Archived: Rheola Care Home

Rheola Care Home is a residential care home that was providing personal care to 38 older people at the time of this inspection. The service can accommodate up to 42 people in one adapted building.

People’s experience of using this service and what we found

People were safe, risks were assessed, monitored and well managed. A person told us, "I feel very safe, the staff look after me very well." Staffing levels met people's personalised care needs. Staff followed good practice guidelines to prevent the spread of infection and gave people their medicines safely. The service was clean and tidy.

People were supported to access health and social care professionals. Dietary needs were assessed, and guidance provided in care plans. People received enough food to eat and drink. People told us they were happy with the variety and choice of the food they were offered.

There were various activities on offer for people to engage in as they wished. Families were welcomed into the service, when guidelines had allowed this to happen. There was a complaints procedure in place and the provider responded to complaints appropriately.

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 told us the staff were kind and caring. A person said. "The staff are wonderful; they are always doing their best for us." Care plans contained detailed, personalised information. The management team continued to review the care and support provided.

The registered manager and their team carried out regular checks on the quality and safety of the service. The registered manager understood their regulatory responsibilities. People and staff gave positive feedback about the management. A member of staff said, "(The registered manager's) door is always open, they are always checking that we are okay." Staff stated that the registered manager was always open to their suggestions and provided them with support when required.

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 good (published 9 April 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

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.

We found the following examples of good practice.

The service was only receiving essential visitors at the time of our inspection. People entering the building had their temperature taken, completed a health questionnaire, washed their hands and wore full personal protective equipment (PPE).

As relatives and friends were unable to visits residents at the time of this inspection, care home staff were supporting residents to stay in touch with the people who are important to them in different ways, including daily face to face calls, window visits and sending cards and photos to loved ones.

The building was clean and free from clutter. The cleaning schedule was updated at the beginning of the COVID-19 pandemic. This now included high frequency touch point cleaning, where all regularly touched areas, such as light switches and door handles, were disinfected.

To minimise the risk of cross infection, smaller units had been formed. Wherever possible, staff worked only in one unit and staff handovers were undertaken at unit level. Staff breaktimes had been staggered to ensure that only two staff members used the staff room and could do so in a socially distanced manner at any one time.

Staff worked hard to reduce the risk of incoming infection to the home, including regular COVID-19 testing for all staff members. To date no residents in Rheola Care Home have tested positive for COVID-19. Where residents needed to isolate themselves, measures were in place to ensure that this could be undertaken safely for the individual resident, other residents and staff.

Staff told us that they were motivated to do their best to protect the health and wellbeing of residents. They confirmed that the managerial team were supportive and caring and that any staff who needed to shield or who tested positive for COVID-19 were treated well and that their emotional, healthcare and financial needs were met.

Rheola Care Home is a residential care home that was providing personal care to 34 older people at the time of this inspection.

People’s experience of using this service:

People we met and spoke with were happy with the care home and the staff that provided their care. One person told us, “These [staff] are really kind, sometimes I’m fed up, they give me a lift; pull my leg. It’s very jolly.”

People felt safe living at the home because staff knew what they were doing, they had been trained and cared for people in the way people wanted. Risks in the home were assessed and reduced as much as possible. There were enough staff, and the registered manager also spoke with people regularly. Key recruitment checks were obtained before new staff started work.

People received their medicines and staff knew how these should be given. Medicine records were completed accurately and with enough detail. Staff supported people with meals and drinks. They used protective equipment, such as gloves and aprons. Staff followed advice from health care professionals and made sure they asked people’s consent before caring for them.

People liked the staff that cared for them. Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected. Staff worked well together, they understood the home’s aim to deliver high quality care, which helped people to continue to live as independently as possible.

Staff kept care records up to date and included national guidance if relevant. Complaints were dealt with and resolved quickly.

Systems to monitor how well the home was running were carried out well. Where concerns were identified, the registered manager followed this up to make sure action was taken to rectify the issue. Changes were made where issues had occurred elsewhere, so that the risk of a similar incident occurring again was reduced. People were asked their view of the home and action was taken to change any areas they were not happy with.

Rating at last inspection: Requires improvement. (Report published March 2018)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor information we receive about the service until we return to visit as scheduled in our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The home accommodates up to 42 people in one adapted building, which is divided into a number of units. One of the units provides care to people living with advanced dementia. Nursing care is not provided.

At our previous inspection in November 2015 the home was rated Good. At our inspection on 3 and 10 January 2018 the service had deteriorated to Requires Improvement. The inspection visits to the home took place on 3 and 10 January 2018. On 3 January 2018 the visit was unannounced. We arranged with the registered manager to return on 10 January 2018.

There was a registered manager in post who had been managing the home for five years. A registered manager is a person who has registered with the CQC to manage the home. 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 home is run.

During our first visit to the home we found that medicines were not always being managed safely and care planning was not complete or up to date. By our second visit, the registered manager had strengthened the systems in place to check medicine management and care plans had been re-written. Safeguarding concerns had not always been discussed with the local authority safeguarding team. Quality assurance processes were in place but were not always robust enough to ensure that a quality service was being provided.

People felt safe living at the home, with the staff and with the care and support the staff gave them. Assessments of all potential risks to people were carried out and guidance put in place to minimise the risks.

There was a sufficient number of staff with the right experience, skills and knowledge deployed to make sure that people were kept as safe as possible. There was an effective recruitment process in place to reduce the risk of unsuitable staff being employed. Staff followed the correct procedures to prevent the spread of infection.

Assessments of people’s support needs were carried out before the person was offered a place at the home, to ensure that the staff could provide the care and support that the person needed and in the way they preferred. Technology and equipment, such as a mobile phone for use when people went out unescorted, electronic care records and hoists were used to enhance the support being provided.

Staff received induction, training and support to enable them to do their job well. People were provided with healthy, nutritious and appetizing meals and special diets were catered for. A range of external health and social care professionals worked with the staff team to support people to maintain their health.

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

People and their relatives praised the staff, had good relationships with them and described them as caring, supportive and professional. Staff made people feel they mattered and knew each person and the details about the care and support the person needed, very well.

People and their relatives were involved in planning their care. Information about advocacy services was available if anyone wanted an independent person to assist them with their affairs. Staff respected people’s privacy and dignity and encouraged people to remain as independent as possible.

At our second visit staff had updated care plans and they were more personalised than previously. Activities, entertainment and outings were arranged if people wanted to join in. A complaints process was in place and people were confident that any issues would be addressed by the management team. End-of-life care was planned and provided when required

The service had received a number of compliments from people and their relatives and staff and external professionals would happily recommend this home to other people who needed this type of care. The registered manager ensured that staff were clear about their role to provide people with a high quality service. Staff were happy to be working at the home.

People and their relatives were given opportunities, such as written questionnaires and meetings, to give their views about the service and how it could be improved. The home had strong links with the local community.

The manager was aware of their responsibility to uphold legal requirements, including notifying the CQC of various matters. The management team worked in partnership with other professionals to ensure that joined-up care was provided to people.

The majority of people who we spoke with were very satisfied with the standard and quality of their support and care. One person, for instance, told us that there was always something for them to do and said that their support and care needs were met in the way that they preferred.

People said that they were given a choice of what they would like to like to eat and drink. They also said that the food was good and that there was always plenty of it. We saw that people were supported to eat and drink sufficient amounts.

Rheola Care Centre was a safe place for people to live, visit and work because equipment was maintained and safe for people to use.

Members of staff were well liked by people who used the service and their family members. There were recruitment systems in place which protected people who used the service from unsuitable, prospective members of staff.

People were made aware of the complaints procedure. They were also provided with opportunities to make suggestions and comments about the standard of their support and care. Where people had made a complaint or concern, they were satisfied with the how the management of Rheola Care Centre had responded.