We carried out a review of the data available to us about Russell Churcher Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Russell Churcher Court, you can give feedback on this service.
We found the following examples of good practice.
¿ A recent outbreak of COVID-19 was well managed. Staff followed guidance in people's risk assessments and care plans to keep people safe. The provider had ensured people and staff who tested positive, or displayed COVID-19 symptoms, had isolated in line with government guidance.
¿ Since the outbreak the provider had maintained a no visiting policy, with an exception for people who were nearing the end of their life. The provider kept their visiting policy under review to ensure they supported people to keep safe.
¿ The provider had also built a visiting pod with screening to minimise the risk of spreading infection. This enabled people to continue to receive their visitors in a comfortable and safe way when the home is able to reopen to visitors.
¿ People were supported to keep in touch with their relatives via telephone calls or video links which helped maintain their wellbeing.
¿ People and staff underwent regular COVID-19 testing in line with government guidance. This ensured anyone who had contracted COVID-19 could be identified in a timely way.
¿ Staff had received training about good practice for infection prevention and control, including how to put on and remove personal protective equipment (PPE) safely.
¿ There were sufficient stocks of PPE in the home. Stocks included masks, gloves, aprons and visors. There were also sufficient stocks of hand sanitiser and cleaning materials.
¿ Staff used special fogging machines at reception, that enabled them to sanitise incoming mail and parcels before handing to people living in the service.
¿ The provider had robust contingency plans in place. This ensured the safety of the service during the pandemic.
Russell Churcher Court is a residential care home providing personal care and accommodation to 44 people (43 at the time of inspection), aged 65 and over. The majority of people living at the home were living with dementia
People’s experience of using this service and what we found
The registered manager had developed safe systems to ensure people received their medication as prescribed. People said they felt safe and comfortable. The registered manager had sufficiently skilled numbers of staff to deliver care in a safe environment. They had a good understanding of protecting people from harm or abuse.
The provider had an extensive training programme to develop their staff. A relative commented, "Staff are wonderful and really experienced." The registered manager monitored people against the risk of malnutrition. 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. Staff helped people to make their day-to-day decisions.
The registered manager placed people and their relatives at the heart of their care planning in the delivery of personalised care. One person said staff were responsive to their preferences. The provider's core values centred on optimising people's human rights and guiding staff to respect their individuality.
The registered manager assessed people's needs and created care plans with them to meet their individual requirements. The registered manager had a programme of activities for each person's stimulation. One individual stated, "There's plenty to do here for my needs."
The provider promoted inclusive, transparent care delivery to optimise people's experiences. One person stated, "[The registered manager] is fantastic. Their kindness is the most essential thing to me." The registered manager audited service delivery as part of their quality assurance oversight.
The service was well managed. When speaking about the registered manager, people said, "Wonderful manager" and "So well organised." Quality assurance processes ensured people received high quality care.
People, relatives and staff were positive about the running of the service and the support they received from the management team and providers. People and staff felt there had been improvements in all aspects of the service since the last inspection.
The management team were open and transparent. They understood their regulatory responsibilities. People and their relatives said the management team were open, approachable and supportive. There were effective governance systems in place to identify concerns in the service and drive improvement.
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 requires improvement (published 8 March 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We previously carried out an unannounced comprehensive inspection of this service in January 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do to improve safe care and treatment, recruitment procedures and governance of the service. This inspection was carried out to follow up on action we told the provider to take at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Russell Churcher court on our website at www.cqc.org.uk.
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.
People’s experience of using this service:
• Everyone told us they enjoyed living at Russell Churcher Court. They said they felt safe and cared for by kind and compassionate staff.
• Although we found some improvements since the last inspection in October 2017 we found some areas of practice had not improved and had the potential to place people at risk.
• Risks associated with people’s needs were not always effectively assessed and appropriate plans were not consistently implemented to reduce those risks. Where incidents had occurred, there was not always effective and timely action taken to reduce the risk of reoccurrence and it was not clear how lessons were learned from these. Staff recruitment records lacked the required information to demonstrate that staff had been safely recruited. Governance systems used to assess the quality and safety of the service did not always identify concerns and drive improvement; Feedback from people and others was sought but we have recommended the provider seek advice from a reputable source about using this feedback to develop timely actions plans to drive improvement.
• People were supported by skilled staff who were supported to understand their responsibility in relation to safeguarding people and to recognise people’s rights to make their own decisions.
• People received their medicines safely and as prescribed, while being looked after in a clean and well-maintained environment aimed to promote independence and meet people’s needs.
• People received compassionate support which met their needs from kind and caring staff. People had developed meaningful relationships with the staff. Staff knew what was important to people and ensured people had support that met their needs and choices. However, care records to guide staff about peoples individualised needs required work to ensure they were person centred, up to date and accurate. People’s dignity and privacy were respected and their independence was promoted.
• More information is in the detailed findings below
Rating at last inspection: Requires Improvement (report published January 2018)
Why we inspected: This was a planned inspection based on our last rating. At the previous inspection in October 2017, we found three breaches of regulations. These were breaches of Regulation 12, Safe care and treatment, Regulation 17, Good governance and Regulation 18, Staffing. The provider informed us what they would do to meet the regulations. This inspection was planned to follow up on these areas.
Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up: We found two repeated breaches of regulations and one new breach of regulation. The service also remained rated as requires improvement, we will request an action plan from the registered provider about how they plan to improve the rating to good and meet the requirements of the regulations. In addition, we will plan to meet with the provider to discuss their plans to make improvements. We will also continue to monitor all information received about the service to monitor any risks that may arise and to ensure the next planned inspection is scheduled accordingly.
Russell Churcher Court provides residential care and support for up to 44 older people some of who are living with dementia. People were accommodated in individual rooms with a toilet and shower and small kitchenette. Communal facilities include a lounge, dining room and conservatory and secure outside spaces. At the time of our inspection, 44 were living at the home.
A registered manager was not in post and the previous registered manager left on 30 June 2017. 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 provider had recruited a manager and they were currently applying for registration.
People told us they were safely cared for at Russell Churcher. However, we found people were not always protected from risks associated with their care and support. We found people’s needs were not always reviewed when they experienced a fall to ensure detailed plans were in place to minimise the risk of a reoccurrence.
Records showed information to enable staff to effectively monitor, evaluate and mitigate the risks to people from dehydration and malnutrition was not consistently recorded. Topical creams prescribed to protect people from the risks associated with pressure sores were not always recorded as applied as prescribed. Information was not always readily available to staff about where to apply the creams. From the examples seen we could not be assured people were always receiving sufficient fluids, food and skin care to prevent the risk of deterioration in their health.
Risk assessments and continuity plans were in place to guide staff on how to support people in an emergency situation such as a fire or flood. People were supported safely and appropriately with their moving and handling needs.
Robust procedures were not in place to ensure medicines were always managed safely. We identified medicines were not always stored and disposed of safely. Cream and liquid medicines were not dated when opened to ensure they remained effective. Staff administering people’s medicines had not been routinely assessed as competent to do so line with the provider’s policy and current guidance.
The provider had recently increased care staff hours during the day. We received mixed feedback about the staffing levels in the home from people and staff. The provider planned to carry out a more detailed analysis of people’s dependency needs to ensure sufficient numbers of staff were deployed to meet people’s needs.
Staff had the knowledge to identify safeguarding concerns and acted on these to keep people safe. Safe recruitment practices were followed before new staff were employed to work with people. Checks were made to ensure staff were of good character and suitable for their role.
Staff did not receive regular supervision sessions. Supervision helps to ensure people are cared for by staff who are appropriately supported in their role.
Staff completed an induction and on-going training to develop the knowledge and skills required to meet people’s needs.
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 support this practice.
People spoke positively about the food available in the home. Some people may have benefited from more attention during meal times to encourage eating.
People received support with their healthcare needs from the relevant health care professionals. Care plans did not always contain detailed information about how their healthcare needs were being met. The manager took action to ensure people’s records were updated as required following our inspection.
People and their relatives told us the staff were kind and caring and we saw interactions between staff and people to support this view. However, we observed staff during lunchtime were not always respectful and caring towards people. The manager told us they would address this with staff.
People and their relatives told us they were satisfied with the care provided in the home. At the time of our inspection, work was in progress to review and update people’s care plans to ensure they were personalised and reflected people’s needs, choices and involvement.
People had a range of activities they could be involved in. In addition to group activities, people were able to maintain hobbies and interests. However, we observed there was less staff engagement and meaningful activity for those who did not participate in group activities.
A system was in place to manage complaints. Information about this was available to people and their relatives Concerns and complaints were used as an opportunity for learning or improvement.
Most people, their relatives and staff told us the home was well led. It was clear the provider and manager were acting to make improvements in the home and the service people received. Systems in place to identify improvements required were not always effective and had not identified all the concerns we found.
A system was in place to gather feedback from people, their relatives and visitors to the home. Feedback from people had been used to make improvements.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.