10 January 2023
During an inspection looking at part of the service
Restgarth is a residential care home providing personal and nursing care to up to 32 people. The service provides support to people of all ages with a range of health needs, physical disabilities and people living with dementia. At the time of our inspection there were 26 people using the service.
People’s experience of using this service and what we found
Medicines were managed by an electronic system. The system helped support staff to administer medicines safely. One of the prompts for this focused inspection was that CQC had been informed of a recent medicine administration error. We found appropriate action was being taken to help ensure this did not reoccur.
CQC had received concerns about the lack of management and leadership support prior to this inspection. The service had been without a registered manager since August 2022. A newly appointed manager was in post at the time of this inspection. They had been at the service for a few days prior to this inspection and intended to apply to become the registered manager.
The two deputy managers had worked hard to lead the staff team in the absence of a registered manager. Ensuring staff support and training and regular audits continued to take place.
CQC had received concerns about staffing levels. The service was fully staffed at the time of this inspection. Staff were recruited safely in sufficient numbers to ensure people’s needs were met. People were supported by staff who had completed an induction, training and were supervised.
We looked at infection prevention and control and found we were somewhat assured that the provider was protecting people, staff and visitors from the risk of infection. Several unnamed hoist slings were found hanging in the communal bathrooms. The sharing of slings poses a potential infection risk. These were removed by the manager at the time. We have made a recommendation about this in the safe section of this report.
Some people living at the service were cared for in bed due to their health care needs. These people had been assessed as requiring pressure relieving mattresses to help ensure they did not develop pressure damage to their skin. The audit of these mattress settings was not always effective. We have made a recommendation about the audit process at Restgarth in the well led section of this report.
Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. People’s communication needs were identified.
People told us they were happy with the care they received, and people said they felt safe living there. Comments from people included, "The staff are all lovely," "The food is particularly good here and it is all very clean everywhere," "It is all well organized, I can't think of anything that could be better."
People looked happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service. People were seen to be engaging in activities during 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.
Staff knew how to keep people safe from harm. People and relatives confirmed they felt the service was safe.
Staff received appropriate training and support to enable them to carry out their role safely, including nutritional support and dementia care.
The environment was safe, well decorated and appointed. There were no malodours. Cleaning processes were thorough.
People had access to equipment where needed. Equipment was regularly checked and serviced.
People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.
Records were accessible and up to date. The staff knew people well and worked together to help ensure people received a good service.
People and their families were provided with information about how to make a complaint. People had been asked for their views and experiences and responses had been positive.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was good. (Published 26 August 2022)
Why we inspected
We received concerns in relation to staffing levels and lack of consistent leadership. There had been a medicine error and some safeguarding concerns were being investigated by the local authority. 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 not changed following this inspection. We did not identify breaches of regulations but have made recommendations in this report and the well led section of this report has been rated requires improvement.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Restgarth 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.