Redbrick Court

Redbrick Court is a care home that provides personal care for older people, some of whom are living with dementia, and or physical or sensory disabilities. In addition, the home provides respite to people from hospital to aid their recovery. At the time of the inspection, 27 people lived at the service. The home provides a range of communal areas to include; cinema room, sensory room, library area and café.

People’s experience of using this service:

People’s medicines were not always stored safely. Staff had not recognised that some medicines were stored at incorrect temperatures which made them unsafe to use. Expired medicines had not all been returned to the pharmacy and there was insufficient room in the medicine trolleys for people’s medicines to be organised and stored safely.

People and their relatives told us they felt happy and safe. People were satisfied there were enough staff to support them, although occupancy levels were low. Risks to people’s safety and well-being were identified and managed. However, falls analysis needed to improve to further reduce risks. People had a clean and hygienic environment to live in.

People enjoyed the meals and had regular access to drinks. Risks related to nutrition and hydration were monitored to ensure people remained well. People had access to health care support and staff followed recommendations to support people’s health needs. People's capacity was assessed and their consent was obtained before care and support was given. People were supported in the least restrictive way possible; the policies and systems in the service supported this practice. Facilities had been designed to consider people’s specific needs.

People and their relatives described staff as kind and patient. We saw people being treated with respect. People’s dignity and privacy was protected and they had support to maintain and develop their independence.

People’s care was responsive to their needs and people said staff knew their preferences and routines. Care plans were regularly updated to provide guidance to staff on how to meet people’s needs. Complaints were dealt with appropriately to include written outcomes to people. People were encouraged to participate in activities and utilise the facilities available such as the cinema room. The registered manager was looking how they could increase recreational visits outside of the home. Systems and training was in place to support people’s end of life care.

The management team had increased and staff felt positive about the way the service was run. The registered manager divided her time between other locations owned by the provider. Staff felt they would benefit from full-time leadership. People and relatives said they were happy with the service. Their views were sought and acted on to improve the service provided. Quality assurance checks were in place, however for some areas, these had not identified where improvements needed to be made.

Rating at last inspection:

Requires improvement (report published 26 March 2018.

Why we inspected

This was a planned inspection based on the rating at the last inspection.

Enforcement

No enforcement action was required.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our reinspection programme. If any concerning information is received we may inspect sooner.

Redbrick Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to 37 people in one adapted building and specialises in providing care to older people some of whom are living with dementia, and or physical or sensory disabilities. In addition the service provides Pathway 3 beds. [These are for people who had been discharged from hospital for short term care].

The service did not have a registered manager in place. There had been three changes of manager since the home began operating in September 2017. At the time of our inspection Redbrick Court had a new manager who had been managing the home for a few weeks. The provider had submitted an application to register this manager for Redbrick Court. 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.

This is the first inspection since the provider registered with the Care Quality Commission in July 2017. This inspection was brought forward because we received some concerns and complaints about the service and we wanted to make sure people were receiving safe care. The concerns related to management changes, medicines training for staff and infection control practices. During this inspection we found no evidence of people being harmed by poor practice and saw the provider was taking action to improve the management of the home and the delivery of care to people.

Our findings showed that staff knew how to recognise signs of abuse or harm and how to report this. Staff knew the risks people faced in relation to their health conditions and how to support people with these. However the monitoring of risks needed to improve to ensure that people were being supported consistently, safely and in line with their assessed needs. There had been occasions when staffing levels had not been sufficient to meet people’s needs. Recent improvements in staffing levels were evident and showed staff responded promptly to people. The provider had taken action to ensure people received their medicines from staff who had been trained to administer these safely. There were processes in place to ensure the premises and equipment were regularly checked and to manage the prevention and control of infection. The manager reviewed accidents and falls to ensure people had the right support to keep them safe.

Staff had not had effective support or supervision and we found some gaps in training due to the training schedule being interrupted by the changes in management and staff turnover. Plans were in place to address this shortfall and staff were confident in the support they currently had from the new manager. People had no concerns about staff skills to support them. Staff sought people’s consent before providing personal care. 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. However further development of these processes was needed to ensure related assessments of people’s capacity were undertaken.

People told us that the meals had improved recently and it was evident that people were offered a choice of meal. The cook was working in the home temporarily whist the post was recruited to but had information about people’s likes and dislikes. People received regular drinks throughout the day, but the monitoring of people at risk of dehydration had not been consistent. There were effective processes in place to ensure staff communicated effectively between themselves and with other organisations. People were supported to live healthier lives and have access to other professionals to meet their needs. The premises were suitable to meet the needs of the people who used the service.

People were complimentary about the caring approach of staff. There were positive comments from relatives about the compassion staff showed when caring for people and how they had protected people’s dignity. People were supported to regain their independence following an illness and people enjoyed undertaking daily tasks in line with their independence. People were supported on a daily basis to express their views about the care they received, although resident meetings had not been fully established.

We saw staff responded without delay when people required support and people described staff as responsive to them. People were supported with some activities and events, but this was reliant on care staff availability. The provider had invested in facilities that were designed around people’s specific needs, such as a cinema room, sensory room, garden room and library but these had not been fully utilised. Plans to structure activities and staffing levels to accommodate people’s needs in this area were evident. People and relatives we spoke with knew who they could speak with to raise any concerns and action to address any concerns had been taken. The provider had linked with other organisations to source training for the staff team in relation to providing people with compassionate end of life care when this was needed.

There had been inconsistent management of the service due to a turnover of managers. The leadership of the home had recently improved although a full management team was not in place to ensure staff performance and to maintain a good standard of care delivery to people. The provider was overseeing the service and supporting the manager to check that tasks were being carried out effectively. Quality assurance systems were in in place but needed strengthening to ensure any risks to people were identified and mitigated. The provider had established links with other agencies to gain advice and share best practices to improve the quality of care to people. People’s views on the service were sought and staff were confident in the new manager to drive improvements.