CQC report explained · a residential care home
What the CQC found at Reuben Manor
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found medicines were managed safely, risks were assessed and monitored, staffing was suitable, and infection control procedures were robust. Some people said they sometimes waited for assistance, but their needs were met.
- Effective?
- Good
- This area was not examined during this focused inspection. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This area was not examined during this focused inspection. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This area was not examined during this focused inspection. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found strong quality checks, an open management culture and evidence that the manager was acting on risks and working with other professionals.
What inspectors found, December 2020
Rated Good; inspectors found safe, kind care and strong improvements since the previous inspection.
This was an unannounced focused inspection carried out on 13 and 29 October 2020. Inspectors checked whether earlier problems with medicines, safety and management had been fixed. They reviewed records, medicines, recruitment checks, the building and infection control, and spoke with people, relatives and staff.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found medicines were managed safely, risks were assessed, staffing was suitable and infection control arrangements were strong. People and relatives generally said they felt safe and well cared for.
The previous inspection had rated the home Requires Improvement and found a breach of Regulation 12. Inspectors found the improvements had been made, so the home was no longer in breach. This inspection did not reassess all five areas, so some ratings carried over from the earlier comprehensive inspection.
Safe medicines management
The earlier problem with checking medicines had been addressed. Records were accurate, regularly reviewed and monitored through the home's quality checks.
“Medicines were managed safely, and the service had improved the processes for monitoring the administration of medicines.” from the report
Risk management
Inspectors found clear risk assessments for people and the building. These were reviewed and included instructions for staff on how to keep people safe.
“Risks were clearly identified, assessed, mitigated and monitored.” from the report
Infection control
The home had extra measures to reduce infection risks, including entry checks, social distancing, PPE, testing and frequent cleaning.
“Additional cleaning had been implemented including areas of high contact being cleaned every 20 minutes.” from the report
Positive care culture
People and relatives were very positive about staff. Inspectors also found a friendly, person-centred culture and supportive management.
“People and their relatives were very happy with the care provided from staff.” from the report
Quality oversight
The manager and provider had strengthened their checks on safety and care. Incidents were reviewed and lessons were shared with staff.
“The quality and assurance systems in place had been reviewed and embedded throughout the service and were used to continuously improve the service and quality of care provided to people.” from the report
Occasional waits for help
minorSome people said they sometimes had to wait for assistance because staff were helping someone else. Inspectors said people's needs were met.
“People did tell us they sometimes had to wait for assistance but their needs were met.” from the report
- 01How do you check that medicines are still being administered and recorded safely?
- 02How do you decide whether there are enough staff for my relative's needs, especially at busy times?
- 03What is the usual waiting time when someone needs assistance?
- 04How are my relative's risks reviewed, and how will I be involved?
- 05What infection control and visiting arrangements are currently in place?
This was a focused inspection of Safe and Well-led, including infection control; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 17 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, December 2019
Rated Requires Improvement; inspectors found kind, responsive care but unsafe medicine systems and weak quality checks.
This was an unannounced inspection on 30 October and 4 November 2019. Inspectors spoke with people living at the home, relatives and staff. They observed care and checked care, medicine, staff and management records.
The home was rated Good for Effective, Caring and Responsive. People said they felt safe, staff were kind and respectful, and there were enough staff to meet people's needs. Food was good and activities were available, including a popular choir.
The home was rated Requires Improvement for Safe and Well-led. Medicines were not always recorded or given safely, and some risk assessments and care plans lacked important detail. Management checks had not found these problems, although managers responded quickly to the inspection feedback and began making changes.
Kind and respectful staff
People described staff as kind and helpful. Inspectors saw a calm and relaxed atmosphere, with people treated with dignity and respect.
“Staff treated people with kindness and respect. The atmosphere in the service was calm and relaxed.” from the report
Enough staff
Inspectors found staffing levels met people's needs. Recruitment checks were also followed.
“Staffing levels met the needs of the people using the service.” from the report
Training and healthcare
Staff training was monitored and kept up to date. People could access a range of healthcare professionals, including a regular community matron drop-in session.
“The registered manager had established good links with the local professionals, a regular community matron drop in session was in place” from the report
Activities and relationships
People could join a range of activities or receive one-to-one time if they preferred. The home also supported people to maintain family relationships and achieve personal goals.
“There was a very popular and well attended choir with performances planned and rehearsals every week.” from the report
Medicine safety
seriousMedicine counts and records were sometimes wrong. One medicine was given five times in 24 hours instead of four, and records did not always show why as-needed medicines were given or whether they worked.
“Some medicines counts were not correct, and as a result an error in dose had not been identified.” from the report
Risk information
needs fixingSome risk assessments were completed incorrectly. Care plans did not always contain enough detail to show staff how to support people safely, including people with catheters.
“Risk assessments were in place; however, these were not always completed correctly by staff.” from the report
Management checks
needs fixingThe home's audits had not identified the medicine and risk-management problems found during the inspection. Inspectors said these improvements needed to be checked over time.
“Although the registered manager and wider management team carried out regular audits they had not successfully identified the issues we found with medicines management.” from the report
Meal choice
minorSome people said they were not always offered a choice before food was served. The manager said staff would be reminded to show the available plated meals.
“Some people told us they did not always get a choice of the meal they wanted.” from the report
Personal care plans
needs fixingCare plans did not always explain people's individual preferences or which parts of their care they could do independently. The manager said this would be addressed.
“Care plans required more detail to be person centred and reflect people's individual preferences and the level of support they required from staff.” from the report
- 01What changes have been made to medicine counts, medicine administration records and records for as-needed medicines since the inspection?
- 02How do you now check that topical medicines, returned medicines and dose timings are recorded correctly?
- 03How are risk assessments checked for accuracy, especially for tissue damage and catheter care?
- 04How do you make sure care plans record each person's preferences and what they can do independently?
- 05How do your audits now identify problems quickly, and how will you show that improvements have lasted?
This was an unannounced comprehensive inspection covering all five CQC questions after a change in the registered provider; the previous rating was Good and had been published on 13 December 2018. This explanation was written from the published report of 4 December 2019 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 Reuben Manor
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- December 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2018
Registered with the Care Quality Commission on 10 December 2018.
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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Most charge £980 to £1,190 a week. 40 can care for a couple. 10 years' experience on average.
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