28 June 2023
During an inspection looking at part of 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 We also found some records were out of date or incomplete because some information about people’s medicines was out of date, some staff files were missing key information about recruitment decisions, and some records relating to the servicing and maintenance of systems and equipment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.