Background to this inspection
Updated
13 August 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.
Service and service type
Randolph 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.
Notice of inspection
This inspection was announced from outside the service on the day of inspection. We did this to discuss the safety of people, staff and inspectors with reference to Covid-19.
What we did before 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 including an independent consumer champion for health and social care services in England. 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 two people who used the service about their experience of the care provided. We spoke with seven members of staff including a senior care worker, care workers, the regional operational manager, regional quality assurance manager and registered manager.
We reviewed a range of records. We looked at multiple medication records and a variety of records relating to the management of the service, including policies and procedures were reviewed. We also looked at three staff files in relation to recruitment and staff supervision.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records. We spoke with two professionals who visit the service and two relatives about their experience of the care provided.
Updated
13 August 2020
About the service
Randolph House is a residential care home providing accommodation and personal care to up to 70 older people some of who have dementia or a physical disability. At the time of the inspection 35 people lived at the service.
People’s experience of using this service and what we found
Improvements had been made to ensure people received their medicines safely. Medicine administration record (MAR) were completed and medicine audits ensured any errors were actioned timely.
For people who had ‘as required’ medicines, the process of recording when medication had been administered was not consistent.
We have made a recommendation about recording ‘as required’ medicines.
Staff were recruited safely. Checks were completed to ensure they were safe to work with vulnerable people. They received an induction, training and shadowing prior to starting work.
People were supported by staff who knew them well which enabled positive relationships to develop. One resident told us, “The staff are all really good, they are smashing.”
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.
The registered manager and staff had a clear understanding of their roles and responsibilities and staff understood when to escalate any concerns for further investigation and transparency.
There was a positive approach to continuous improvement in the service. Regular checks, audits and feedback were reviewed to ensure standards were maintained. Where improvements were required, these were actioned to ensure the safety and quality of the service people received.
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 requires improvement (published 24 April 2019) and there was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Randolph House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.