Red Brick House

Red Brick House is a care home providing personal and nursing care to up to up to 50 people. The service provides support to mainly older people, some of whom are living with dementia-related conditions. At the time of our inspection there were 41 people using the service.

The home provided purpose-built accommodation across two floors. One floor mainly accommodated people with dementia and one floor mainly accommodated people who had nursing needs.

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

Records about potential risks to people were not always in place or were not detailed enough. This meant staff did not always have guidance about the right support to reduce potential risks to people. The management team were aware of this and had begun to address this gap. We have made a recommendation about this.

People and relatives praised the friendly atmosphere in the home and described staff as helpful and kind. The home had a warm and welcoming culture. Staff were engaging with people.

People and relatives said the home was a safe place to live and staff were “very caring”. People said staff came quickly when they requested support. There were enough staff to provide safe care, although staff said more staff would allow more quality time with people.

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible and in their best interests; the policies and systems in the service upheld this practice. People said they were encouraged to make their own choices.

The home was clean and comfortable. The provider had sufficient equipment to reduce the spread of COVID-19, although screening of professional visitors had not always taken place.

Relatives said staff had kept them well-informed throughout the pandemic. The home had good links with the local community and worked alongside health and social care agencies to support the well-being of the people who live there.

The provider and management team were open and approachable. Staff said they felt supported by the new management team and enjoyed working at the home.

The provider carried out checks of the quality and safety of the service. The provider was committed to improvement and refurbishment programme was taking place.

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 16 August 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. In February 2022, we completed a direct monitoring activity, which involves gathering feedback from staff, relatives and people who use the service as well as looking at a wide range of documents. This identified some areas which were potentially of concern and needed further exploration. These were particularly around incidents between people and what risk management strategies were in place to reduce these.

The inspection was also prompted in part due to concerns received about staff practice in infection control. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

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 changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Red Brick House 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.

¿ Systems were in place to screen any visitors before they entered the home to reduce the potential spread of infection.

¿ Staff wore personal protective equipment (PPE) and management staff checked they did this in the right way. Staff had training in infection prevention and control measures and PPE.

¿ Social distancing was encouraged, and changes had been made to furniture to promote this.

¿ Regular testing for Covid-19 was in place for people and the staff team.

¿ The home looked clean and housekeeping staff made sure they frequently cleaned touch points, such as door handles and light switches.

Further information is in the findings below.

Red Brick House is a residential care home providing personal and nursing care for up to a maximum of 50 people in one adapted building. At the time of inspection there were 46 people living at the service, some of whom were living with a dementia.

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

People and their relatives were positive about the support they received from staff. Staff treated people with kindness and compassion. Staff upheld people’s privacy and dignity at all times.

People were encouraged to join in a range of activities to promote their independence, improve their social inclusion and allow them to pursue their own interests. The service had actively increased its links to the wider and local community, to give people a vast range of meaningful activities to be part of.

People had detailed care plans which were regularly reviewed to make sure they had all of their needs met. People, relatives and staff worked together to create packages of care that were individual and person-centred.

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.

Staff followed best practice guidance and worked in partnership with other agencies to make sure people had continuous care. Medicines continued to be managed safely.

Staff continued to be safely recruited and received regular refresher training. New staff to the service were provided with an in-depth induction which provided them with all knowledge and skills needed to safely support people.

The registered manager and provider continued to monitor the effectiveness of the service through robust quality and assurance systems. These systems allowed the service to address issues, provide action plans and improve the quality of care provided to people.

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 04 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor the service through information we receive from the service, provider, the public and partnership agencies. We will re-visit the service in line with our inspection programme. If we receive any concerning information we may inspect sooner.

Red Brick House provides nursing and residential care for up to 50 people, some of whom are living with dementia. At the time of our inspection there were 42 people living at the service including one person who was in hospital and returned to the service on the last day of inspection.

The service had a registered manager in post. 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 told us they felt safe. Staff were aware of their safeguarding responsibilities and told us they would report anything of concern.

Medicines were managed safely and staff had received training and additional support with the introduction of a new electronic medicines system.

Any risks had been identified and risk assessments put in place. The provider had a robust risk monitoring procedure and risks were reviewed regularly and when any issues arose. Where accidents had occurred, they were recorded and monitored by the registered manager.

The premises were clean and there were no malodours. Checks and tests had been carried out to ensure that the premises and equipment were safe such as electrical and gas safety tests and lift maintenance. The registered manager ensured that emergency plans were in place in case of emergencies like flooding or fire and every person in the service had their own personal emergency evacuation plan to aid the emergency service should the building need to be cleared.

Safe recruitment procedures were in place and staff were checked prior to starting work to ensure they were suitable for their role and safe to work with vulnerable people. Staff told us they were well supported and received suitable training to allow them to complete their work safely. The majority of staff had worked at the service for some time or had been appointed from another care home.

A full induction programme was in place and when we checked it was comprehensive, but was not linked to the Care Certificate. The Care Certificate was officially launched in April 2015. It aims to equip health and social care workers with the knowledge and skills which they need to provide safe, compassionate care. It replaces the National Minimum Training Standards and the Common Induction Standards. The provider told us they would ensure that any new staff with no experience of care would complete their induction based on the Care Certificate.

The provider had enough staff on duty to meet the needs of people living at the service and had employed bank staff to support them when shortages due to sickness or holiday occurred. We saw that staff carried out their duties in a calm unhurried manner and were available to provide emotional support to people.

The Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. In England, the local authority authorises applications to deprive people of their liberty. We found the provider was complying with their legal requirements.

We saw that people enjoyed the food prepared for them and were able to confirm this when asked. There was a range of nutritious meals and refreshments were available throughout the day. We saw staff supported people who needed help with eating or drinking.

Staff made arrangements for people to see GP’s and other healthcare professionals when they needed to and we saw evidence of referrals being made on people’s records.

People were treated with dignity and respect. There was a good rapport between people and staff. We observed staff were available in communal lounges to check on people’s safety and wellbeing. People were supported to be as independent as possible with staff encouraging people to do things for themselves.

A wide range of activities were planned for people and staff at the service had recently fund raised and had enough money to purchase a bus for transporting people to community events and activities.

People had their needs assessed and the assessments had been used to develop care plans which were tailored around individuals. People were able to choose what they wanted to do and that included when they got up and when they went to bed.

The home’s complaints procedure was available and on display around the service. Where people or relatives had made a complaint, it had been dealt with effectively.

Staff told us the service had a culture of being open and honest. Relatives told us that the manager and staff were approachable and responsive. People were encouraged to make their views known and the service supported this by holding meetings for people and their relatives and completing surveys.

A range of audits and monitoring tools were used to assess the quality of the service provided. Representatives from the provider organisation regularly visited the home and provided feedback on their observations. Actions identified to improve the service had been carried out and signed off when completed.

The provider had submitted statutory notifications as legally required and had displayed ratings of previous inspections within the service and also on the provider’s website.

People told us they happy with medication administration within the home. One person said, "They (staff) bring my tablets and give them to me on a spoon. I always take them." Another person told us, "They (staff) stand with me while I take my medication."

We found that the provider managed medicines appropriately.

We found that people's care and support needs were appropriately assessed and their care and support was planned. Where people required input into their care from external healthcare professionals this had been arranged.

People received care which reduced the risk of poor nutrition and dehydration. Where necessary, external healthcare professionals had been consulted about people's dietary concerns.

We identified shortfalls in respect of medicine management which meant that people's health and welfare was put at risk.

Care was provided in an environment that was suitable for purpose and adequately maintained. People staff and visitors were protected from the risks associated with unsafe or unsuitable premises.

We found the provider had a structured staff selection and recruitment policy in place which aimed to ensure staff were suitably skilled, experienced and qualified to deliver care safely.

People told us their consent was gained prior to care being delivered and we found that staff acted in accordance with their wishes. Where appropriate we found that the provider acted in accordance with legal requirements if people did not have the capacity to consent themselves.

We found that people's care and support needs were appropriately assessed and their care was planned. They received care safely, and to an appropriate standard.

People were cared for in a clean and hygienic environment and we found that the service had appropriate measures in place to monitor and manage infection control.

There were enough suitably skilled and qualified staff on duty to met people's needs safely and appropriately.

We saw the provider had a complaints policy and procedure in place and people told us they were confident the manager would deal with any complaints they raised.