We carried out a review of the data available to us about The Red House 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 The Red House, you can give feedback on this service.
People’s experience of using this service:
People using the service benefitted from kind, caring and committed staff. People and their relatives told us they were treated with kindness, compassion and respect.
We observed positive and compassionate interactions between staff and the people they supported. People were able to be as independent as they wanted and were also provided with prompt, sensitive support when needed.
People were placed at the heart of the service and were as far as possible involved in decisions about their care and lifestyle. People and their relatives told us they were listened to and their care was personalised.
People’s care was delivered safely. The staff team was consistent, employed in sufficient numbers and had the skills and training to care for people safely.
People’s risks were understood and managed well. People’s rights and independence were respected and promoted. Management and staff understood their role with regards to the Mental Capacity Act (2005). People’s consent was sought before care and support was provided. When people were unable to consent, and make decisions for themselves appropriate processes were followed. People were protected from discrimination and abuse because staff understood how to safeguard people.
People lived in a home that was well-maintained, comfortable and designed to meet their needs. Much consideration had been given to making sure people had lots of opportunity to occupy their time in a meaningful way. Relatives were made to feel welcome and were kept fully involved in issues relating to their loved one’s care.
People lived in a service which had a positive culture and was led by a passionate and dedicated registered manager. The Red House had good relationships with health and social care professionals and liaised with these services to help ensure people’s full range of care needs were met.
Rating at last inspection: At the last inspection the service was rated as Good. The last report was published in December 2016.
Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained Good
Follow up: We will continue to monitor the service to ensure people receive safe, compassionate, high quality care. Further inspections will be planned based on the rating. If we receive any concerns we will bring the inspection forward.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The Red House is a care home which provides accommodation and personal care to a maximum of 28 older people. There were 25 people using the service at the time of our inspection. People's healthcare needs are met through the local community services, such as the district nurses and GPs.
The manager was in the process of registering with us. 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.
A new electronic recording system had been introduced to the service since the last inspection which replaced the paper records. Staff were positive in their feedback about this system telling us it made information easy to locate and saved time in writing records. However we found there was limited personalised information on the system, such as details about the person’s strengths, background, history, likes and dislikes. In addition, care plans and daily notes lacked detail or guidance for staff on how to meet a person’s needs. This was highlighted to the manager who said it would be addressed and that some work had begun in adding information from life story books to the records.
We observed positive, compassionate and caring interactions between people and staff. Staff took the time to stop and chat with people and to share appropriate humour. Staff knew the people they cared for well and spoke about them with fondness and affection. One relative said; “We always know [our relative] is very well looked after, and when we leave, we have confidence in that”.
People told us they enjoyed the food. Mealtimes were a positive experience, which people told us they looked forward to. People told us meals were of sufficient quality and quantity and there were always alternatives on offer for them to choose from. People were involved in planning the menus and their feedback on the food was sought.
People had their healthcare needs met. For example, people had their medicines as prescribed and on time. People were supported to see a range of health and social care professionals including social workers, chiropodists, district nurses and doctors.
People were kept mentally and socially engaged through a range of activities inside and outside the home. The service employed an activities coordinator who had developed a programme of personalised activities to suit people’s individual needs. This was regularly reviewed and updated. The atmosphere in the home was upbeat and vibrant and we observed people taking part in the activities.
People were kept safe by suitable staffing levels. Relatives told us there were enough staff on duty and we observed unhurried interactions between people and staff. This meant that people’s needs were met in a timely manner. Recruitment practices were safe. Checks were carried out prior to staff commencing their employment to ensure they had the correct characteristics to work with vulnerable people.
Staff had received training relevant to their role and there was a system in place to remind them when it was due to be renewed or refreshed. Staff were supported in their role by an on-going programme of supervision, appraisal and competency checks.
There was a safeguarding adult’s policy in place and staff had undergone training. Staff described how they would recognise and report any signs of abuse. The manager promoted an ethos of openness and honesty which demonstrated the requirements of the duty of candour. There was a policy in place on whistleblowing which supported staff to question and report poor practice.
Staff were knowledgeable about the Mental Capacity Act and how this applied to their role. Where people lacked the capacity to make decisions for themselves, processes ensured that their rights were protected. Where people’s liberty was restricted in their best interests, the correct legal procedures had been followed. People were involved in planning their care and staff sought their consent prior to providing them with assistance.
People, staff and relatives were encouraged to give feedback through staff meetings and residents’ meetings. This feedback was used to drive improvements within the service. There was a system in place for receiving and managing complaints. Care records were electronically audited.
The manager had arrangements in place to dispose of domestic waste and a
contract in place for the removal of clinical waste. The provider had systems in place to monitor the safety of the premises, which included fire checks, water temperatures, legionnaire’s checks and PAT testing.
This inspection visit took place on 26 November 2014 and was unannounced.
The Red House is a care home which provides accommodation and personal care to a maximum of 28 people. There were 22 people using the service at the time of our inspection. People's healthcare needs are met through the local community services, such as the district nurses and GPs.
At the last inspection on 15 November 2013, we asked the provider to take action to make improvements for safeguarding people. This action had been completed by January 2014 when we did a desktop review of the improvements.
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 of Health and Social Care Act and associated Regulations about how the service is run.
Staff were unsure what deprivation of liberty meant although we saw no evidence that people’s liberties were deprived or restricted and people’s independence was promoted. Where people’s families were consulted on their behalf regarding decisions about their care and welfare, people’s capacity to make those decisions themselves had not always been assessed or maximised. This meant the service was not routinely working to the values which underpin the legal requirements of the Mental Capacity Act 2005 (MCA) code of practice and Deprivation of Liberty safeguards (DoLS).
People were supported by staff that were skilled, trained and supported in their role. Staff knew people well. There had been occasions when staff numbers were lower than planned for, but staff were being recruited and staffing arrangements were under regular review. The recruitment arrangements protected people from staff who might not be suitable to work at The Red House.
People were treated as individuals, with respect and kindness. People led busy and fulfilled lives and were supported to follow interests outside of the home. People received a nutritious diet which they enjoyed and where there were changes in people’s health advice was sought promptly. Staff understood people’s vulnerability and how to protect them from abuse, harm and injury.
The registered manager set the standards staff were expected to meet. She was available to hear the views of people and their families and support staff. Any issues or complaints were investigated and led to improvement.
The standard of service provided was based on people’s views, close monitoring of people’s health and needs and audits. Changes were made which improved people’s lives where this was possible.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Staff did not have an understanding of deprivation of liberty or their responsibilities under the Mental Capacity Act 2005. You can see what action we told the provider to take at the back of the full version of this report.
Our inspection of 15 November 2013 found that care workers had not been trained in the Mental Capacity Act 2005, which provides legal safeguards for people who do not have capacity to make decisions about their own welfare. We found no evidence that this lack of training had resulted in people's human rights not being upheld.
We received a plan from the registered manager providing a timescale for staff training in the Mental Capacity Act 2005. When that timescale was reached we rang the home and were told that the majority of care workers had received the training and arrangements were in place for the other care workers to receive it. The registered manager also said that the training was now included in the home's regular training arrangements. People were now better protected from the risks of abuse.
Care workers told us "The manager is always on call", "Training is very good" and "We make things as normal as possible for people here."
We found that appropriate and individualised care was provided by a well-supported and enthusiastic staff.
Medicines were handled in a way that ensured people got the correct medicine at the correct time.
People were safeguarded through the arrangements to protect people from abuse but those arrangements could be more robust and they did not ensure people's rights would be upheld if they lacked capacity to make some decisions.
There were good arrangements in place to monitor the quality of the service and there was a keenness to ensure high standards.
People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.
People told us they were happy with all aspects of the care they received and the staff who supported them. People said, "absolutely marvellous", and "they are all good, young people, fresh and clean - nice having a few men too!"
Relative's comments from letters we saw included, "treated with humour, respect, kindness and great dignity".
We observed people interacting together and enjoying a crossword puzzle. We saw people enjoying their own personal hobbies including reading and bird watching. There were photographs of recent seasonal events being celebrated on the notice board. People also told us they were in the process of making Easter bonnets for an in house competition.
We saw evidence of person centred care plans which included people's preferences. People told us they felt involved in their care planning and felt their choices were respected.
Staff told us they felt supported and shared concerns openly with the management team. We found staff were able to recognise and respond appropriately when someone was not well because they knew people well and had the necessary skills to care and protect people.
People told us they were happy with the service. Comments included:
"I am treated with respect and consideration... carers do their best"
"We have the best chef about"
"It's always a bit of fun"
People were very complimentary about the food provided.
We saw people interacting and they told us that they enjoyed social activities together. Staff also interacted with people, one example being reading out crossword clues to a group in the lounge. People told us they had regular trips off site using the home's minibus, including trips to Plymouth and to Dartmoor National Park. One person told us that their faith needs were met and that a local curate came in once a week. Another said that they enjoyed the regular "reminiscence" sessions.
People told us they could get up or go to bed at whatever time they liked. We saw bedrooms which were personalised and individual. People told us that they had seen their care plans and felt able to discuss their care. They said that they would feel confident in complaining if something was wrong.
People appeared to receive a high standard of personal care and a district nurse said she had no concerns at all about how the home ensured people's health care needs were met.
People spoke highly of the staff and the manager. Staff receive training and supervision of their work and knew the importance of speaking out if they had concerns. However, whilst they knew how to escalate concerns, so as to safeguard people from abuse, the systems in place at the home made this difficult.
There are systems in place at the home to ensure that people can express their views and the home runs in a safe and orderly way, but policies and procedures had not been reviewed regularly and some were of limited use to staff.