We carried out a review of the data available to us about Rutland Care Village 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 Rutland Care Village, you can give feedback on this service.
Rutland Care Village provides accommodation, nursing and personal care for up to 82 people. At the time of our inspection 70 people were using the service. The service has 4 separate units and supports older people, some of whom were living with dementia and/or physical disabilities.
People’s experience of using this service and what we found
Relatives made many positive comments about the service and said they would recommend it to others. A relative told us, “I’m impressed with the home. It’s clean, and the staff are wonderful. [Person’s] getting great care.”
The service had a happy, homely atmosphere. Mealtimes were lively and sociable. A relative said, “There seems to be an endless supply of food and drinks!” Staff did activities with people, socialised with them, and met their needs promptly.
Staff knew how to keep people safe and took action if they had concerns about their well-being. They were trained in safeguarding and knowledgeable about protecting people from risk.
The service was well-staffed with nurses and care workers. Staff were trained, experienced and understood people’s needs. A relative said, “It’s very good care – they know [person] very well.”
The registered manager and staff had good working relationships with external healthcare professionals. They met with them regularly to ensure people’s healthcare needs were met, and made referrals when people needed extra support with their health and well-being.
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.
The registered manager was well-regarded by people, relatives and staff. A relative said, “[The registered manager] is on top of everything, really on the ball. I see them a lot and they are always able to chat.” A staff member told us, “[The registered manager] always listens, is always upbeat, helps us care for the residents, and supports us in everything we do.”
There were effective management systems in place to monitor how the service was operating and plan any improvements that were needed.
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 good (report published on 10 April 2020).
Why we inspected
The inspection was prompted in part due to concerns received about people’s safety. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Well-led question sections of this report. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We also looked at infection prevention and control measures under the Safe and Well-led key questions. 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rutland Care Village 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.
Rutland Care Village is a residential and nursing care home, providing personal care for up to 82 people with some people living with dementia. At the time of the inspection 80 people were using the service. Accommodation is provided over four buildings consisting of ensuite bedrooms and communal facilities.
People's experience of using this service and what we found
People received their medicines safely and as prescribed. Medicine management practices were safe. However, it was highlighted the service should review it’s recording practices of administration of PRN and topical creams.
People at the home felt safe and well cared for. People's preferences were respected, and staff were sensitive and attentive to people's needs.
There were adequate numbers of staff employed to ensure people's needs were met at the time of the inspection.
Recruitment practices were safe, and staff received the training they required for their role.
Risks to people's health, safety and well-being were assessed and care plans were in place to ensure risks were mitigated as much as possible.
Staff were aware of their responsibilities to safeguard people and the home had procedures in place.
People's care plans contained personalised information detailing how people wanted their care to be delivered.
Staff were keen to ensure people's rights were respected including those related ethnicity and dietary requirements.
The service was provided in a clean environment.
Consideration was given to providing a variety of leisure and social activities for people to enjoy. This included the use of and onsite day centre and utilising technology.
Quality assurance systems were in place to assess, monitor and improve the quality and safety of the service provided.
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.
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 (report published 10th July 2017).
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.
Rutland Care Village provides nursing and personal care for up to 84 people. At the time of our inspection 76 people were using the service. Rutland Care Village is a purpose built service consisting of four buildings. All accommodation and communal areas are on ground floor level. The village includes a day care facility used by people who use the service and people who live in Rutland.
At the last inspection in May 2015 the service was rated Good overall. We rated the service as requiring improvement for being Responsive because a person’s care was not consistent with what was in their care plan. We found at this inspection that the care and support people received was in line with their needs and preferences.
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.
People were safe because staff knew how to recognise and report signs of abuse. People were supported to be as independent as they wanted to be. Staff were safely recruited and enough suitably skilled and experienced staff were available to meet people’s needs, though on occasion the provider’s procedures for covering unplanned staff absences did not work. This was something the registered manager was addressing.
Staff used equipment safely when they transferred people or assisted them with their mobility.
People received their medicines on time, though arrangements for administering medicines did not always reflect best practice. The registered manager addressed this on the day of our inspection and arranged by amending the medicines administration policy.
People using the service told us they felt staff were knowledgeable about their needs Staff received relevant training and support to be able to meet the needs of people using the service. Refresher training was sometimes late, but all staff had training scheduled. Staff had received specialist training about supporting people who lived with dementia.
The registered manager, deputy manager and all staff we spoke with had a good working knowledge of the relevance of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; polices and systems in the service supported this practice.
People’s nutritional needs were met. People had a choice of foods and drinks and most spoke in complimentary terms about the meals that were provided. Meals were prepared by a chef and looked appetising and well presented. Staff were attentive to people’s health needs and supported people to access health services when they needed them. People had access to a medical centre adjacent to Rutland Care Village. The service worked collaboratively with the medical centre to meet people’s health needs.
Staff were caring. We saw examples of staff showing kindness and compassion. People using the service and their relatives had opportunities to be involved in decisions about their care and support. People were treated with dignity and staff respected people’s privacy.
People received care and support that was centred on their needs. People had access to social activities and staff supported people to follow their interests and hobbies. They were supported with their cultural and faith needs.
The provider had commissioned a consultant to lead a project to improve the décor and furnishings of an area used by people who lived with dementia. The improvements had a beneficial impact on the people who lived in and used that area. People had opportunities to make suggestions and raise concerns. They told us they were confident about raising concerns and that they would be listened to. The provider had acted upon people’s comments and feedback, for example in relation to social activities and meals.
The management team were visible and available to people using the service. The management team had clearly defined aims and objectives about what they wanted to achieve for the service. Staff said they were well led and supported. The provider had effective procedures for monitoring and assessing the service.
We carried out an unannounced inspection of the service on 20 May 2015.
Rutland Care Village provides nursing and personal care for up to 84 people. At the time of our inspection 76 people were using the service. Rutland Care Village is a purpose built home split into four units. The village includes a day care facility.
A registered manager left the service in January 2015 when an interim manager took over the management of the service. At the time of our inspection the interim manager had applied to be the 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.
People were safe because staff knew how to recognise and report signs of abuse. People were supported to be as independent as possible. Enough suitably skilled and experienced staff were available to meet people’s needs.
Staff used equipment safely when they transferred people or assisted them with their mobility.
The provider had robust recruitment procedures.
People received their medicines on time.
People using the service told us they felt staff were knowledgeable about their needs Staff received relevant training and support to be able to meet the needs of people using the service.
The manager, deputy manager and senior staff had a good working knowledge of the relevance of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Other staff had an awareness of the legislation.
People’s nutritional needs were met. People had a choice of foods and drinks and spoke in complimentary terms about the meals that were provided. Staff were attentive to people’s health needs and supported people to access health services when they needed them.
Staff were caring. We saw examples of staff showing kindness and compassion. People using the service and their relatives had opportunities to be involved in decisions about their care and support. People were treated with dignity and staff respected people’s privacy.
People received care and support that was centred on their needs. However, we saw that recent changes to a person’s care plan had not been implemented and they may have been at risk had we not brought the matter to the provider’s attention. People had access to social activities and staff supported people to follow their interests and hobbies. The provider had begun to pilot a new programme to support people living with dementia by providing individually tailored activities for them.
People had opportunities to make suggestions and raise concerns. They told us they were confident about raising concerns and that they would be listened to. The provider had acted upon people’s comments and feedback, for example in relation to social activities.
The management team were clearly visible and available to people using the service. The management team had clearly defined aims and objectives about what they wanted to achieve for the service. Staff felt well led. The provider had effective procedures for monitoring and assessing the service.
Rutland Care Village provides nursing care, personal care and support for up to 82 people. It is made up of a purpose built home split into four units, one of which is a specialist dementia care unit. The village also includes a day care facility known as ‘Brambles’ and residential bungalows. These were not included in our inspection.
We found the provider had appropriate systems in place to help ensure that people were protected from the risk of abuse and avoidable harm. When appropriate, people’s capacity to make decisions had been considered and the provider had acted in their best interests. People were cared for in an environment that was safe and appropriate for their needs. People and their relatives felt their care and support needs were being met and nobody we spoke with raised any concerns about their care or treatment.
People received care and support that met their needs and promoted many aspects of their well-being. Care plans provided guidance for staff about how people’s needs should be met and these had been regularly reviewed and updated. We found that people’s health had been monitored and guidance from health professionals had been sought when appropriate. People had been protected from the risk of malnutrition and dehydration and people’s special diets or food preferences had been catered for. However, care plans did not always record people’s involvement in the planning and delivery of their care.
Staff had a good understanding of the needs of people who used the service and had many had completed an induction programme. However, the staff team had not always been supported to deliver appropriate and effective care as many had not received training in important areas such as infection control, Mental Capacity Act and Dementia Awareness. This meant there had been a breach of the relevant legal regulation and the action we have asked the provider to take can be found at the back of this report.
We observed that the staff team were mostly friendly and professional in their interactions with people and staff were able to give examples of how they protected people’s privacy and promoted their dignity. We used our SOFI (Short Observational Framework for Inspection) tool to see what the experiences of people living in the specialist dementia unit were. We found that staff did not always have the skills required to support people with dementia. Staff interactions were focused on tasks such as giving people drinks and taking them to the toilet rather than positive communication. Many staff had not shown consideration for people’s emotional well-being when supporting them during our period of observations. We saw limited attempts to interact with people or provide activities in any meaningful way. However, when staff did take the time to engage with people we found they did respond positively. We have asked the provider to make improvements in this area.
There were sufficient numbers of staff to ensure the safe and effective delivery of care and our observations showed that staff responded promptly to people when they required support. Most of the staff we spoke with felt staffing numbers were adequate and people we spoke with told us they had the care and support they required at the time it was needed.
People and their relatives had been involved in the running of the service and had been asked for their views in regular meetings and an annual questionnaire. However there was no action plan to record the improvements highlighted by the meetings or survey or to assure that they would be made. People’s complaints and concerns were recorded and responded to promptly.
However, people’s involvement in the planning and delivery of their care was not always consistent. The majority of care plans and records we looked at contained insufficient information about people’s choices, wishes and preferences so they could not be assured that they would be met. The provider had a day centre which had a programme of activities. However, many people had not been encouraged to access this service and during our inspection people who did not visit the day centre were not encouraged to engage in alternative activities that were relevant to them. Some people told us they would have liked more opportunities to go into the community or attend activities and others told us they had been lonely at times. This meant there had been a breach of the relevant legal regulation and the action we have asked the provider to take can be found at the back of this report.
People we spoke with and their relatives considered that the service was well managed and many of them told us about the improvements the registered manager had made since they had been in post. Staff were also positive about the management of the service and were clear about their roles and responsibilities.
There was a management system in place which monitored and assessed the quality of service provided. This included audits and reviews of care plans and records, checks of the environment and other audits such as call bell audits and falls audits. These had been carried out regularly and were well documented. However this could be improved by ensuring that action taken as result of these checks had been recorded.
We looked at a sample of monitoring sheets and found an improvment in the detail recorded. We spoke with the team leaders on each unit and they told us that they checked the monitoring sheets twice a day to ensure people were having adequate food and drinks and that care was being given appropriately. We found a few instances where there were discrepancies on the monitoring sheets but no record that this had been identified or addressed.
We spoke with twelve people who used the service and five relatives. The feedback we received was generally positive with comments such as, 'The girls (staff) are good here. I trust my relative with them.' And 'Absolutely brilliant. You cannot fault any of them'.
We looked at a selection of the audits that had been completed such as audits of the numbers and treatment of pressure ulcers, audit of when people had fallen and an audit of response times for staff to answer people's call bells. We saw that the manager had included a front sheet with details of the purpose of the audit and a summary of the findings and actions.
When we visited Rutland Care Village on 31 January and 01 February 2013 we found that the system to monitor food and fluid charts; charts showing when people were assisted to change position and observation charts, was not always effective and was not identifying when people were not receiving care as specified in their care plans. Following our visit the manager told us that she had introduced new recording charts for monitoring food and fluid intake, when people were repositioned and other observations. When we visited 03 and 04 July 2013 we found that new recording charts had been introduced but these charts were not being regularly monitored or reviewed to ensure people were receiving appropriate and safe care in line with their assessed needs.
Records showed that people were not being assisted to change position as often as specified in their care plans. This meant that people were at increased risk of developing pressure ulcers.
We found instances where people's fluid and food intake was recorded as being low but this had not been identified by the monitoring sheets and there was no record of action taken to offer people additional drinks.
We spoke with four staff about staffing and received mixed feedback. Two members of staff told us that there were not enough staff. One person explained that although they ensured people's care needs were met they did not have time to spend with people talking or doing activities.
We looked at training records and saw that 39 out of 70 care and nursing staff had not received training in dementia.
We found that the system to monitor food and fluid charts, charts showing when people were assisted to change position and observation charts was not always effective in identifying when people were not receiving care as specified in their care plans. Following our visit the manager told us that she had introduced new recording sheets.
One person who used the service said 'I am very happy here, the staff are nice, and I like my room, they always make sure I have my call bell'
We spoke to several staff on nights and the following day staff. None indicated a staff shortage at any time, one member of staff did say 'this is a dementia unit, you could always use an extra pair of hands.' The same person stated they had been short of staff on occasions, where people had phoned in sick, however this was not the case recently. Overall we spoke to 7 members of staff, none were concerned regarding poor staffing levels at the home.
Relatives spoken with stated that they are generally pleased with the home and the care that their relative received. They added they were involved in the care planning process and they had provided a detailed history of her needs prior to her admission. They also stated that the rooms are never locked as people could not operate the locks, and this led to a number of problems including others coming into the room. They had once returned their mother from a trip out, to find that someone had relieved themselves on the floor and left their soiled continence wear on the floor. The registered manager took the comments on board and indicated this would be dealt with within the new dementia initiative.
We also observed the hairdresser discussing how one person was afraid of the hair dryer and asked the nurse to explain to the relatives why she was setting the hair rather than using the dryer. This demonstrated the exchange of information about the people using the service between people who are supporting their care.
Relatives of a person using the service stated that 'overall we are happy with the home', though they also indicated they were now aware of their relatives key worker as the information in her bedroom was incomplete for some time after moving in.
Staff indicated they had spoken with the registered manager regarding the staffing numbers in the home. This had resulted in an increase in staffing numbers which assisted with peoples increasing dependencies.