Rutland House Care Home

Updated 28 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Rutland House Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Rutland House Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people using the service, 3 relatives and a visitor to the home. We asked them for their feedback about the service. We observed interactions between people and staff to understand people’s experiences. We also spoke with the registered manager, 2 care support workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 4 people's care records, medicines stock and administration records (MARs), 3 staff recruitment files and other records relating to the management of the service.

Updated 28 July 2023

About the service

Rutland House Care Home is a residential care home providing personal care to up to 20 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 15 people using the service.

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

The provider was not working within the principles of the Mental Capacity Act. They had not obtained legal authorisations to deprive people of their liberty, where required. This meant people were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service at the time of this inspection did not support this practice.

Risks to people’s safety were not always managed well. One person had recently started using the service, but the provider had not assessed risks to their safety and wellbeing at the service. This meant there were no risk management plans for staff to follow, to reduce the risk of injury or harm to the person and/or to others. However, staff had been provided information about risks to other people’s safety and wellbeing. They understood these risks well and what action they should take to help keep people safe.

The provider’s governance systems were not entirely effective, because the provider had not identified and taken action to address the issues above through their own audits and checks. We also found some records were out of date or incomplete because some information about people’s medicines was out of date, some staff files were missing key information about recruitment decisions, and some records relating to the servicing and maintenance of systems and equipment did not contain current information.

The provider took responsibility for the issues we found and responded immediately after the inspection to make improvements that were required. This included submitting applications to deprive people of their liberty to the appropriate authority and putting risk management plans in place for the person that recently moved in.

Staff had been trained to safeguard people from abuse and understood when and how to report safeguarding concerns to the appropriate authority.

There were enough staff to support people and meet their needs. Recruitment and criminal records checks were undertaken on staff to make sure they were suitable to support people. The provider was taking action after this inspection to make sure decisions to employ staff, before all the relevant checks had been completed, were suitably risk assessed and documented.

Health and safety checks were carried out of the premises and equipment to make sure they were safe. The service was clean and hygienic because staff followed current infection control and hygiene practice, to reduce the risk of infection. People’s relatives and friends were free to visit without any unnecessary restrictions.

Medicines were managed safely, and people took their medicines as prescribed. The provider was taking action after this inspection to make sure guidance for ‘as required’ medicines was reviewed, in a timely way, in line with their own policy.

People were satisfied with the care and support they received from staff. People’s feedback indicated staff were kind, caring and they treated people well.

People and staff spoke positively about the management of the service. The registered manager was experienced and understood how people’s needs should be met. Staff felt valued and well supported by the management team at the service.

There were systems in place to obtain feedback from people, staff and others about how the service could be improved. Accidents, incidents and complaints were fully investigated, and people involved and informed of the outcome. Lessons learnt were shared with staff to help them improve the safety and quality of care and support provided.

The provider worked with healthcare professionals involved in people’s care and acted on their recommendations to deliver care and support that met people’s needs.

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 good (published 14 February 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.

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 full report.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding service users from abuse and improper treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.