CQC report explained · a residential care home
What the CQC found at Aspire in the Community Rushbrooke House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2020
Aspire in the Community Rushbrooke House is rated Requires Improvement; inspectors found safe, well-led care, but effective and responsive care still needed improvement.
This was an unannounced focused inspection on 14 October 2020. Two inspectors spoke with four people and 10 staff. They reviewed care, medicine and staff records, risk assessments, audits and other management information.
The home was rated Good for Safe and Well-led. Inspectors found people felt happy and safe, medicines were managed safely, risks were assessed, staffing was sufficient and infection control arrangements were suitable. They also found better safeguarding, record keeping and management oversight than at the previous inspection.
The overall rating stayed Requires Improvement because the Effective and Responsive ratings from the previous comprehensive inspection were still Requires Improvement. Those areas were not examined during this visit. The home was no longer in breach of regulations that had been breached at the previous inspection.
People felt safe
People told inspectors they felt happy and safe. Staff had good relationships with people and understood how to protect them from abuse.
“People said they felt happy and safe at the service; they were calm, settled and had good relationships with the staff.” from the report
Risk management
Risks were assessed and reviewed. Staff had current information about the support people needed, and the home reviewed incidents to learn lessons.
“Risk assessments and care plans were accurate and in line with the support the person needed.” from the report
Safe medicines
Inspectors found that medicines were administered and recorded safely. Staff had been trained and understood the medicine systems.
“Medicines were administered and managed in a safe and robust way.” from the report
Improved leadership
Management systems had improved since the previous inspection. The home used audits, meetings and staff supervision to monitor care and address issues.
“There was a clear understanding of the roles and responsibilities of different members of staff.” from the report
Monitoring instructions were not followed exactly
needs fixingOne care plan said weekly weights were needed, but weights had been recorded monthly. Management said the care plan instruction was an error and agreed to change it.
“We found that one person's care plan identified weekly weights needed to be taken but they were been taken monthly.” from the report
Some care goals were not updated
needs fixingCare plans were generally up to date, but some goals had not been revised or updated. Inspectors raised this with management.
“We found overall care plans were kept up to date but there were instances where goals were not revised or updated.” from the report
- 01What has the home done since the previous inspection to improve the Effective and Responsive ratings?
- 02How does the home check that care goals are reviewed and updated when people's needs or wishes change?
- 03How will the home prevent errors in care plans from leading to incorrect monitoring, such as the weight-recording issue?
- 04What evidence can you show that the improvements identified after the previous inspection have been maintained?
- 05What was the outcome of the separate enquiries into the incident mentioned in the report?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 1 December 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2020
Rushbrook House rated Requires Improvement; inspectors found kind care but serious weaknesses in safeguarding, nutrition, staff support and management.
The inspection took place on 17 December 2019. One inspector spoke with people, relatives, staff and professionals, and checked care records, medicines records, staff files and management records.
People generally said they felt safe and received good care. Staff were kind, respectful and supportive. Medicines were managed safely, staffing levels were usually sufficient, and the home was clean.
However, standards were less consistent in the bungalows. Some safeguarding incidents were not reported, risks were not always reviewed after incidents, nutritional plans were not always followed, and staff did not always receive enough support. Reviews of care, activities and personal goals were also inconsistent.
The overall rating was Requires Improvement. Caring remained Good, but Safe, Effective, Responsive and Well-led fell from Good at the previous inspection in 2017. The provider had an action plan, and inspectors said they would monitor progress.
Kind and respectful care
People and relatives said staff treated people well. Inspectors saw staff who were patient, caring and committed to meeting people's needs.
“People and relatives said staff treated people well.” from the report
Medicines and staffing
People received medicines as prescribed and records were clear. There were generally enough staff to provide the assessed support.
“Medicines were managed in a safe and proper way.” from the report
Personalised support
Care was often planned around each person's choices, needs and communication style. The home promoted independence through individual living spaces and practical activities.
“People's daily life was designed around their individual needs, with food, activities and all other aspects of support doing on an individual basis.” from the report
Complaints handling
People felt able to raise concerns, and the complaints received had been responded to appropriately.
“Those that had been received had been responded to appropriately.” from the report
Safeguarding reports
seriousTwo incidents involving a risk of harm were not reported to CQC or the local safeguarding team. The report also found that policies for seclusion and segregation were missing.
“We identified inconsistent practice with two incidents where people were at risk of harm were not reported to CQC or the local safeguarding team.” from the report
Risk management
seriousSome risk assessments were not updated after incidents or changes in circumstances. Management did not always record what preventative action had been taken or whether staff concerns had been considered.
“This meant systems to assess, monitor and mitigate risk were not sufficiently robust and put people at increased risk of harm.” from the report
Nutrition in the bungalows
seriousTwo people did not always have the weekly weight checks required by their care plans. Healthy living plans, meal planning and reviews were not consistently completed.
“People's nutritional needs were not consistently met by the service.” from the report
Staff support
needs fixingStaff in the bungalows said their concerns about complex needs were not always addressed. Debriefings, supervision, appraisals and training updates were not consistently provided on time.
“Training and support mechanisms for staff were inconsistent.” from the report
Inconsistent care reviews
needs fixingReviews did not always check whether goals, activities, behaviour and diet plans were working. Some care plans were not updated when people's needs changed.
“There was an inconsistent approach to the review and evaluation of people's care which was a barrier to the service being consistently responsive.” from the report
- 01What action has been completed to make sure all safeguarding incidents are reported to CQC and the local safeguarding team?
- 02How are risks reviewed and preventative actions recorded after incidents, especially in the bungalows?
- 03How are weekly weights, healthy living plans and meal planning checked for people who need nutritional support?
- 04How often do bungalow staff now receive supervision, debriefing, staff meetings and updated training?
- 05How are care reviews now checking progress with people's goals, activities, behaviour and diet?
This was a planned inspection covering the premises and care provided, with all five CQC questions rated; the previous inspection was published in 2017. This explanation was written from the published report of 12 May 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Aspire in the Community Rushbrooke House
3 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- December 2020Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
Read what inspectors found at Aspire in the Community Rushbrooke House →
- May 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Aspire in the Community Rushbrooke House →
- June 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015
Registered with the Care Quality Commission on 10 July 2015.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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