Robinson House Care Home

Updated 14 February 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector, an assistant inspector and an Expert by Experience on the first day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day of the inspection was carried out by one inspector.

Service and service type

Robinson House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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. This included two GPs, the care home liaison team, the dementia wellbeing team, commissioners and an advocacy service.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and ten relatives about their experience of the care provided. We spent time throughout the visit observing how people were supported and cared for including over the lunchtime.

We spoke with the manager, the deputy manager, three senior managers for Brunelcare and seven care staff including a nurse.

We reviewed a range of records. This included five people’s care records and multiple medication records and daily recordings for people. We looked at three staff files in relation to recruitment and training and supervision for the whole team.

We looked at a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider and the manager to validate evidence found. We looked at training data and quality assurance records which had been sent to us via email.

Updated 14 February 2020

About the service

Robinson House is a care home providing personal and nursing care for up to 70 people. The service is provided in one building, which was divided into four houses, Blaise, Dundry, Clifton and Ashton. Two of the houses were on the ground floor and the other two were on the first floor. At the time of our inspection, there were 69 people using the service.

The service had two flexi beds, which supported people in the community that had gone into crisis, and two end of life beds. The service worked closely with commissioners of the services to support these very vulnerable people and their families.

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

People continued to receive a safe service. Risk assessments were carried out to enable people to receive care with minimum risk to themselves or others involving health and social care professionals. People received their medicines safely. However, there were some gaps in the recordings of topical cream. The manager said they would take appropriate action to ensure there was no gaps in the recordings and had already put in a system of daily checks.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Where safeguarding concerns had been raised these had been addressed.

Systems were in place to ensure people were safe including safe recruitment processes. There was sufficient staff to keep people safe and respond to their needs.

People continued to receive effective care. Staff had the skills and knowledge required to support

them. Staff received training and support that was relevant to their roles. There were some gaps in the frequency that staff received supervisions. However, the new manager was aware and had developed an action plan to address.

People's healthcare needs were monitored by the staff. Other health and social care professionals were involved in the care and support of the people living at Robinson House. Feedback from health and social care professionals was positive in respect of the care delivery, timely referrals and following their advice.

The home was homely, clean and met the needs of people they were supporting including those people living with dementia.

Care was person centred and based on the wishes of the individual. Relatives had been involved in how their loved ones were supported. There was good communication between staff and relatives. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were supported to have meaningful occupation and had access to daily organised activities. Homemakers were responsible for helping with social activities, either in small groups or individually with people. Staff were attentive in their approach and showed empathy. They knew people well.

People were involved in making decisions, had access to a complaints procedure and their views sought through surveys and care reviews. The service had been accredited with the Gold Standard Framework for their end of life care. Staff supported people exceptionally well in this area continuing to provide a very person-centred approach, taking into consideration the wishes of the person and their family.

There were various systems in place to ensure that aspects of the service were quality assured and actions taken, where shortfalls were identified. The provider was very much part of the service, driving improvements and supporting the team. The manager and staff worked with other organisations for the benefit of people using the service. The new manager and provider had developed a robust action plan to drive improvements and was planning to spend more time in the home working alongside staff enabling them to get to know people.

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

Rating at last inspection

The last rating for this service was good (published on 7 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Robinson House on our website at www.cqc.org.uk.