Archived: Ruishton Court Nursing Home

We carried out a second visit on 20 December 2011 to confirm that all the people who had been living in the home had moved to alternative accommodation. The appointed administrator confirmed that they would be sending The Care Quality Commission (CQC) an application to cancel the registration of the home.

During our inspection we spoke to nine of the fourteen people living in the home. People spoken with said they felt well cared for and were treated in a respectful and dignified way. People told us that they felt they could talk to staff and make decisions about how they spent their day.

We spoke to one person having their hair done they said they looked forward to the hairdresser visiting and it made them feel like 'a new person'. Another person said, 'I am as happy as you can expect to be when you are not in your own home, the staff are polite and kind so can't really expect more.'

We spoke with people about the food provided in the home. They said that they received 'really good meals' and one person said they were always offered plenty to eat.

Two people spoken with said they felt very unsettled living in the home as there had been so many changes. They said they were not kept informed and were worried about future decisions.

Everybody spoken to said that they felt well cared for and were very happy with the care provided in the home. People told us that they were happy living at Ruishton Court and those who were aware of the issues raised by the last review were concerned saying they wanted to stay at Ruishton Court.

We spoke to people about the way their care was delivered. They said they felt the care was provided in a way that was respectful and dignified, one person said 'I feel respected and I can do what I want, I usually want to stay in my room and the staff help me to do just that.' Another person said ' they always tell me what is happening and I know what is about to take place.' Whilst another person commented on the way staff enabled them to chose what they did through the day, 'I want to stay in my room most days but sometimes I want to join in with something happening in the home, staff help me do what I want,' One person told us about their relationship with the care staff saying they enjoyed a 'banter with the girls.'

We observed the way care was provided in the home during our visit, we saw staff working in a cheerful and relaxed way whilst maintaining a professional manner. We observed staff members asking questions that gave people an opportunity to make their own decisions.

We asked people about how they consent to the care and treatment they received. They said that they were spoken to on a daily basis about what they liked and what they would like to do, but no one was aware of their care plan and what it contained. People did confirm that there was plenty to do if you chose to attend and two people spoke about the planned trip to Minehead the following day. We observed staff asking people if they would like to go to the dining room to lunch. We also observed staff asking people what they wanted to do in the afternoon, and supporting them in achieving that choice.

When we discussed meals with people we got a mixed response. One person said, 'I looked forward to lunch and it was worth waiting for.' Whilst another person commenting on the pizza said,'I wouldn't like to say what it is. Well, it was edible that's all I can say about it'. We observed how lunch was managed in the home. The mealtime was relaxed and people were assisted appropriately and respectfully. We heard people telling staff members that the meal was very good and that they had 'enjoyed it.'

One person spoken to said, ' it's all right living here, you get what you want if you are 'compos mentis'.' (This means, 'if you are able to understand what is happening.')

Whilst discussing mealtimes, one person said ' the food is marvellous, really too much, she comes round with a menu to ask what we want, we get afternoon tea with a biscuit and a sandwich or sausage roll at teatime. There's a night drink, which is occasionally cold. Another person said, 'I don't like the mince they give me but I guess that's what I need, and I don't drink enough, I know.' One person commented on the activities they enjoyed attending' A lady organises all sorts of things. I go down to the church service and occasionally play bingo.

We observed staff interactions over the two days of our visit to the home. What we saw confirmed what people had told us. We saw some people receiving respectful and supportive care, spoken to and assisted in a respectful and dignified manner. However we also observed people sat in the lounge with no engagement with staff. Nobody came to speak to them, check that they were all right or offer them a drink. We observed practices at mealtimes that showed people were not helped in a dignified manner when being assisted to eat. Care workers fed people whilst talking to each other over the person's head or watching TV. One person's food was put next to them but not given to them until two other people had been helped. This person was slumped in a wheelchair and in obvious discomfort, they were not moved or made comfortable and the care worker did not speak to them during the meal. Another person with dementia was told, 'use your spoon,' however they are unable to use a spoon to feed themselves. We saw that their care plan said the person needed finger foods, food they could pick up with their hands to feed themselves.

We also observed one person dressed inappropriately with little concern from staff members. The lady was brought into the lounge with laddered tights, when commented upon the care worker simply replied 'yeah' and did nothing to change the way they were dressed.