Red Court Care Home

Red Court Care Home is a nursing home providing personal and nursing care to up to 35 people. The service provides support to older people in an adapted building. At the time of our inspection there were 26 people using the service.

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

The provider managed risks to the premises with a range of checks such as those relating to fire, electrical, gas and water safety. Risks relating to people’s care were also assessed and clear guidance was in place for staff to follow to reduce the risks. People’s medicines were managed safely by staff. There were enough staff and staff were recruited through processes to check they were suitable to work with vulnerable people. Staff understood how to safeguard people from abuse and neglect. The provider investigated accidents and incidents to check the right action was taken in response, to reduce a risk of reoccurrence. Learning was shared across the organisation.

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 involved in decisions about their care and support.

The manager was new in post and was in the process of registering with CQC. They were experienced and understood their role and responsibilities, as did staff. The manager notified CQC of significant events, such as allegations of abuse, as required by law. The registered manager communicated openly with people, relatives and staff through regular meetings and surveys. Staff felt well supported by the manager and provider. The provider undertook checks to monitor, review and improve the quality and safety of the service.

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

Rating at last inspection

The last rating for this service was good (report published September 2020).

Why we inspected

The inspection took place on 20 September 2022. We received concerns in relation to safety of the premises relating to an accident involving the use of the fixed ramp behind the building. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

We looked at infection prevention and control measures under the safe key question. We look at this in all 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Red Court Care Home 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. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

• The provider had appropriate arrangements for all visitors to help prevent the spread of Covid 19. They were required to wash their hands, have their temperatures taken, complete a Covid 19 risk assessment which included screening for symptoms of Covid 19 before being allowed to enter the home. Visitors were required to wear a face covering when visiting, and wash hands before and after mask use. Hand sanitiser stations were available throughout the home.

• The provider had appropriate arrangements to test people and staff for Covid 19 and was following government guidance on testing. This ensured that people and staff were tested for Covid 19 so that appropriate action could be taken if any cases were identified.

• From the start of the Covid 19 outbreak the provider recognised the effectiveness of ensuring comprehensive communication with all parties including staff, residents and their families as well as other health and social care professionals. An example of this were the regular staff update meetings at which staff were able to ask any questions or express their concerns were arranged.

• The provider ensured that all their staff received appropriate training and support to understand and to manage Covid 19. This included best practice for infection control and the use of PPE.

• Staff also received appropriate guidance on how to support people with dementia to understand the pandemic and Covid 19. Staff were cohorted to work in specified areas of the home including domestic and housekeeping staff.

• The provider made appropriate support services available to staff in order to support their mental wellbeing through the pandemic and if they became unwell and when they returned to work.

• The provider made very good provision for people using the service to maintain links with family members, relatives and friends. People were supported to have visits from their relatives and friends in sheltered areas of the garden where two metre social distancing was observed. Visits were pre-booked and visiting areas were cleaned between visits.

Further information is in the detailed findings below

At our last comprehensive inspection in May 2016 the overall rating for the service was good. We found there were improvements required for the administration of medicines and rated the ‘safe’ question as requires improvement. We returned to the service in March 2017 and found improvements had been made and the service met the requirements to be rated good for each of the five key questions we ask. Is the service safe, effective, caring, responsive and well led? At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us they felt safe. Staff had completed safeguarding training and knew how to recognise abuse and report safeguarding incidents. People's needs were assessed and reflected in clear risk assessments. Staff knew how to keep people safe from risk.

There were sufficient numbers of staff to keep people safe. However, everyone we spoke with felt there needed to be more staff at certain times of the day. The manager gave assurances they would look at the busy periods during the week and over the weekends to ensure staffing levels could adequately meet people’s needs. Shortly after our inspection we received confirmation that this had been done.

Safe recruitment procedures were followed. The service provided a safe and comfortable environment for people, staff and visitors. The service was clean and hygienic. There were systems in place for the safe storage, administration and recording of medicines.

People were cared for by staff who had the knowledge and skills they needed to deliver safe and effective care. Staff completed regular training.

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 were supported to keep healthy and well. People had access to healthcare professionals when they needed to. People told us they liked the food served at Red Court Care Home and were supported to have sufficient amounts to eat and drink. Risks associated with people’s diet had been identified and people’s dietary needs were catered for.

Staff supported people in a way which was kind, caring, and respectful. People were encouraged to participate in a wide range of activities.

The service regularly obtained feedback about people's experiences and had systems in place to ensure people were listed to. People and their family members knew how to make complaints and felt the manager would listen to them and act on their concerns. The service had appropriate processes for dealing with complaints.

When people needed end of life care, the service was able to provide care in line with people's wishes.

People and staff spoke positively about the manager and her team and said they were approachable. There were a number of audits and quality assurance systems to help the provider understand the quality of the care and support people received and look at ways to continually improve the service.

Further information is in the detailed findings below.

Red Court Care Home provides residential personal care and nursing care for up to thirty-five people. The service has a registered manager.

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.

We examined records and medicines for people using the service. We found the service had made improvements in relation to managing medicines. The service had introduced a system of daily checks by staff administering medicines and audits on a weekly and monthly basis. Wherever possible medicines were included in monitored dosage systems so that the service had reduced to a minimum the number of pro re nata (as required) medicines and homely remedies. This decreased the likelihood of counting errors.

We found the changes made by the service had improved medicines' management and the service was meeting the Regulations by safely managing medicines.

At the previous inspection in July 2014 the service was meeting the Regulations we inspected.

Red Court Care Home provides residential and nursing care for up to thirty-five people.

The service had a registered manager. 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 did not always manage medicines appropriately. You can see what action we told the provider to take at the back of the full version of the report.

People told us they felt safe. Staff had completed safeguarding training and knew how to recognise abuse and report safeguarding incidents. Handovers between shifts ensured staff were up to date and well informed about people they cared for. People’s needs were assessed and reflected in clear risk assessments. There were sufficient numbers of staff to meet people’s needs and safe recruitment procedures were followed. The service provided a safe and comfortable environment for people, staff and visitors. The service was clean and hygienic.

People were cared for by staff who had the knowledge and skills they needed to deliver safe and effective care. Staff completed regular training. Staff were aware of the provisions of the Mental Capacity Act and Deprivation of Liberty Safeguards. People were provided with a balanced diet. People using the service were supported with their healthcare needs including weekly GP rounds.

Care was delivered by staff in a patient, friendly and sensitive manner. People were supported to express their views and be involved in the planning and delivery of their care and support. People’s preferences were taken into account. Staff treated people with dignity and respected their privacy. People were encouraged and supported to maintain their independence wherever possible.

People received person centred care that was responsive to their needs. They provided a framework for staff to deliver safe and appropriate care and support. People benefited from various activities which reduced the risks of boredom or isolation. The service regularly obtained feedback about people’s experiences of the service with service improvement in mind. The service had appropriate processes for dealing with complaints.

Staff spoke positively about the management team and said they were approachable. The service had a system of staff meetings that enabled staff to feedback concerns and ideas. There was a system of reviews, checks and audits to assess and monitor the quality of service provided and identify any risks to the health safety and welfare of people using the service, staff and visitors. We found that records relating to the provision of care by the service were fit for purpose.

Please read the full report for evidence that supports our summary.

Is the service safe?

We found that there were enough qualified, skilled and experienced staff to meet people's needs.

We saw that care plans were regularly reviewed and up to date which supported staff to deliver safe and appropriate care.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found that medicines were kept securely and safely administered.

The Care Quality Commission monitors operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We saw that the service had policies, procedures and training in place. People using the service had their mental capacity assessed and recorded in their care plans.

Is the service effective?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We were told that an assessment of people's needs was carried out before people moved in.

We were told that there was an activity coordinator for the service five days a week. People spoke positively about the activities provided. We saw a timetable of activities displayed.

Is the service caring?

We observed that staff appeared to be kind and caring and saw good examples of care. We spoke with people using the service and visitors. Most of their comments about staff and the care and treatment they received were positive.

Is the service responsive?

People expressed their views and were involved in making decisions about their care and treatment. We saw that care plans were person centred and recorded people's preferences.

People and staff were listened to and where appropriate the service responded.

Is the service well led?

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We spoke with people using the service, visitors and members of staff who told us that the manager operated an 'open door' policy and was approachable.

We found that the service had regular audits and meetings in place to assess and monitor the quality of their service provision.

Relatives we spoke with said, 'The staff are really friendly, I'm really happy with the home, my father was also here." And, 'Very good. Clean. Always got things going on for the residents.'

We found that the home correctly stored, managed ad administered medicines. They also had an effective complaints procedure in place to protect people from inappropriate or unsafe care.

We found that members of staff had undergone a robust recruitment procedure and were appropriately qualified.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.