The Red House Care Home

Updated 26 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

2 Inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Red House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Red House Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced and took place over 2 days.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke and communicated with 12 people who used the service and 9 relatives about their experience of the care provided. People who used the service who were unable to talk with us used different ways of communicating such as using their body language. We spent lots of time observing how staff interacted with people using the service.

We spoke with 14 members of staff including nurses, care workers, activity support workers, domestic care staff, kitchen staff, deputy manager, the registered manager, and a member of the quality management team.

We reviewed a range of records. This included 6 people's care records and multiple medication records and monitoring charts. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 26 May 2023

About the service

The Red House Care Home provides accommodation for people who require nursing or personal care. People may be older, living with dementia and may have physical disabilities. The care home is registered to provide care for up to 60 people across two buildings. Each building provides accommodation over two floors. There were 34 people living at the service at the time of this inspection.

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

We found improvements had been made since the last inspection, however, further oversight in specific areas is required. At this inspection we found improvements were still required to ensure peoples’ supplementary charts, to support health and wellbeing, were consistently completed. Furthermore, some peoples’ records provided contradictory information for example, one person’s wound was graded differently within the care records. We identified some risks around safety, use of pressure relieving equipment, and completion of food intake records Some effective audits were in place; however, these required embedding, and further development, to ensure responsive action is taken outside of inspection processes.

We have recommended that the provider ensure that an effective system in place to ensure information is reviewed and kept accurate to enable staff to have all the required information to keep people safe at all times.

People living in the service and their relatives were all positive about the standard of care provided at The Red House Care Home. Comments included, “There has been much improvement and I have no complaints about the care.” “I am really happy and lucky to be here.” And “I don’t think anything could be done any better.”

People were kept safe and were confident any concerns they raised would be listened to. Staff understood how to safeguard people. People were cared for and supported by staff who knew how to manage risks they might face.

The premises was hygienically clean, and staff followed current best practice guidelines regarding the prevention and control of infection. Medicines systems were well-organised, and people received their medicine as prescribed. Protocols for medicines ‘when required’ needed additional information to give the action for staff to take prior to the administration.

There were enough staff to support the needs of people. The provider had followed safe recruitment practices. Staff had the right levels of training, support, and experience to deliver effective care and meet the needs of people living at the service.

People had access to a wide variety of food and drink that met their dietary needs and wishes. Improvements were required to the food charts to show the exact quantities people consumed to ensure effective monitoring and support was provided. People were helped to stay healthy and well.

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. Although some terminology in the records was not always respectful or dignified.

Most Staff treated people with respect and dignity and upheld their right to privacy. People were encouraged and supported to maintain their independence. People were encouraged to make decisions about the care and support they received and had their choices respected.

Person-centred care plans were in place, which enabled staff to understand and meet their needs and expressed wishes and preferences. Staff ensured they communicated and shared information with people in a way they could easily understand.

People were supported to participate in meaningful recreational and leisure activities that reflected their social interests. People's concerns and complaints were well-managed, and the provider recognised the importance of learning lessons when things went wrong. One relative told us, “I think the meetings are productive. They have asked for feedback, and you can just speak up when you are here.” People, their relatives and staff working in the service were all complimentary about the way the service was managed. People and their relatives told us how approachable the staff all were.

Plans were in place to help people nearing the end of their life receive compassionate care in accordance with their needs and expressed wishes. The provider promoted an open and inclusive culture which sought the views of people living at the service, their relatives, community health and social care professionals and staff working there. The provider worked in close partnership with various community health and social care professionals and agencies to plan and deliver people's packages of care and support.

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 inadequate (published 24 October 2022) and there were breaches of regulation. At this inspection we found improvements had been made, and the provider was no longer in breach of all regulations identified at the last inspection. However, a continued breach of 1 regulation was found.

This service has been in Special Measures since 24 October 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to monitor the service and will take further action if needed.

We have identified a continued breach in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.