Archived: Redlands Care Home

Throughout this inspection we focused on these five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were not cared for in an environment that was clean and free from the risk of the spread of infection. Bedrooms were odour free but required more substantial cleaning that was currently being provided. Bathrooms and toilets were clean but required maintenance work to reduce the risk of the spread of infection. Communal areas were tidy, but also required cleaning. Outside areas were poorly maintained and laundry was dried outside in an area that contained litter and next to a dirty staircase.

Staff provided care for people in a way that safe and met their needs. They were patient and friendly and had a good knowledge of each person's needs. A person who used the service said, 'I do feel safe.'

There was guidance in place for staff to follow to assist a person living with diabetes. Staff also had good knowledge of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005. Correctly applied DoLS make sure that people in care homes are looked after in a way that does not inappropriately restrict their freedom. The safeguards should ensure that care homes only deprive someone of their liberty in a safe and correct way, and that this is only done when it is in the best interests of the person and there is no other way to look after them.

The low numbers of staff posed a risk to the safety of people who used the service. In addition to their caring role, care assistants were also expected to carry out domestic duties as well cooking and the laundry.

Is the service effective?

People were asked for their consent and staff acted in accordance with their wishes. However, assessments of people's capacity to support decision making were not always completed where required by the Mental Capacity Act (MCA). The MCA is legislation used to protect people who might not be able to make informed decisions on their own about the care and support they received.

End of life care was discussed with people who used the service and/or their relatives. However a decision had been made not to resuscitate a person. This decision was not supported by the correct legal documentation which meant that emergency or medical services might not be able to act in accordance with the person's wishes.

Is the service caring?

Staff provided care in a caring manner. We observed staff assist people with eating and drinking and when possible stopped to talk to people.

Is the service responsive?

A relative we spoke with said, 'My family member has never told me they are unhappy or in pain. We have seen a definite improvement in their well-being since the moved here. They [staff] look after my family member really well.'

GP's and external professionals were requested to attend to people's needs in a timely manner.

Is the service well-led?

There had been some improvement on the review process to identify, assess and manage risks to the health, safety and welfare of people who used the service, however there were still risks to people's safety that had not been addressed. The lack of maintenance of the environment people lived in, the lack of staff numbers and poor standards of cleanliness meant people's safety and wellbeing were placed at risk.

Care planning documentation had been reviewed but the content of the reviews was limited. There were no details recorded of who had been consulted in relation to the review or what had been discussed.

'I have never been cold here, I'm very happy and the food is good.' 'The staff particularly the owner is like a son to me and very kind'. And, 'I enjoy the food.'

We found that improvements had ensured that each person who used the service had an up to date plan of care in place to enable staff to monitor their needs and provide care and support to meet their needs.

We found we had concerns that the manager had no system in place that would ensure care plans would be effectively kept up to date. We also found that appropriate changes were not being made to act on the advice of an infection control audit report provided by Nottinghamshire County Council.

We found that the provider had made some improvements since our last inspection, ensuring that staff recruitment was undertaken in accordance with essential standards and the health and safety systems protected people who used the service.

However, we found that the maintenance of appropriate standards of cleanliness and hygiene in relation to the premises and equipment did not safeguard people who used the service from infection.

We found that the provider had taken some steps to provide care in an environment that was adequately maintained but more needed to be done to take account of identified risks and ensure that some areas were adequately maintained. Records for the care, treatment and support of people who used the service were not properly managed because they were not always accurately completed and they were not stored safely.