Rush Hill Mews

Rush Hill Mews is a residential care home providing regulated activities accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury to up to 62 people. The service provides support to people living with dementia, a physical disability and older and younger adults. At the time of our inspection there were 57 people using the service.

Rush Hills Mews provides purpose-built accommodation over three floors, each floor can be accessed using the lift or stairs. Bedrooms are en-suite and there are additional communal toilets and washing facilities on each floor. There is level access to a large well-maintained garden and communal dining and lounging spaces throughout.

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

People told us they were safe. We found there were systems and processes in place to help protect people from the risk of avoidable harm and abuse. There were sufficient numbers of safely recruited staff to meet people’s needs. Staff spoke positively about the service and people they supported. Overall medicines were managed safely; however we found some recording errors. The registered manager said they would support staff with additional training. Food and fluid monitoring was not always consistent. We found no impact on people and the registered manager said they would work to rectify this shortfall.

There were systems in place to monitor and improve the quality and safety of care provision in the service, overall these were used effectively to drive improvement. Statutory notifications were submitted to CQC in line with statutory requirements. The provider engaged with stakeholders and had oversight of the service. A local Church visited and held regular religious services. The activities coordinator had a plan in place to drive improvement in relation to activities provision.

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 May 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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

This service has a dual registration which means there are two registered providers jointly managing the regulated activities at this single location. They are WT UK Opco 4 and Care UK Community Partnerships Ltd. This means the service is subject to one inspection visit however the report is published on our website twice, under each provider.

We found the following examples of good practice:

¿ The service was clean and fresh, the daily cleaning routines had been reviewed and enhanced during the pandemic, these now included a number of additional tasks, such as cleaning of any regular touchpoint surfaces.

¿ There were safe arrangements in place for both professionals and people’s relatives visiting the service. These included a requirement to present a confirmed negative result of a lateral flow device test (LFD) and a COVID-19 vaccination pass. Visitors were reminded about the requirement to wear the required personal protective equipment (PPE) and ensuring hand hygiene and sanitisation.

¿ All staff had received training and followed correct infection control and were observed using appropriate PPE.

¿ The provider ensured people were supported to see their relatives safely and in line with the government guidance. The provider introduced a designated visitors' room that was divided by a screen and had a separate entrance for visitors as an alternative to visiting people in their bedrooms

¿ The registered manager reported good support from the local health and social care professionals and the provider’s head office.

Gracewell of Bath has a dual registration. Which mean two providers, Gracewell Healthcare Limited and Gracewell Healthcare 3 Limited are jointly responsible for service delivery at the one location.

Gracewell of Bath is a purpose built establishment; it provides care and support for up to 62 people. The service provides care over three separate floors depending on their level of need; Poolside (residential), Sulis Way (dementia care) and Globetrotter (nursing). Each floor has its own lounge, dining room and utility kitchen. All bedrooms are single with en-suite toilet facilities. At the time of our inspection, there were 43 people living in the home.

Staff supported people living with dementia; however there was limited evidence of the development of the environment for people with specific needs affected by their condition. We have made a recommendation about the development of the environment to meet the specialised needs of people living with dementia.

There was a registered manager in post at the service. 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.

Medication Administration Records were completed accurately and guidance was in place for people who were prescribed 'as required' medication. People told us they were happy with how their medicines were managed and received this when they needed it.

Risk assessments were detailed and contained sufficient information to guide staff on how to minimise the risk of harm for people who lived at the home.

Fire procedures in the event of an evacuation were clear and regular mock fire drills were completed.

Checks were completed to ensure the environment was free from hazards.

The training records showed staff had received relevant training to ensure they had the skills to support people effectively. Our discussions with staff showed that they had a good knowledge about the people they supported and understood people's individual 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 supported this practice. The service operated within the principles of the Mental Capacity Act 2005 (MCA). Our review of records showed that processes were in place to assess people's capacity and make decisions in their best interests.

People were supported to maintain good health and well-being. The home had a good relationship with a local GP and had regular dialogue with the local community mental health team. Referrals were made promptly to health professionals such as speech and language team, the dietician and tissue viability nurses.

People told us they enjoyed the food served at the home. Staff knew, and catered to, people's individual dietary needs and preferences. Nutritional risk assessments were completed and diet and fluid charts were in place for those who required them.

We observed kind and compassionate interactions between staff and the people they supported. Staff offered reassurance to people in distress. People told us they liked the staff that supported them. Care plans were personalised and evaluated monthly. We noted that any changes in people's needs were documented and actioned appropriately.

A complaints policy was on display in the home, which contained details for the local authority and Local Government Ombudsman if complainants were not happy to go to the provider. People told us they would not hesitate to raise concerns with the registered manager if they felt they needed to. Complaints were documented and managed in accordance with the registered provider's complaints policy.

Quality assurance systems were effective and measured service provision. Regular audits were completed for different aspects of the service such as medication, care plans and accidents and incidents. Opportunities were provided for people and their relatives to provide feedback on their experience of the care provided and contribute to improving the service delivery. This included quality assurance surveys, a suggestion box, residents, and relatives meetings.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with statutory requirements.