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Archived: Rubens House Good

Inspection Summary


Overall summary & rating

Good

Updated 19 May 2018

This inspection took place on 22, 23 and 28 March 2018 and was unannounced. At the last inspection on 24 and 27 January 2017 we found the service was in breach of six regulations as stipulated by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At the last inspection we found that people using the service were insufficiently protected by the service's procedures to ensure that all decisions were made in their best interests within the requirements of the Mental Capacity Act 2005. The care and treatment delivered did not always meet people’s needs and reflect their preferences. Risks to people’s health and safety had not been appropriately assessed and the service was not doing all that is reasonably practicable to mitigate any such risks which included the proper and safe management of medicines. The nutritional and hydration needs of people were not always met. Sufficient numbers of staff were not always deployed to meet people's needs effectively. The service failed to effectively operate systems to: assess, monitor and improve the quality and safety of the services provided.

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 of safe, effective, caring, responsive and well-led to at least good. During this inspection we found that the service had made appropriate improvements to the issues that we identified and how they planned to ensure sustainability of these improvements for the future.

Rubens House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rubens House accommodates up to 46 people in one purpose built building. Rubens House is operated and run by Jewish Care, a voluntary organisation and supports people from the Jewish community. Within the building there are three floors, each of which has separate adapted facilities. All three floors specialise in providing care and support to people living with dementia and physical health needs. At the time of this inspection there were 32 people using the service.

At the last inspection the provider had transferred an experienced manager from one of their other locations. This manager had become the registered manager for Rubens House. 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 and relatives told us that they were safe living at Rubens House and that care staff ensured their safety at all times. Care staff demonstrated a good understanding of how to keep people safe and how to protect them from risk of abuse or harm.

Each person’s individual risks associated with their health and care needs had been identified and clear guidance was available for staff on how to reduce and mitigate the known risks to ensure people’s safety.

The service had policies and procedures in place to ensure the safe management and administration of medicines. Issues noted at the last inspection had been addressed.

Robust recruitment processes were in place to ensure only staff assessed as safe to work with vulnerable people were recruited. We observed there to be sufficient staff available to support people with their needs. Staff did not seem to be rushed and people’s needs were met appropriately. The service manager used a level of need assessment tool to ensure that appropriate staffing levels were maintained to ensure people’s needs were safely met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way

Inspection areas

Safe

Good

Updated 19 May 2018

The service was safe. People told us they were safe living at Rubens House. Appropriate systems and processes were in place which protected people from abuse and harm.

The service had robust processes in place to ensure the safe management and administration of medicines.

We observed appropriate staffing levels in place which safely met the needs of people.

Safe recruitment processes were followed to ensure only staff assessed as safe to work with vulnerable people were recruited.

All accidents and incidents were clearly documented with details of how the service reflected and learnt from each incident in order to prevent future re-occurrences.

Appropriate guidance and equipment was provided to all staff to ensure people were protected by the prevention and control of infection.

Effective

Good

Updated 19 May 2018

The service was effective. People’s needs and choices were comprehensively assessed and documented to ensure people received the appropriate care and support that they required.

Care staff were supported to effectively carry out their role and develop through training, regular supervisions and annual appraisals.

People were appropriately supported to drink and eat in order to maintain a healthy lifestyle.

Care staff understood and provided care and support according to the key principles of the Mental Capacity Act 2005.

The service ensured that they worked effectively within the home and across a variety of other health and social care organisations so that people received care and support through a holistic approach.

People had access to a variety of healthcare services to ensure their health and medical care needs were effectively met.

Caring

Good

Updated 19 May 2018

The service was caring. We observed people had built positive and caring relationships with each other as well as the entire staff team within the home.

People were observed to be asked and involved in all day to day decisions. People were supported to maintain their independence where possible.

Care staff knew people well and had a good knowledge and understanding of their needs, wishes and choices.

People and relatives confirmed that staff always respected their privacy and dignity and we observed this to be the case.

Responsive

Good

Updated 19 May 2018

The service was responsive. A variety of activities had been scheduled and delivered whilst the inspection was taking place. Activities were planned with consideration given to people’s needs and abilities.

Care plans were detailed, person centred and responsive to people’s needs. Care plans were reviewed regularly.

All complaints and feedback from people, relatives, visitors and health care professionals were recorded and responded to appropriately.

Well-led

Good

Updated 19 May 2018

The service was well-led. The service had made significant improvements since the last inspection to ensure that people received safe, effective, caring and responsive care and support.

Improved systems were in place to monitor and check the quality of care provided.

The management team had introduced a variety of new initiatives to ensure people, relatives and staff received a positive experience of living and working at Rubens House.

There was a clear management structure in place and people and staff spoke positively of the senior management team and especially the improvements that had been made since the last inspection.

People, relatives and staff were regularly involved and engaged in a variety of ways in order to obtain feedback about the quality of service provision as well as gain ideas and suggestions of where further improvements could be made.