Archived: Russell Green Care Home

We conducted an unannounced inspection of the service on 3 May 2016. There were 16 people living in the home and 17 people using the homecare service on the day of our inspection.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (‘the provider’) they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection, no one using the service was subject to a DoLS order or application.

Staff knew how to recognise signs of potential abuse and how to report any concerns. Staff were also aware of the MCA but the provider’s use of ‘best interests’ decision-making processes to support people who lacked capacity to make some decisions was not consistently effective.

Action was also required to improve systems of communication and decision-making between the directors of the registered provider and the registered manager.

Staffing levels were sufficient to support people safely and effectively. Staff were appropriately recruited to ensure they were suitable to work with vulnerable people and received the training and support they needed to meet people’s needs and preferences. The provider encouraged staff to study for advanced qualifications.

People were cared for safely and were treated with dignity and respect. People were able to access a range of healthcare professionals when they required specialist support and their medicines were managed safely.

People and their relatives were closely involved in planning the care and support provided by the service. Staff listened to people and understood and respected their needs. Staff worked with each other in a friendly and supportive way and reflected people’s wishes and preferences in the way they delivered care.

People were supported to enjoy a range of activities and pursue their personal interests. Food and drink were provided to a good standard.

People and their relatives knew how to raise a concern and were confident that the provider would respond positively in response to any feedback received. There were systems in place for handling and resolving formal complaints and the provider regularly assessed and monitored the quality of the service provided.

Is the service caring?

People who used both service said that staff were respectful, kind and attentive.

Is the service responsive?

We saw that people's individual needs for care were assessed so that they could be fully met. People were involved in making decisions about the care they received and were supported to give informed consent.

Is the service safe?

Staff had understood their roles and responsibilities to ensure that people were protected from the risk of abuse. People were protected against the use of unlawful or excessive control or restraint because the provider had made suitable arrangements. No one was having their liberty restricted at the time of our inspection visit.

Is the service effective?

We found that staff knew people's individual personal and healthcare needs. Both in the care home and in their own homes people received the care they needed.

Is the service well led?

The quality assurance system helped to ensure that people using both services received care in a reliable, consistent and safe way.

People's privacy, dignity and independence were respected. Staff were courteous and polite.

Some of the care provided for people living in the care home was not robustly planned and was not delivered in a safe way.

People were protected against the risks of unsafe or unsuitable premises.

Some of the necessary security checks on staff had not been completed. This reduced the confidence people could have that only suitable and trustworthy people were employed.

Although quality checks had been completed some of them had not been sufficiently robust. This had resulted in some people being placed at increased risk of not receiving all of the care they needed.

We looked at six people's care records, three who lived in the home and three who received care in their own home. We spoke with registered manager of the care home and the provider. We also spent time talking to staff and observing how people were supported.

People received individualised care and support, from staff who were knowledgeable about their needs, wishes and preferences. However records of staff induction training and supervision were not always completed in an appropriate way.

People told us they felt safe living at the home and were asked for their consent for any care given to them. They told us they could make choices and decisions about the care they received and their privacy and dignity was always respected. They also told us they knew how to make a compliant if they needed to.

People who used the services made comments such as, 'Very caring staff', 'Excellent, can't fault them [staff]' and 'The manager and the owner are very good, they listen to what you have to say and sort it out.'

Relatives told us things like, 'I'd give them [staff] a five star plus for what they do' and 'I feel reassured by the service and confident in the honesty of the staff.'