Russets

Updated 18 February 2023

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

Two inspectors carried out this inspection. An Expert by Experience supported the inspection by making calls to people’s relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Russets is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Russets is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. 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 2 people and 7 relatives about their experience of the care provided. We spoke with 11 members of staff including the registered manager, deputy manager, administrator, care workers, assistant unit managers, a kitchen assistant and a compliance manager. We also received feedback from four external professionals. We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 18 February 2023

About the service

Russets provides full time residential care for up to 7 people and respite care for up to 11 people with learning disabilities, in one adapted building. There are 2 flats within the building, one accommodates 4 people and the other accommodates 3 people. The rest of the building provides support to those people receiving respite care. Respite care is short term. At the time of our inspection 6 people were living at Russets.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Although the service is larger than current best practice guidance, this was mitigated by the building design. People lived within smaller flats in part of the building and had privacy for themselves and their visitors. We identified some environmental safety risks and we made a recommendation about this. The service was located so people could participate in the local community.

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. However, records relating to consent and capacity needed improving and we have made a recommendation about this.

Right Care: People received support from staff who knew them well, understood their needs and considered their preferences. Staff understood how to protect people from poor care and abuse. Healthcare professionals had been referred to appropriately and staff ensured their advice was followed. People's support plans reflected their range of needs and this promoted their wellbeing. Risks associated with people’s needs were understood by staff.

Right Culture: Quality assurance processes had not identified all the concerns in the service and where they had, enough improvement had not taken place. Records were not always complete. It was not always clear how people were involved in making decisions about how they wanted to achieve their goals. We have made a recommendation about this.

The culture at Russets had improved since the last inspection and was positive. People and their families told us they felt the management team was supportive. Complaints were listened to and acted upon. Staff received the training, support and information they needed to provide effective care.

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 15 June 2019) and there was a breach of regulation.

At this inspection we found the provider remained in breach of regulation. The service remains rated requires improvement and has been rated requires improvement for the last three consecutive inspections. We will describe what we will do about the repeat requires improvement in the follow up section below.

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.

We carried out an unannounced comprehensive inspection of this service on 7 May 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.

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. 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 Russets on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to Governance at this inspection.

At our last inspection we recommended that the provider sought reputable guidance to support people to maximise their skills to their full potential. At this inspection we found improvement was still needed. We have made a recommendation about the management of environmental risks in the service and records relating to consent and capacity.

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, and meet with them 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.