Welcome House - Ruby Lodge

Updated 24 September 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Welcome House – Ruby Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Welcome House – Ruby Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 12 September 2022 and ended on 15 September 2022. We visited the service on 12 September 2022.

What we did before inspection

We reviewed information we had received about the service since the last inspection including the action plan submitted. We sought feedback from Healthwatch, Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with six people about their experience of the support provided. We spoke with six staff members including, the registered manager, the operations and quality assurance manager, the deputy manager, a senior support worker and support workers. We spoke with two health care professionals who regularly visit the service. We reviewed a range of records including five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 24 September 2022

About the service

Welcome House – Ruby Lodge is a residential care home providing support and personal care to up to 17 people. The service provides support to people living with mental health conditions, such as, paranoid schizophrenia and bipolar affective disorder. At the time of our inspection there were 13 people using the service.

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

People told us they felt safe and would speak with the registered manager or staff if they had any concerns. We observed people were relaxed and spoke openly with staff and the registered manager. One person told us, “I am good yeah. I can talk to [registered manager] if I wasn’t.” Staff understood their responsibilities to safeguard people from the risk of abuse and knew how to report concerns.

People's needs were assessed; risks relating to their mental and physical health were frequently reviewed and care records updated following changes or professional advice. Accidents and incidents were analysed, patterns were identified and investigated to lessen the risk of reoccurrence. Risks were mitigated as staff knew people well, detailed documentation guided staff to support people to recognise when they may experience a relapse in their mental health. People told us they felt settled and supported by staff.

People were supported by enough staff who were suitably trained and skilled to meet their needs. Staff administered medicines to people safely and encouraged people to follow professional advice. One person told us, “I have lost some weight, I have stopped eating cakes, sugar, sweets and chocolates. I am really trying. My psychiatrist said to lose weight, my medication makes me put on weight.”

People were protected from the risks of COVID-19 and other infections. Staff wore appropriate personal protective equipment (PPE) and followed the provider’s infection prevention and control policy. People told us they were able to go out and see friends and family or they were welcomed to go into the service for visits.

People knew the registered manager and staff well; most had worked at the service for many years. The registered manager told us about a positive outcome following a person’s mental health relapse. They said, “The way you communicate with your clients is important, they listen, and they open up. Our good relationship helped [person] recover.”

People were empowered to make decisions and were asked for their opinions on the service. House meetings, keyworker meetings and informal discussions were held for people to express their views. People and staff told us they felt able to approach the registered manager with ideas. One person told us, “We all get our say about things here, like what we eat and how we want things done.” A staff member said, “The service users are treated well, they are given respect and choices. Anything they want, staff do what they can to make sure they have independence.”

People were appropriately referred where professional advice was needed. The registered manager and staff worked closely with professionals to improve people’s care, safety and well-being. One health care professional told us, “I have never had any issues with the service, all of the staff have been approachable and happy to help. They provide the support we ask them to provide. It seems calm and clean, never had any issues.”

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.

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 9 February 2022). 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 12 and 17.

Why we inspected

We undertook 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 and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this 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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. 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 Welcome House – Ruby Lodge on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.