Red House Residential Home

Updated 14 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 19 June 2018 and was unannounced. The inspection was planned in line with our methodology and within the specified return date to check improvements made since the last inspection.

The inspection took place over one day but additional information was requested following the inspection. We also spoke with several people and a staff member following the inspection.

The inspection was undertaken by two inspectors and one expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. We received a provider information return before our inspection which gives us information about the service and what is in place to meet the required key lines of enquiry we inspect against. We reviewed information already known about the service such as previous inspection reports and notifications which are specific events the service is required to notify us of.

The service provides two regulated activities but only has one registered location. We inspect against the location so looked at both elements of this service but are only required to complete one inspection report. For the domiciliary care service which currently supports 20 people we spoke with two staff and met a further three staff. We carried out visits to three people and spoke to a further two over the telephone. We met one relative. We reviewed care plans and risk assessment in each person’s house.

For the residential service we spoke with two visiting professionals, one relative, two activity staff and four people using the service. We spoke with the general manager, the deputy manager, two care staff and the staff member cooking people’s meals.

We reviewed care plans and risk assessments for three people and a sample of people’s medicines records. We also checked a selection of records associated with the quality and safety of the service.

Updated 14 August 2018

The inspection took place on 19 June 2018 and unannounced. At the last inspection to this service on 29 March 2017 we found the service was good in three of the key questions we inspect against but we found a breach of regulation in safe. People were not receiving their medicines as intended. We rated the service requires improvement overall. The service immediately took actions to ensure people received their medicines as intended and told us what actions they had taken to demonstrate their compliance. At our inspection on the 19 June the service was compliant throughout and rated as good.

This service is registered to provide both a domiciliary care agency and a residential service. It provides personal care to people living in their own houses and flats in the community. Red House is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection there were 11 people living at Red House. It is registered for 15 people. There was also a person coming in once a week for day care. The domiciliary care service supported 20 people.

Red house had shared communal areas and individual bedrooms on the ground and first floor. There are separate offices at the back of the house from where the domiciliary service is managed from.

The service had a registered manager overseeing two residential services in the local area of Thetford. Both come under separate registrations so require separate inspections. Attached to Red house residential service there is also a domiciliary care service which is registered under the same umbrella as the residential service. The general manager has responsibility and oversight for this service. They have delegated some responsibility to another member of staff who oversaw and managed the staff and coordinated the care.

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.

Improvements were noted at this inspection with regards to the safe administration of people’s medicines. We identified a few things which could be improved upon and these were actioned straight away by the general manager.

We found on the whole this was a solid good service which was small and personable. It also offered flexibility in as much as it supported people in their own homes as far as possible but also provided residential and some day care. This meant they could support people with a wide range of needs and had enough staff to do so. The service was well planned and well managed so people felt safe with their care delivery and found the service reliable. The only exception to this is some people living in the residential home raised concern about only having one member of night staff on duty. However, there was an on-call system and we did not find any evidence that people’s needs were not met at night.

Risks to people’s safety were well managed and the environment had been assessed as safe. Where risks were identified there were sufficient control measures to reduce the level of risk as far as reasonably possible.

Staff were well supported and were only appointed after going through a recruitment process. This could be a bit more robust to help ensure only suitable staff were employed.

The service was hygienically clean but refurbishment of the service meant it was difficult to assess this completely. People living in their own homes received support around their assessed needs which might include support with personal care, taking medicines, managing a home or social support.

The service monitored accidents and incidents and took steps to reduce these whenever possible. They also ensured staff learnt from specific events to help ensure they did not happen again.

Staff received training, induction and support around their specific job role. This could be explored further to ensure staff support was adequately recorded and staff were supported in accordance with the regulated activity they were carrying out.

Where needed, people were supported to eat and drink in sufficient quantities. People’s weights were monitored to help ensure a healthy weight was promoted and people stayed sufficiently hydrated.

People or, where appropriate, their relatives, consented to their care and their choices were respected. Staff had received training in the Mental Capacity Act 2005 (MCA). The MCA ensures that people’s capacity to consent to their care and treatment is assessed. If people do not have the capacity to consent for themselves the appropriate professionals, relatives or legal representatives should be involved to ensure that decisions are taken in people’s best interests according to a structured process. There remained some confusion in records with regards to consent to care and treatment but it was clear that people, or their relatives if appropriate, were being asked.

People had their health care needs met and there was enough information for staff about how to meet people’s needs. Some additional training around people’s specific needs might be helpful.

People had their needs assessed, planned for and reviewed and received effective care.

Care was provided around people’s preferred routines and preferences and care staff were respectful of people’s cultural needs and need for privacy.

People felt consulted about their care needs and the service considered feedback from people whether it was positive or less so. There was an established complaints procedure and a quality assurance system.

Some activities were provided in the residential service and people were supported to stay active and engaged. This varied from person to person and some felt there were not enough activities.

The service was well managed and transparent. All the staff from the general manager to the care staff contributed to the smooth running of both services.

Staff and people using the service had confidence in it and felt it to be well managed and well organised. This reduced risks and enhanced people’s wellbeing.