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Russell Court Requires improvement

We are carrying out a review of quality at Russell Court. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 26 March 2021

During a routine inspection

About the service

Russell Court is a care home providing personal and nursing care for up to 42 people, some living with dementia, in one adapted building. The service accommodates people across two floors. At the time of the inspection on the 26 March 2021, 19 people were living there and this had reduced to 16 people by the 30 March 2021. The service plans to specialise in becoming a short-term, step down service for people discharged from hospital who are not quite well enough to return home.

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

At the last inspection we had identified breaches in regulations 12, safe care and treatment and 17, good governance. We found at this inspection improvements had been made, although there were some further improvements required.

Care plans and risk assessments had been, or were in the process of being, reviewed. There was some further improvement to be made to ensure people’s assessed needs and identified risks were consistently and accurately recorded. People felt safe. Risks associate with COVID-19 were assessed and mitigated. Medicines were managed safely. Staff understood safeguarding and safeguarding concerns were referred to the local authority. Incidents and accidents were monitored for future learning. There were enough staff on duty to meet people’s needs and recruitment processes were in place to safely recruit staff.

Staff felt supported by the new management team and the running of the home had improved since its last inspection. Staff had started to receive supervision to help them in their roles and training had been completed or in the process of being arranged for them. We found there was good communication with healthcare agencies.

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.

People told us they were offered a choice of meals and drinks. We saw any changes to people’s dietary requirements had been promptly referred to the GP or dietician. There were no concerns raised about the home environment.

We saw kind and caring staff interactions with people. This was supported with the compliments we saw the service had received. People told us staff respected their wishes and choices and had ensured their dignity independence was promoted.

Complaints processes had been improved to make sure feedback was used to learn from and to help improve the quality of the service. The service had processes in place to support people, who were deemed to be at the end of their life, with a dignified and respectful death.

Everyone spoken with said the new manager had improved the service's communication and systems were in place to gather their feedback to help improve the quality of the service and to help inform person-centred care. The provider understood their regulatory responsibilities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection and update:

The last rating for this service was inadequate (published 06 January 2021 and update published ?? April 2021) and there were 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.

This service has been in Special Measures since January 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question.

Inspection carried out on 12 November 2020

During an inspection looking at part of the service

About the service

Russell Court is a residential care home providing personal and nursing care up to 42 people. As part of the local area’s response to the COVID-19 pandemic, the service had agreed with a local hospital to reserve 21 of the care home beds for people recently discharged from hospital. People went into isolation in their rooms on arrival to the home, due to risks associated with COVID-19. Some people were recovering from COVID-19 and following a hospital stay.

There was a quick turnaround of people staying at the home, with some people staying for a short period of a number of days or weeks. On the first day of our inspection, the service was supporting 23 people and on the second day of our inspection six days later, the service was supporting 30 people. Two people lived at the home on a longer-term basis.

People were accommodated in one building that had been adapted to provide designated areas for people with and without COVID-19, to help reduce the spread of infection. People who joined the service with a positive COVID-19 test were cared for in a separate wing which was designated for people with COVID-19 to reside in. There were additional wings and areas of the home designated to care for people who did not have COVID-19.

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

We identified a breach in relation to safe care and treatment because people’s risks were poorly assessed and we found widespread, significant concerns as to how the service managed people’s medicines and the risks associated with COVID-19. Incidents were not learned from to help improve the safety of the service. Though we saw staff were aware of safeguarding concerns being referred to the local authority, not all staff had received safeguarding training and not all staff understood their responsibilities in protecting people from abuse. Feedback indicated there were enough staff to meet people’s needs and on the whole, recruitment processes were safe. We asked the provider to immediately address shortfalls where they posed risk of harm to people. Although the provider gave us assurances they would do so after the first day of our inspection, our second site visit six days later found continued shortfalls in this area and additional ways that people and staff were being exposed to risk of significant harm. The provider could not demonstrate that people’s risks were consistently well managed. However, we saw some examples of how people’s risks and needs were responded to appropriately.

We identified a second breach of the regulations due to the provider’s poor systems and oversight of the quality and safety of the service. Despite the provider’s role in the local response to the pandemic and supporting people with COVID-19, they had not ensured their service was fit for purpose to safely meet people’s needs and manage infection risks. We needed to ask for immediate concerns around infection control to be addressed. We saw additional widespread concerns in relation to care planning to meet people’s individual needs and wishes. At the time of the inspection, relatives described the service’s communication as poor and we found there were no systems in use to effectively gather feedback to improve the quality of the service or to help inform person-centred care. The provider understood their regulatory requirements. The provider acknowledged our concerns and after our inspection, decided to suspend further admissions to the home whilst they addressed concerns with input and support from the local authority.

Staff told us they felt supported and welcomed recent improvements to the home. However, the provider’s training plans had not been maintained to ensure all staff received the training and supervision required for their roles. Poor quality care records, combined with staff training gaps, did not give us assurance that people’s needs could be effectively met at all times. Care staff and nurses described good communication