We carried out a review of the data available to us about Rushley House Retirement Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rushley House Retirement Home, you can give feedback on this service.
Rushley House Retirement Home is a residential care home registered to accommodate up to 13 people in need of personal care. Accommodation is provided over two floors with single rooms. On the day of the inspection, there were 12 people living at the home.
People’s experience of using this service and what we found
Improvements had been made around recording issues seen at an earlier inspection and this meant we were assured staff were supporting people in a caring and sensitive way. People's needs and requirements were properly recorded in care records.
There was no formal activities programme and an absence of records around people's wishes in this area. Although there were some activities taking place, people did not always have access to a range of activities and we have made a recommendation about this in the 'Responsive' section of the report.
Infection, Prevention and Control (IPC) processes were thorough. We were assured about the service's ability to mitigate the transmission of infections.
Safe visiting processes were in place to ensure people could see visitors when they wished and could maintain relationships that were important to them. There had been no recent complaints but we were assured any would be dealt with appropriately.
People told us they felt cared for and were happy with the service they received. Relatives said staff were kind and caring and treated their loved ones well. At inspection, we noted good interactions between people, management and staff.
Care plan records provided a guide to staff to help people to retain their independence and receive support with minimum risk to themselves or others. People's care and support needs were assessed prior to them using the service to ensure their needs could be met. Where people's needs could not be met, the home worked well with others to ensure people were appropriately supported.
People were supported to live healthy lives and had access to health and social care professionals.
The home worked in partnership with other organisations to provide effective and consistent care. 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.
People were treated as individuals which helped protect their dignity. Their equality and diversity needs were respected by a caring staff team. Staff understood the importance of giving people their time and the importance of encouraging people to maintain their independence.
People were happy with the way the service was managed. People's views and opinions of the service were sought and acted on.
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 'Requires improvement' (published 24 October 2020). Although that inspection noted improvements from an inspection in 2019, the overall rating remained the same. The earlier inspection was published on 26 April 2019.
At our inspection in 2019, we made recommendations in three areas. These were -
Improving on staff record keeping which did not always show they responded in a caring manner.
Records not always reflecting people's needs.
The service not always supporting people to take part in a range of activities.
At this inspection, we found the provider had acted on recommendations on the care plan recording issues and improvements were seen. However, it had not acted on the recommendation related to activities and we did not note any improvement. A further recommendation on this can be seen within the 'Responsive' section of this report.
Why we inspected
This inspection was carried out to follow up on improvements we told the provider to take at the 2019 inspection. As a result, we undertook a focused inspection to review the key questions of 'Caring', 'Responsive' and 'Well-led'. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control (IPC) measures in the 'Safe' domain but have not provided a rating for this key question. It was considered in detail at the 29 October 2020 inspection and there were no grounds to look at it in detail at this inspection. We look at IPC measures 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 were assured in all areas and appropriate IPC measures were in place.
The overall rating for the service has changed from 'Requires improvement' to 'Good' based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rushley House Retirement Home 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.
Rushley House Retirement Home is a residential care home for 13 people. The home is situated near Morecambe town centre, close to local shops and amenities. Private car parking is available. The home is a large detached house built over two floors. Communal space consists of a main lounge, dining room and a separate conservatory. There is a stair lift for access to the first floor. At the time of our inspection visit there were 11 people who lived at the home.
People’s experience of using this service and what we found
Infection control systems and audits ensured a clean environment to keep people safe. The registered manager had introduced some guidance and followed some recommendations in relation to Covid – 19. We have made a recommendation about how to work safe in care homes. We have made a recommendation the registered manager documents the risk of not following best practice.
Staff were recruited safely. People told us enough staff were available to meet their needs. Medicines were managed and administered safely. Safeguarding procedures were in place to protect people from the risk of abuse. Staff understood and were trained on how to recognise and respond to safeguarding concerns.
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. People and relatives praised the food and confirmed healthcare services were contacted when required. Staff told us they were supported by management and they received ongoing training to fulfil their roles.
The management team were clear about their roles and provided care which resulted in good outcomes for people. They worked in partnership with a variety of agencies to ensure people's health were met. They had worked to address areas of concern previously identified, engaged with people, relatives and stakeholders to promote a positive environment through positive communication and effective teamwork. The manager used a variety of methods to assess and monitor the quality 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 and update: The last rating for this service was requires improvement (published 26 April 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 13,14 February and 01 March 2019. Breaches of legal requirements were found. The provider completed an action plan after the
last inspection to show what they would do and by when to improve; Safe care and treatment, Good governance, Fit and proper persons employed and Staffing. We carried out this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for
Rushley House Retirement Home 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 reinspection programme. If we receive any concerning information we may inspect sooner.
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Why we inspected – The inspection was prompted in part by receiving information of an incident following which a person using the service sustained a serious injury. The information shared with CQC about the incident indicated potential concerns about the management and leadership at the home. This inspection examined these concerns. This incident was being reviewed by the local authority safeguarding team at the time of the visit and had not been concluded.
Inspection team: The first two days of the inspection were carried out by two adult social care inspectors. One adult social care inspector returned to the home unannounced on the third day to complete the inspection process.
Service and service type: Rushley House Retirement Home 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: The first and last day of the inspection were unannounced.
What we did: Before the inspection, we reviewed information we held about the service. This included previous inspection reports and notifications submitted by the provider related to incidents, accidents, health and safety and safeguarding concerns which affect the health and wellbeing of people who lived at the home. We also spoke with the Lancashire County Council safeguarding and contracts and commissioning team. This allowed us to gain information related to the quality and safety of service being provided. We used our planning tool to collate and analyse this information to help us plan our inspection visit.
During the inspection process we spoke with three people and five relatives. We spoke with three members of staff and the registered manager.
To gather information, we looked at a variety of records. This included care records related to three people who used the service. We also looked at other information related to the management of the service. We did this to ensure the registered manager had oversight on the home and to ensure the service could be appropriately managed.
Following the inspection visit we spoke with Lancashire County Council safeguarding team, the infection prevention and control team and Lancashire Fire and Rescue Service to update them with our findings.
There were two registered managers who were also the owners of 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.
At the last inspection in September 2015, the service was rated ‘Good’. At this inspection, we found the service remained ‘Good’.
People told us staff were caring towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives. One person told us, “I think they [staff] are respectful, I can have a laugh with them.”
We found there were sufficient staff during our inspection visit. They were trained and able to deliver care in a compassionate and patient manner. One person commented, “There is always quite a few on [staff]. There is always one on at night, and she keeps a check on me to make sure that I am alright.”
Staff we spoke with confirmed they did not start their job until the registered provider received relevant checks. We checked staff records and noted employees received training appropriate to their roles. One staff member told us, “It made a difference. You couldn’t just come in and get on with it.”
Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.
We looked around the home and found it had been maintained and was a safe place for people to live. For example, we found equipment had been serviced and maintained as required.
Medication care plans and risk assessments provided staff with a good understanding about specific requirements of each person who lived at Rushley House Retirement Home. Staff had relevant training to assist them in the safe administration of medicines.
Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. We found supplies were available for staff to use when required, such as hand gels.
People were supported to have maximum choice and control of their lives and staff helped them in the least restrictive way possible; the policies and systems in the service supported this practice.
We received positive comments about the quality of meals provided. Comments included, “I keep putting on weight the food is that good.” They added, “They make a menu of what we want and it varies a lot. I even have breakfast in bed.” We observed lunch time service and noted people had their meal in the dining room, where they sat or in their own bedroom. People told us it was their choice where they ate their meal.
We observed positive interactions between staff and people who lived at Rushley House Retirement Home. There was a culture of promoting dignity and respect towards people. People told us staff treated them as individuals and delivered personalised care that was focused on them as an individual. Care plans seen confirmed this.
People who lived at the home and their visitors told us they were happy with the activities on offer.
There was a complaints procedure which was made available to people and their relatives. People we spoke with told us they were happy and had no complaints.
The management team used a variety of methods to assess and monitor the quality of the service. These included regular audits, staff meetings and daily discussions with people who lived at the home to seek their views about the service provided.
Further information is in the detailed findings below.
This unannounced inspection took place on 10 & 11 September 2015.
Rushley House is a residential care home for 13 people. The home is situated near Morecambe town centre, close to local shops and amenities. The home is a large detached house built over two floors, set in its own grounds. All bedrooms are for single occupancy and a number are provided with an en-suite facility. Communal space consists of a main lounge, dining room and a separate conservatory. There is a stair lift for access to the first floor.
There were thirteen people living at the home on the day of inspection.
There was a registered manager in place. 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.
The service was last inspected 05 November 2013. We identified no concerns at this inspection and found the provider was meeting all standards that we assessed.
Feedback from relatives and visitors was mainly positive and people who lived at the service spoke highly about the quality of service provision on offer.
Suitable arrangements were in place to protect people from the risk of abuse. People told us they felt safe and secure. Robust recruitment procedures were in place to ensure staff were correctly vetted before being employed.
People were not always safe. We found suitable arrangements were not in place for storage of prescribed items and the registered manager had failed to identify environmental hazards that have the potential to cause harm. Window restrictors were not in situ for all windows and infection control processes were sometimes compromised.
All people had a detailed care plan which covered their support needs and personal wishes. We saw plans had been reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required.
Staff were positive about their work and confirmed they were supported by the manager. Staff received regular training to make sure they had the skills and knowledge to meet people’s needs.
Good care practices were observed and people were found to be having their nutritional needs met. We saw the staff team providing sensitive and flexible personal care support. The staff were kind and patient and showed a good understanding of the needs of the person in their care.
The people we spoke with said their relatives were receiving safe and appropriate care which was meeting their needs. One person said, 'I am really pleased with mum's care. She is a poorly lady and I know she can be difficult. The staff are very kind and patient with her'. Another person said, 'I visit my friend three times a week. She loves it here. The girls are brilliant with her. The meals are lovely and the staff are always available with tea and biscuits'.
During our inspection we contacted the Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.
Although some residents had limited verbal communication due to a dementia condition, we did receive positive comments about the service. They included, 'The place is 'top hole', it couldn't be any better.' Another resident said, 'The staff and owner are wonderful nothing is a bother to them.'
People we spoke with told us they could express their views and were involved in discussions about their care. They told us they felt listened to when discussing their care needs.
Staff members we spoke with were knowledgeable about people's individual needs and how they could be met. One staff member said, 'It's a small home and we are all involved in the care of residents. This helps us get to know everyone well.'
Residents and staff we spoke with said the home was kept clean and they were happy with the level of cleanliness maintained. People liked their bedrooms and were able to furnish them with their own belongings and possessions. One resident said, 'Look at all my pictures it reminds me so much of home.' Another resident spoken with about the cleanliness of the home said, 'It's always clean and tidy the staff do a good job.'
Comments made about the care and support provided by the staff team was positive. One person told us, 'The best thing here is the care'. A resident said, 'This is as good as there is. We are looked after'.
A relative told us that staff were: 'Good at getting the doctor out'. A District Nurse who was visiting told us, 'There is nothing to worry about here' and confirmed that there was a good working relationship with staff at the home. A person living at the home described a visit by a mental health specialist several days earlier and stated, 'If there is anything wrong I tell **** (Registered manager) and she sorts it out'.
When asked, one person we spoke with said that he felt safe and comfortable living at the home. A member of staff confirmed that everybody working at the home had received adult abuse training that was regularly updated.
A resident said, 'The staff will do anything and sit and talk including the night staff. They will make me a cup of tea at 5:00am and sit and chat'. A friend of a person living at the home told us, 'Staff are great, they really are fantastic. I am not just saying that, nothing is too much trouble for them, absolutely brilliant'. Staff spoke positively about the training provided.
A person living at the home told us that they were asked their thoughts and views regarding the service provided to them. A friend of a person living at Rushley House confirmed that friends and relatives were always encouraged to voice their opinions and suggestions for improvement.
One person told us that he knew who to speak with if he did have a concern and that it would be 'dealt with'. The friend of a service user spoken with stated that there was good communication with the staff team and that she felt confident that any concern would be addressed.