The Red House Welfare & Housing Society

The Red House Welfare & Housing Society is a residential care home, providing personal care and accommodation for up to 34 people aged 65 and older. The service provides support to older people and people living with dementia. At the time of our inspection 25 people were living in the service.

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

We had rated this service requires improvement and taken additional enforcement action over the last two inspections. At this inspection we found progress had been made. Despite some remaining areas for improvement, such as the need to consistently ensure effective oversight, the service had enhanced leadership and there were improved management systems and governance . The embedding of these new ways of working are now required to ensure consistency moving forward.

We received lots of positive feedback from people living at The Red House Welfare & Housing Society about how safe they felt living at the care home. We also heard from many relatives who told us they felt their family members were well looked after and cared for.

Systems were now in place to manage and mitigate risk and support people's health and well-being. Medicines systems had been reviewed and improvements implemented. People received their medicines safely and in accordance with their prescription.

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 was passionate about their role and making continued improvements of the service. They were open and proactive to any queries we raised during the inspection.

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

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. We have found evidence that the provider needs to make improvements. Please see the well-led section of this full report.

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 The Red House Welfare & Housing Society 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.

The Red House Welfare and Housing Society is a residential care home, providing personal care and accommodation for up to 34 people aged 65 and older. The service provides support to older people and people living with dementia. At the time of our inspection 25 people were living in the service.

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

The systems in place to assess and mitigate risk were not robust. The governance systems were not sufficient to support the provider and management team to independently identify shortfalls and address them.

Recognition and response to potential risk was not always effective. Environmental risks had not been independently identified and therefore people were at risk of harm. There were gaps in employment processes and records and audits had not identified all the issues found on inspection.

There were sufficient staff on duty to keep people safe. People were kept safe from the risk of abuse and staff understood their safeguarding responsibilities.

The registered manager was transparent and committed to learning lessons when things went wrong and improving the quality of care. Throughout the inspection, the registered manager displayed a candid and transparent approach. They spoke openly about challenges and shared the plans they had in place to address them. They responded to our feedback and were making improvements to the service following the inspection.

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 21 December 2019) and there was a breach of regulation. 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.

Why we inspected

This was a planned focused inspection.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Red House Welfare and Housing Society on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed. We have identified breaches in relation to the governance 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 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.

The Red House is a residential care home, providing personal care and accommodation for people aged 65 and older. At the time of our inspection 30 people were living in the service.

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

Quality and safety checks by the manager and senior staff did not always help ensure people were safe and protected from harm.

Staff were trained in safeguarding and knew what to do if they had concerns about people's wellbeing. There were enough trained staff to meet people's needs and people's medicines were administered safely.

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's specific communication needs were known, respected and met.

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 6 February 2019).

Why we inspected

The inspection was prompted in part by notification of a specific incident. Following which a person using the service sustained a serious injury. We are currently making further enquiries about this incident. The information CQC received about the incident indicated concerns about the management of risks associated with the use of wheelchairs. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only. This inspection examined those risks.

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.

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 Good to Requires Improvement. 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 The Red House Welfare and Housing Society on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered person failed to ensure risks relating to the safety, health and welfare of people using the service were assessed and managed. Please see the action we have told the provider to take at the end of this report.

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.

The Red House is a residential care home, providing personal care and accommodation for people aged 65 and older. At the time of our inspection 29 people were living in the service.

People’s experience of using this service:

People were safe living in the service. Risks had been identified and people told us they felt safe and well looked after.

Staff were kind and caring and supported people to be as independent as possible.

People had access to healthcare professionals when required.

Staff knew how to care for people. Staff used their skills and the resources and equipment provided so they risk of accidental harm or infections was reduced. People were supported to have the medicines they needed to remain well and as prescribed.

People were supported to eat and drink. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The registered manager had clear oversight of the service and worked alongside staff. Staff were respectful of the register manager and told us they were approachable and supportive.

We found the service continued to meet the characteristics of a “Good” rating in all areas; More information is available in the full report.

Rating at last inspection:

Good (The date of the last report published was 19 July 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor this service in line with our re-inspection schedule for those services rated as Good.

There were 26 people living in the service when we inspected on 20 June 2016. This was an unannounced inspection.

There was a registered manager in post, who was also a provider. 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.

There were procedures and processes in place to ensure the safety of the people who used the service. Risk assessments provided guidance to staff on how risks to people were minimised. There were appropriate arrangements in place to ensure people’s medicines were stored and administered safely.

Staff were available when people needed assistance, care and support. The recruitment of staff was done to make sure that they were suitable to work in the service and people were safe. Staff were trained and supported to meet the needs of the people who used the service.

The service was up to date with the Mental Capacity Act (MCA) 20015 and Deprivation of Liberty Safeguards (DoLS). People’s nutritional needs were assessed and met. People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

Staff had good relationships with people who used the service and were attentive to their needs. Staff respected people’s privacy and dignity and interacted with people in a caring, respectful and professional manner. People and/or their representatives were involved in making decisions about their care and support.

People were provided with personalised care and support which was planned to meet their individual needs. People were provided with the opportunity to participate in activities which interested them. A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

There was an open and empowering culture in the service. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system and shortfalls were addressed promptly. As a result the quality of the service continued to improve.

At this follow up inspection we found improvements had been made. During our inspection on 11 April 2013 we saw that people who used the service or their representatives had consented to the care plans in place. People's individual risk assessments had all been reviewed and updated within the past three months.

We found that people's personal care needs were being met. There were suitable arrangements in place that ensured people's dignity was maintained. We saw people's rights to independence and personal choice were being maintained and people were supported by caring and well trained staff.

One person told us, "I like living here as there is always someone to talk to and before I moved here I was lonely living at home on my own ." Another person told us, "Although staff are always busy they always come when I call them and I never have to ask for anything more than once." We were told by two people that they considered that The Red House offered "Good value for money."

Three staff told us that they considered the new relief manager both approachable and professional and they had provided them with a good system of support which enabled them to carry out their role effectively and safely.

People told us that they were able to choose what activities they liked to do and another person told us that they 'Liked the choice of meals provided'. One person told us that "I like all the staff and I am happy here."

We found that some care plans had not been updated since 2011 and there were inadequate systems in place that identified and recorded people's individual risks.

We found that people had not been fully assessed when they moved into the service with regard to their nutritional needs.

Some people had not signed or consented to the content of their care plans.

We found that all 12 relatives that responded to a questionnaire completed by the service in 2012 considered the Red House to be a homely and caring environment. One person stated that 'There is always love and warmth in this home.' Another person commented that 'There is a great community spirit here.'

We found that the service was meeting the personal, emotional and healthcare needs of people using the service. We found that the environment was maintained safely and odour free and that all health and safety checks were up to date.

Four people told us that they found the standard of meals was good with one person stating that 'The food here is like old fashioned home cooking, just how I like it and nothing is too much trouble. I can even have wine if I want it.'

People told us that they had been able to bring in personal items from their own homes in order to make their bedrooms more familiar and homely.

We found that not all mandatory training was up to date.