Rushall Care Home

Rushall Care Home is a residential care home providing personal and nursing care to up to 39 people. The service provides support to younger adults and older people some of who mahy be living with dementia. At the time of our inspection there were 36 people using the service.

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

People were safeguarded from the risk of abuse and felt safe living at the service. Where people had risks to their safety these were assessed, and plans put in place to minimise them. There were enough suitably qualified staff available to meet people’s needs. People had support to take their medicines as prescribed and risks from infection were minimised as staff understood how to prevent cross infection. Where incidents occurred, these were reviewed, and learning applied to prevent reoccurrence.

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.

People relatives and staff all spoke positively about the service and the management team. Staff were supported and received updates to their training as needed. The registered manager had a good oversight of the service and used feedback to learn and improve the quality of the care people received. The registered manager understood their role and responsibilities and had worked in partnership with other agencies to support people. There was a system in place to ensure any improvements needed were identified and the registered manager ensured there was an action plan in place to make the required changes.

Rating at last inspection and update

The last rating for this service was requires improvement (published 7 September 2022)

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook a focused inspection to review the key questions of safe and well-led only.

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 requires improvement to good based on the findings of this inspection.

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

Follow up

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

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

Rushall Care Home is a residential care home providing accommodation for persons who require nursing or personal care personal to up to 39 people. The service provides support to older people some of whom have dementia. At the time of our inspection there were 34 people using the service.

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

Risks regarding pressure care deterioration where not always mitigated. People did not always receive the support they needed from staff with repositioning. Maintenance concerns were not always reported. People’s medicines were not always stored safely. Staff were recruited safely and received an induction. Infection control procedures were in line with current government guidance. People said they felt safe in the home and staff knew how to raise safeguarding concerns.

The provider’s systems and processes to provide oversight of the service delivery were not always sufficiently robust. The provider worked with external professionals though feedback from them was not always positive.

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.

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 19 February 2021).

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 the provider remained in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to tissue viability, repositioning records, weight loss, management of the home and reporting of safeguarding concerns. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 remained 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 report.

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

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

We have identified breaches in relation to repositioning of people with pressure care needs and the registered managers oversight systems at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Rushall Care Home is a residential care home providing personal and nursing care to 35 people aged 65 and over, at the time of the inspection some of whom were living with Dementia. The service can support up to 39 people.

The home is set over three floors with access to all floors through a lift. There are communal areas on each floor for people to access.

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

Whilst many aspects of medicine management were safe, we determined that further improvement was needed in some areas.

People had not received a service that was consistently well led. Whilst there were systems to monitor the quality and safety of the service, we found these needed further improvement. There was a new manager at the service who had identified these improvements were needed. Further time was needed to enable the planned improvements to be put into practice.

People were supported by staff who were knowledgeable about how to recognise and escalate safeguarding concerns. Staff were recruited safely and there were systems in place to determine safe staffing levels.

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 01 December 2018)

Why we inspected

We received concerns in relation to the management of pressure care and infection control practice. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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

We have found evidence that the provider needs to make improvement.

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

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 coronavirus and other infection outbreaks effectively.

Follow up

We will request an action plan for 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.

At our last inspection in August 2015 we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This unannounced, comprehensive inspection took place on the 31 October 2018. Rushall Care Home is registered as a ‘care home’ with nursing. 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.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, 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.’

People were safe from harm and abuse. Staff understood how to spot signs of abuse and how to report concerns. Risks to people were assessed and managed. Staff were available to meet people’s current needs. People received their medicines as required. Staff wore personal protective equipment (PPE) when required and the home was kept clean and tidy.

People continued to receive effective support from staff that had the skills to meet their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were encouraged to eat a healthy diet and ensure they had sufficient amounts to eat and drink. People had access to health professionals when required.

People continued to receive a service that was caring. People were supported by staff who knew them well and respected their privacy. Staff encouraged people to be as independent as possible.

People continued to receive a responsive service. People were involved in their assessments and regular reviews of their care needs. People’s care plans were personalised and included their likes, dislikes and preferences. People were supported to engage in both group and individual activities that they enjoyed. There was a process in place to respond to any concerns or complaints.

The service continued to be well-led. There were systems in place to ensure people received good quality care and improvements were made as required. People and staff were encouraged to give feedback and were kept informed and involved in any changes within the home. The provider worked closely with other agencies and professionals.

Further information is in the detailed findings below