacre and Strawberry Fields. All units provide accommodation, bathrooms and communal areas. All bedrooms have single occupancy and some have en-suite facilities. There is a passenger lift providing access to the first floor. There is large enclosed garden area and car parking is available within the grounds.
There was a registered manager in place at the home. 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.
We found four breaches of regulations relating to arrangements for staff supervision, and safe working practices including the administration of medicines, control of infection practices and environmental and nutritional risks. For example, we saw staff leave medicines in pots close by each user, but did not ensure that they had taken their medicines; doors to rooms and cupboards which should have been kept locked were not locked, and clinical waste procedures were not always followed. Staff were not always provided with supervision or appraisal.
You can see what action we told the provider to take at the back of the full version of the report.
We also made a recommendation relating to the provision of food. See the comments in the main body of the report.
People told us they felt safe. We were told “Its home. I definitely feel safe here” and “I know the staff very well. I’m very comfortable here.” Visitors told us they were reassured that their loved ones were safe; we were told by one relative that, “I like what I see. If there was anything untoward I know I can speak to the manager, and it would be sorted out.”
Systems were in place to reduce the risk of harm and potential abuse. The provider’s safeguarding adults and whistle blowing procedures provided guidance to staff on their responsibilities to protect vulnerable adults from abuse.
Recruitment and selection procedures were in place to help ensure that the staff employed at the home were suitable to work with vulnerable adults. There were sufficient numbers of staff available to support people, with the exception of lunchtime on the day of our visit, due to medication training and attending to a visiting doctor.
The people we spoke with were complimentary about the staff. One person told us, “The staff here are very kind. I have no complaints, and if I did I would be able to speak to [the registered manager].” Another told us, “We are well looked after here. It was a wrench to leave my bungalow, but I made the right decision to come here.”
We saw that people were often left to find their own stimulation and there was little sign of any organised activities taking place. People told us that the level and quality of activities had declined whilst they had been there.
The registered manager was able to demonstrate a good understanding of the Deprivation of Liberty Safeguards procedure (DoLS) and Mental Capacity Act MCA (2005) and the staff we spoke with also had an understanding of capacity and consent issues relating to people who used the service.
Reinbek had a comfortable calm and relaxed atmosphere. It was undergoing extensive refurbishment when we inspected, but this was unobtrusive and caused little obvious inconvenience to the people who lived there
The staff had developed good relationships with all the people who used the service. We observed good social interactions and people were treated with kindness and respect by staff who knew them well.
We saw that the home had a complaints procedure, with the policy on display in the entrance hall. In addition there was a locked box for people who lived there and their visitors to post any comments, and ‘your views are important’ comment cards were available.
The registered manager was respected by the staff we spoke with, who told us that they were confident that she would resolve any issues if they approached her. One staff member told us that she thought morale had improved since the new manager had taken over, and that she looked forward to coming into work.