Archived: Renhold Community Home

Renhold Community Home accommodates up to 5 people with a learning disability in one adapted building. There were two people living at the home during this inspection.

The accommodation is single storey and was accessible for people who may also have a physical disability. This showed the care service had 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.

A registered manager was 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.

At the last inspection of this service in October 2015, the home was rated Good.

During this inspection, which took place on 13 February 2018, we found a number of breaches of regulations and areas requiring improvement. Therefore, on this occasion, we have rated the home as Requires Improvement. This is the first time the service has been rated Requires Improvement.

People were not adequately safeguarded from potential abuse. Staff supported people to manage their finances, because they had been assessed as not having the capacity to manage their own finances. We found there was a lack of clarity about what people were expected to pay for. As a result people had spent money on items and activities that had not been legally agreed. This meant that the home had not always acted in line with legislation and guidance relating to people’s consent.

In addition, the service had failed to report a potential area of abuse to the local authority’s safeguarding team, as required. They had also not reported certain notifiable incidents to us, the Care Quality Commission (CQC).

There were sufficient numbers of suitable staff during the day to keep people safe and meet their needs. However, the provider needed to review the arrangements for staffing at night, to ensure people’s needs could always be met in a safe and timely way.

The provider carried out checks on new staff to make sure they were suitable and safe to work at the home. We found some gaps in the checks that had been undertaken, meaning that not all legally required checks had actually been carried out.

In general, people received their medicines when they needed them. However, on the day of the inspection an error occurred. Staff took swift action to ensure the person involved was safe but work was needed to prevent this from happening again.

Opportunities for the service to learn and improve were sometimes missed, because information had not been shared at provider level. Quality monitoring systems were not sufficiently robust, because they had failed to highlight the areas we identified for improvement during this inspection.

Processes were in place to ensure risks to people were managed safely. The home was also clean and systems were in place to make sure people were protected by the prevention and control of infection.

Appropriate referrals were made to external services, to ensure people’s care and support was delivered in line with current standards and evidence –based guidance.

People were supported to have enough food and drink to maintain a balanced diet. Risks to people with complex eating and drinking needs were being managed appropriately.

People had access to healthcare services, and received appropriate support with their on-going healthcare needs.

The building provided people with sufficient accessible space and modified equipment to meet their needs.

Staff provided care and support in a kind and compassionate way. People were encouraged to make decisions about their daily routines. This meant that 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.

People’s privacy, dignity, and independence was respected and promoted. They received personalised care and were given opportunities to participate in activities, both in and out of the home.

Arrangements were in place for people to raise any concerns or complaints they might have about the home.

Systems were in place to support people at the end of their life to have a comfortable, dignified and pain free death.

Arrangements were in place to involve people in developing the service through a variety of different ways.

The service also worked in partnership with other agencies where needed, for the benefit of the people living there.

After the inspection we attended a meeting with the provider and the local authority, to discuss some of the issues found during the inspection. The provider was well prepared for the meeting and set out a number of positive changes that they intended to make to address the concerns raised. They also sent us an action plan setting how they planned to make these changes. We will carry out another inspection in due course, to check their progress with this.

Further information is in the detailed findings below.

You can see what action we told the provider to take at the back of the full version of the report.

We reviewed four health action plans and two care records and found that people were referred to other professionals for treatment when required. This meant that their health and well-being needs were met appropriately.

We found that Renhold Community Home had effective infection control processes in place and we saw that these were based upon a robust policy, to which staff worked. Staff told us there was accessible personal protective equipment (PPE) to wear when needed.

We saw that the premises within the service were appropriate for the people who lived there and were well maintained. There was sufficient equipment in place for people, to ensure staff provided safe and effective care.

We found that records relating to both people and staff were updated on a regular basis and stored safely, in a locked room so as to protect people's confidentiality.

We looked at the care plans for two of the five people living at the service. The plans were person centred and set out so they were easy to read.

We spoke with two relatives. One felt that staff were knowledgeable about people's needs and would convey any changes quickly. Another said "We couldn't fault it" and went on to say "They have bent over backwards to help." Both were very happy with the quality of the care and felt their relative was safe.

Staff had received training in the safe handling and administration of medication. The initial training was delivered as part of an e-learning course which was then followed up with a competency assessment.

The registered manager said that the deployment of staff was decided on a number of factors including experience, skills and if a driver was needed for the minibus. The number of staff varied to match the needs of the people living at the service and the activities they were undertaking each day.

There was a complaints and compliments procedure which provided easy read details of the ways people could comment on the service. The procedure was written in plain English and contained pictures for people to follow.