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Archived: Redhouse Nursing Home (UK) Ltd Inadequate

We are carrying out a review of quality at Redhouse Nursing Home (UK) Ltd. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 20 September 2019

This inspection took place on 13 and 15 November 2018 and was unannounced. This service has been rated ‘Requires improvement’ overall over the four previous inspections. At our last inspections in May 2017 and September 2017, we identified breaches of the regulations related to safe care and treatment and governance. After the inspection in May 2017, we undertook enforcement action in relation to those breaches, however the provider failed to achieve compliance with the regulations. After the inspection in September 2017, we undertook more significant enforcement action to impose conditions on the provider’s registration. This required the provider to submit monthly reports to the Commission, about actions they took to improve the safety and oversight of the service.

At this inspection in November 2018, we found again that the provider had still not made sufficient improvements and has remained in breach of those regulations since May 2017. This has continued to put people at risk of poor and unsafe care. This inspection identified an additional two breaches of the regulations related to person-centred care and the provider’s failure to submit notifications to the Commission as required. We have taken further enforcement action in line with our processes, in response to this inspection and we have rated the service ‘Inadequate’ overall.

Redhouse Nursing Home is a ‘care home’ with nursing. 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. Redhouse Nursing Home accommodates up to 34 older people in one adapted building.

There was a registered manager who was present during our inspection and had registered in March 2018. 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.

People continued to be at risk of poor and unsafe care as the provider had still failed to provide a consistently safe service. We found various examples of how people’s risks were still not effectively assessed, monitored and mitigated. Lessons were not learned to improve the safety of the service and practices at the home put people at increased risk of harm. This amounted to a continued breach of the regulations in relation to safe care and treatment.

People’s relatives and friends felt the service was safe. One person told us they felt the service was safe, however this was not consistent feedback because two people told us they did not feel safe. Some improvements had been made to how some people’s risks were managed including people’s support with medicines and staffing level changes. Recruitment processes had not always been followed as planned to ensure people’s safety. The registered manager told us they intended to use an improved audit, and to appoint a new infection control lead to support ongoing improvements and ensure good infection control practices at the home.

Staff told us they felt supported and spoke positively about the supervision and training provided, however we found continued concerns that staff were not always equipped with the skills and knowledge to meet all people’s needs. People could not be confident all of their needs would be effectively monitored and met although we saw some positive examples of how people were supported. People were not supported to have maximum choice and control of their lives and staff did not support all people in the least restrictive ways possible.

We received mixed feedback about the food on offer and people’s own choices and preferences were not routinely gathered to help inform menu planning. Although we often found positive practice in the

Inspection areas

Safe

Inadequate

Updated 20 September 2019

The service was not safe.

People continued to be at risk of poor and unsafe care as the provider had still failed to provide a consistently safe service. We found various examples of how people�s risks were not effectively assessed, monitored and mitigated.

Lessons were not learned to improve the safety of the service and practices at the home put people at increased risk of harm.

Most feedback we received suggested people and relatives felt the service was safe, however this was not consistent.

Some improvements had been made to how some people�s risks were managed including support with medicines and staffing levels.

Effective

Requires improvement

Updated 20 September 2019

The service was not effective.

People could not be confident all of needs would be effectively monitored and met although we saw some positive examples of how people were supported.

People were not supported to have maximum choice and control of their lives and staff did not support all people in the least restrictive ways possible.

Although we often found positive practice in these areas, improvements were required to ensure people always received safe and effective support in relation to their dietary and hydration needs and to access healthcare services when needed.

We found continued concerns that staff were not always equipped with the skills and knowledge to meet all people�s needs although staff told us they felt supported.

Caring

Requires improvement

Updated 20 September 2019

The service was not caring.

Some people�s feedback showed staff did not demonstrate a consistently caring approach.

People were not involved in their care as far as possible and opportunities to gather people�s views about their care were missed.

We often saw caring interactions from some staff, however this was not consistent. Staff were not always available to spend time and interact well with people.

Responsive

Requires improvement

Updated 20 September 2019

The service was not responsive.

People did not all receive care in line with their needs and wishes. People�s needs and preferences were not effectively gathered and met and this put people at risk of poor care.

Improvements were required to how people�s care was planned, including end of life care and the design of the home. We found continued concerns around people�s poor access to activities.

Complaints received had been responded to, however systems did not help capture all people�s feedback and concerns to help improve the service.

Well-led

Inadequate

Updated 20 September 2019

The service was not well led.

We found continued concerns in relation to the governance and leadership of the service. Systems and processes still failed to effectively assess, monitor and improve the quality and safety of the service, including people�s experiences. Incidents and concerns were not appropriately rectified and learned from.

Systems failed to ensure people�s risks were effectively assessed, monitored and mitigated which put people at continued risk of poor and unsafe care.

People were not given routine opportunities to discuss their care, and where some people had expressed needs and preferences, these were not always met.

The provider had failed to notify the Commission of all events and incidents as required.