The Red House Nursing Home

Updated 7 July 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The Red House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received and held about the service. We sought feedback from the local authority and professionals who work with the service.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service. We had discussions with the registered manager and looked at a range of records. These included three care plans, three staff recruitment files and the staff training matrix. We checked a sample of quality assurance audits and records related to maintenance and upkeep of the premises. We viewed a range of health and safety records including accident and incident reports.

After the inspection

We requested additional evidence from the registered manager.

We contacted staff and relatives or advocates by email, to invite them to provide feedback. We received replies from four relatives or advocates and one member of staff.

We also contacted the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 7 July 2022

About the service

The Red House Nursing Home provides accommodation and nursing care for up to 32 people. The building has accommodation spread across three floors. Twenty six people were living at the home at the time of our inspection.

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

Practices at the home did not always keep people safe and ensure they were protected from avoidable harm. We found safeguarding referrals had not always been made to the local authority when required. We had not been notified of significant events which providers are required to inform us about. This included skin tears and a fractured thumb.

The home carried out checks when recruiting staff. Agency workers were used to cover gaps on the rotas, when necessary. The provider had not ensured it had obtained satisfactory evidence of recruitment and training from the agency, to make sure people were always cared for by workers with the right skills and experience.

People were not adequately safeguarded from the risks of fire. Records of fire drills were insufficient to demonstrate all staff had been effectively trained and would know what to do in the event of a fire or other emergency.

The provider had not ensured there was effective governance of the service, to make sure people received good standards of care. The nominated individual (representative for the provider) regularly visited the home but there were insufficient records of findings or suggestions for improving care practice.

Providers are required to act in an open and transparent way when things go wrong (duty of candour) and there are specific things they need to do in these circumstances. The registered manager was able to describe some actions taken, such as informing relatives or speaking with the person affected, but they were unable to demonstrate full compliance.

We have made recommendations regarding the risk assessment format for moving and handling, medicines practice and recording of accidents and incidents. We have made a further recommendation regarding the provider’s monitoring of record keeping at the service.

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 were protected from the risks of infection as staff followed good hygiene practices. Staff worked in partnership with other agencies to promote people’s health and well-being. Improvements had been made in some areas to enhance people’s quality of care.

Relatives spoke positively about the home. One relative told us “I will never be able to thank the staff for the happiness and kindness that they have brought into our lives during this difficult time. I would recommend The Red House to anyone in need of care.” People we spoke with were complimentary of staff. One said “Staff are brilliant,” another commented “They’re very good to me.”

Rating at last inspection

The last rating for this service was good (report published 6 November 2018). We also carried out a thematic inspection looking at infection prevention and control (report published 10 March 2022).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

The overall rating for the service has changed from good to 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 The Red House Nursing Home 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 fire safety measures, safeguarding practice, ensuring sufficient recruitment checks have been carried out for temporary workers, notification of significant events, duty of candour and good governance at this inspection.

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