Robin Hood House

Updated 19 November 2022

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

The inspection was carried out by two inspectors.

Service and service type

Robin Hood House is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. Robin Hood House 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 sought feedback from the local authority and professionals who work with the service. 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 four people who used the service and two relatives. We spoke to seven staff members including care staff, senior staff, deputy manager and registered manager. In addition, we spoke to the chef and the provider’s operations manager and managing directors.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed six people’s care records, staff recruitment files, medicine records and other documents relevant to the management of the service.

Updated 19 November 2022

About the service

Robin Hood House is a residential care home providing personal care to 19 people aged 65 and over at the time of the inspection. The service can support up to 23 people.

The home accommodates people over three floors. People had access to various communal areas, such as lounges and dining rooms, where they could spend their time in private or with others. The home had a generous garden and surrounding countryside views which people could enjoy from their bedroom windows.

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

Risk to people were not always fully mitigated. Risk assessments in place were not always completed fully to indicate the level of risk to people’s health or well-being. Guidance for staff was not always in place to help support people safely to manage the medical conditions they lived with. Medicines were not always managed safely. There were not enough staff to keep people safe. Staff were allocated additional tasks like meal preparation which took the support away from people in the communal areas. We found a high number of falls in the home were unwitnessed and in communal areas.

Care records were not always up to date and not completed in enough detail to ensure staff could fully meet people’s needs. Governance systems in place were not always effective in identifying areas in need of improvement. Lessons learnt process was not embedded in daily practice to ensure continuous learning and improvement of care practices.

People and relatives were positive about the staff team and management in the home. People told us they felt safe. However not all safeguarding incidents were reported to the local authority or CQC.

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. However, a detailed record of the least restrictive methods considered for people who had one to one support in place was not kept.

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

Rating at last inspection

At the last inspection the service was not rated (published 22 March 2022.). The last rating for this service was good (published 08 August 2020).

Why we inspected

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.

The inspection was prompted in part due to concerns received about medicines, pressure care, falls and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only and examine those risks.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

The provider developed a service improvement plan following the inspection to ensure they effectively planned the improvement needed. They also increased staffing for day and night shift to ensure the safety of the people in Robin Hood House.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.