Redlands Care Home

Redlands is a residential care home in an adapted domestic property in St Annes, providing personal care to 15 people at the time of the inspection. The service can support up to 20 people. The service supports people who may have previously lived a transient lifestyle, experienced problems with drugs and alcohol and mental health conditions.

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

Staff managed people’s medicines safely. We have made a recommendation around ensuring all medicines records are accurate and complete. Staff kept the home clean and tidy. Staff managed risks well and had plans to follow in case of emergencies. The service had systems to protect people from the risk of abuse and improper treatment.

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 service put people at the heart of the care they received. Staff identified people’s needs and preferences and worked to ensure people were happy with the care they received. The service was led by a registered manager who was described as approachable and supportive. The culture at the service was open and inclusive. Staff understood their roles and responsibilities and worked well with external agencies to meet people’s needs. The provider monitored the quality of the service using a range of systems.

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 (published 10 September 2019).

Why we inspected

We looked at infection prevention and control measures under the Safe key question. 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.

The inspection was prompted in part due to concerns received about staff training and culture. 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 this concern. Please see the full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has not changed.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Redlands 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.

We found the following examples of good practice.

The provider had dedicated staff to ensure people were admitted safely and continued to be supported in the service in accordance with national guidance. Infection prevention and control (IPC) policies and procedures were kept under review. We found safe processes were in place and appropriate action had been taken. The local commissioner’s IPC team was providing advice and support when required.

Social media systems such as computer systems, telephone access and ‘face time’ access were used to facilitate contact between people and their relatives. The registered manager was facilitating safe visiting in line with government guidance.

During our visit we observed the staff using Personal Protective Equipment, (PPE) safely. One staff member said, “No problem we have enough PPE.” The registered manager told us sufficient stocks of PPE were available and we confirmed this on the visit. Staff had received training in the use of PPE and infection control. Signage was in place around the building to remind staff, visitors and people about the use of PPE. In addition, the importance of washing hands and regular use of hand sanitisers which were placed on all floors. However more accessible PPE stations on each floor would ensure staff had easy access when providing personal care for people. The registered manager addressed this during the inspection.

People living at Redlands and staff were tested regularly for COVID-19. There were no staff employed who had not been vaccinated as now required.

The home was clean and hygienic. Cleaning schedules were in place and checks completed. PPE was available for staffing people’s rooms. Staff carried out regular checks of the environment and cleanliness and any issues would be addressed. One person said, “Despite the old building the staff do a very good job from the start of this pandemic.”

Redlands is a residential care home in an adapted domestic property in St Annes, providing personal care to 18 people at the time of the inspection. The service can support up to 20 people. The service supports people who may have previously lived a transient lifestyle, experienced problems with drugs and alcohol and mental health conditions.

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

The service was safe. The provider had systems to protect people from the risk of abuse and improper treatment. Staff managed people’s medicines well and kept the home clean and tidy. Staff managed risks well and had plans to follow in case of emergencies.

People were cared for by staff who were well supported and had the right skills and knowledge to meet their needs effectively, following good practice guidance. Staff supported people with their healthcare needs and worked well with external healthcare professionals. The service met people’s nutritional needs and worked with them to make sure food provision also reflected their preferences. 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. However, the recording of capacity assessments and best interests decisions needed to be improved. We have made a recommendation about this.

People were treated well, with kindness and compassion by staff who respected their privacy and dignity and promoted inclusion. The service supported people to be independent and to regain life skills. We received very positive feedback about the caring approach of staff.

The service put people at the heart of the care they received. Staff used detailed assessments to identify people’s needs and preferences and worked to ensure people were happy with the care they received. If people were not happy, they were confident they could speak with staff to make improvements. Information for staff to follow to support people in a crisis was not always readily available. The registered manager agreed to address this. The service made sure people were supported to communicate their views and planned activities to enhance people’s wellbeing.

The service was led by a registered manager and senior staff who everyone described as approachable, well-organised and caring. The culture at the service was open and inclusive and they worked in partnership with other agencies to ensure people’s needs continued to be met. Senior staff understood their responsibilities and monitored the quality of the service using a range of systems. The registered manager had begun to implement a schedule of audits and checks to monitor and improve the service. However, current audits and checks on quality were not always fit for purpose. We have made a recommendation about this.

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 (published 18 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection in April 2015 we asked the provider to take action to make improvements because we found multiple breaches of legal requirements. This was in relation to ensure people were protected against unsafe care, arrangements were not in place to monitor risk across the service, obtaining valid consent to protect peoples human rights ; and failed to protect people against deprivation of their liberty. The provider sent us an action plan saying they would meet the legal requirements by September 2015. During our inspection visit on 06 December 2016 we found these actions had been completed and concerns addressed.

Redlands is a care home providing personal care and accommodation for up to 23 people. The majority of the people living at the home have previously lived a transient lifestyle and are not necessarily from the local area. The home is located in a residential area and arranged over three floors. There are a variety of communal rooms and a passenger lift is provided for ease of access throughout the building. Redlands is conveniently situated close to the town centre and local amenities. At the time of the inspection there were 14 people who lived at the home.

There was a registered manager in place. 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 management team had developed risk assessments to protect people from unsafe care. We found they were completed for each individual who lived at Redlands. For example these covered, fire and environmental safety and medication. Risk assessments had been developed to minimise the potential risk of harm to people both in the building and whilst out in the community. These had been kept under review and were relevant to the care provided.

We found the provider had improved their systems in relation to the Mental Capacity Act (MCA) and associated Deprivation of Liberty Safeguards (DoLS). Staff had received training and had a good understanding of related principles. We observed staff explained tasks to people and sought their consent prior to assisting them.

We found at this inspection the registered provider was addressing the issues and a rolling programme of refurbishing the building was ongoing. The bathroom facilities had been updated and a new dining room with new furniture and furnishings had been completed. Comments from people who lived at the home included, “The home is lovely now nice and bright.”

People who lived at the home told us staff who supported them were kind, caring and respectful. They also commented on how professional the staff team were. One person said, “I know I am an alcoholic but the staff treat me with so much kindness and understanding.”

Staff knew people they supported and provided a personalised service. The service operated a keyworker system. This is where a member of care staff is allocated to each person and acts as a focal point and will try and ensure the person’s personal requirements are not overlooked. A staff member said, “It works so well and people know they can rely on us.” One person who lived at the home said, “I have a good relationship with [staff member] we work a lot of things out. They look after me.”

Staff spoken with and records seen confirmed an induction training and development programme was in place. Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people who lived at the home.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when needed. Staff had received safeguarding training and they confirmed this when we spoke with them. They understood their responsibilities and process to go through should they witness any abusive practices.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

We found sufficient staffing levels were in place to provide support people required. This was confirmed by our observations and people we spoke with. For example one person who lived at the home said, “Always staff around the place. I go out for a coffee with them.”

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

People told us there were choices at meal times of different food and drink. During the day we saw regular snacks and drinks were provided. At lunchtime staff had prepared a buffet Christmas lunch following a show that had been provided. Comments about the food included, “The food is good at least there is a choice.” Also, “What a lovely buffet always plenty to eat if you like that sort of thing.”

There was a Christmas show put on for people who lived at the home in the morning of the inspection visit. People told us they enjoyed the event and enjoyed many activities and events put on for them. One person who lived at the home said, “I did enjoy going around the illuminations at Blackpool.”

We observed staff supporting people with their care during the inspection visit. We found staff to be patient, kind and respectful. This was confirmed by people we spoke with.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were happy and had no complaints.

We found people had access to healthcare professionals and their healthcare needs were met. People who lived at the home confirmed the service responded promptly if they felt unwell.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, audits, staff and resident meetings and care reviews.

We found staff treated people with respect. People told us they had been involved in agreeing their care plan.

We reviewed the care files for three people who used the service. We found care plans were person centred and supported by a series of risk assessments.

People who used the service told us they felt safe and were confident in the abilities of staff to meet their needs. We found staff had received training on safeguarding vulnerable adults and had access to relevant policies and procedures.

We found the premises were safe and secure and had been maintained to a reasonable standard. All the people we spoke with told us they felt safe and comfortable in the home.

We spoke with two members of staff who told us they felt well supported and confident in carrying out their responsibilities. We saw evidence that staff were appropriately qualified and provided with regular training opportunities.

There were systems in place to monitor the quality and operation of the service. We saw evidence to demonstrate people were asked for their opinion of the service.

We were told, 'It is all right here'. Another person said, 'I want to be here'. Nobody spoken with expressed any real concerns and people appeared comfortable in their surroundings.

We observed the interaction between the staff and the people who used the service. Staff spoke in a friendly way and there was a relaxed, comfortable and homely atmosphere. We observed that staff were respectful of people and treated them with dignity. For example, we saw that staff responded to people in the way they preferred and offered assistance and support in a discreet and dignified manner.

We asked people whether they had seen their care plan and whether they had helped decide what the care plan should say. One person said he was aware of the content of his care plan and happy with what was written. Another person stated he had not seen his care plan. However this person expressed no concern about it saying he was not interested. People did tell us however that they felt comfortable and well cared for.

Members of staff spoken with said the staff team were good at spending time listening to people and spending time with them in individual activities.