CQC report explained · a residential care home
What the CQC found at Russets
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found environmental and food safety problems, including missing window restrictors, dirty fans and out-of-date or undated food. Staff generally understood people's individual risks, and medicines and recruitment processes were mostly managed safely.
- Effective?
- Requires improvement
- Care and support were generally based on assessments, recognised guidance and staff training. However, consent and mental capacity records were sometimes missing, conflicting or unclear.
- Caring?
- Good
- Caring was not covered by this focused inspection. Its previous rating was used when calculating the overall rating.
- Responsive?
- Requires improvement
- People had individual communication plans and were supported with activities, outings and relationships. However, support plans did not clearly explain people's future goals or how staff would help them achieve those goals.
- Well-led?
- Requires improvement
- Managers were visible, approachable and had improved the home's culture. However, quality checks had not identified all the problems, and the home remained in breach because governance systems and records were not effective enough.
What inspectors found, February 2023
Russets is rated Requires Improvement; inspectors found kind and skilled support, but continuing problems with records, safety checks and helping people reach their goals.
This was an unannounced focused inspection on 15 and 19 December 2022. Inspectors spoke with people, relatives, staff and external professionals. They reviewed care records, medicines records, staff recruitment files and management records.
People were generally supported by staff who knew them well. Staff understood people's health and safety needs, supported communication, arranged healthcare and provided activities. Relatives were mostly positive about the care, and the home's culture had improved since the previous inspection.
However, some safety risks were found, including missing window restrictors, dirty fans and out-of-date or undated food. Records about consent, mental capacity, risks and people's goals were not always clear or complete. The home's quality checks had not found all these problems or ensured they were fixed.
The overall rating is Requires Improvement. Safe, Effective, Responsive and Well-led were all rated Requires Improvement. Caring was not inspected in this visit, so its previous rating was carried forward. The home remains in breach of Regulation 17 and has had a Requires Improvement rating for its last three inspections.
Staff knew people well
Staff understood people's individual needs and risks. They supported people with moving, eating, communication and safety in ways that reflected their care plans.
“Staff knew people well and were aware of risks to their health, safety and welfare.” from the report
Training and healthcare
Staff received relevant training and supervision. Healthcare advice was followed, and the home worked with outside health and social care professionals.
“People were supported by staff who had received relevant and good quality training in evidence-based practice.” from the report
Activities and community links
People took part in regular social and leisure activities, including outings chosen around their preferences. The home also supported people to stay connected with the local community.
“People were supported to participate in their chosen social and leisure interests on a regular basis.” from the report
Improved culture
Inspectors found that the culture had become more positive since the previous inspection. Relatives and staff described managers as supportive, approachable and open to feedback.
“People and their families told us they felt the management team was supportive.” from the report
Environmental safety
needs fixingInspectors found missing window restrictors, electrical items without the expected testing, dirty fans and areas needing repair. The manager arranged for some issues to be dealt with promptly, but further checks were recommended.
“We recommend the provider enhances their environmental and equipment checks to ensure risks to people's safety are reduced.” from the report
Consent and capacity records
needs fixingRecords did not always show that people or their legal representatives had agreed to care. Some capacity records were confusing or did not explain how decisions had been reached.
“Records did not always demonstrate that people or their legal representative had consented to their care.” from the report
Goals were not clearly recorded
needs fixingSupport plans did not clearly set out people's future aims or the steps needed to achieve them. Staff were not always clear about how to help people work towards these goals.
“Support plans did not set out clear pathways for people's future goals and aspirations, including supporting people to learn and develop skills and strategies to achieve these.” from the report
- 01What has been done to replace the missing window restrictors and complete the outstanding repairs and electrical safety checks?
- 02How do you now check that consent and mental capacity records are complete, consistent and legally correct?
- 03How will you record each person's goals and the steps staff will take to help them achieve them?
- 04What changes have been made to the quality audits since this inspection, and how will you show that they find and resolve problems?
- 05How are medicines competency checks and guidance for variable-dose medicines now kept up to date?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected and its previous rating was carried forward. This explanation was written from the published report of 18 February 2023 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, June 2019
Rated Requires Improvement; inspectors found kind care and safe medicines, but serious gaps remained in risk management, records and oversight.
Inspectors visited the home without notice on 25 April and 7 May 2019. They spoke with people, relatives, managers, staff and health professionals. They also observed care and checked care, medicine, staff and management records.
The home supported seven people living there and nine people using respite care. Inspectors found kind and respectful staff, a clean environment, enough staff to meet people's needs and medicines that were generally managed safely.
However, risk assessments were not always detailed or complete. Records about medicines, mental capacity, consent, care and people's needs were not always accurate or up to date. There was limited evidence of meaningful activities that developed people's life skills.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were all rated Requires Improvement, while Caring was rated Good. This was the home's third consecutive Requires Improvement rating, so the provider was asked for a clear action plan.
Kind and respectful care
Inspectors saw people who appeared comfortable and happy with staff. Relatives and health professionals also described staff as caring.
“People were supported by kind and caring staff and people were treated with dignity and respect.” from the report
Medicines managed safely
The provider had made changes to medicine policies, storage, training and audits. People received their medicines as prescribed and records of administration were accurate.
“People received their medicines as prescribed and medicine administration records (MAR) were completed accurately.” from the report
Clean environment
The home was clean and staff used infection-control equipment when needed.
“The environment was clean and free from bad odours.” from the report
Access to health support
People were supported to see health professionals, including GPs, nurses, consultants and speech and language therapists.
“People were supported to access services to maintain and improve their health.” from the report
Improving management
The management team was open to feedback and had begun improving staffing, communication, training and the culture of the home.
“The management team were in the process of improving the service, however, more time was needed to fully embed improvements and changes in culture.” from the report
Incomplete risk information
seriousSome people's risks were not assessed with recognised tools, and some risk plans lacked important instructions. Health professionals also reported that staff had twice provided food that increased choking risks.
“Although we found the lack of risk assessment had not negatively impacted upon people at the time of our inspection, we were concerned that people could be at increased risk of harm.” from the report
Missing consent and capacity records
seriousCare plans did not always record consent. Mental capacity assessments and best-interest decisions were not in place for specific decisions where they were needed.
“People's care plans did not contain a record that they or their legal representative had consented to their care.” from the report
Weak quality checks and records
seriousThe provider had strengthened its audits, but they did not identify or resolve all problems quickly. Records about risks, care, medicines and mental capacity were not consistently accurate and complete.
“The quality assurance systems were not fully effective in identifying concerns in the service and driving the necessary improvements in a timely way.” from the report
Limited life-skills activities
needs fixingPeople took part in activities they enjoyed, but there was limited evidence of meaningful activities that developed independence and daily living skills.
“There was limited evidence that people were involved in meaningful activity in the service which may develop their life skills.” from the report
Care plans lacked detail
needs fixingCare plans did not always explain people's history, preferences or preferred personal-care arrangements in enough detail. New and agency staff did not always know people as well as longer-serving staff.
“We found that care plans did not always contain detailed information for staff to support people in a way they may prefer.” from the report
- 01How are you now recording and reviewing risks such as choking, malnutrition, dehydration, skin breakdown and epilepsy?
- 02How do you record consent, mental capacity assessments and best-interest decisions for each person?
- 03What checks confirm that respite users have an up-to-date assessment before they return?
- 04What meaningful activities are now available to help people build daily living and independence skills?
- 05How have you reduced agency staffing and ensured temporary staff understand each person's needs?
This was an unannounced planned inspection covering all five CQC questions, with care, premises, records, medicines, staffing and management examined. This explanation was written from the published report of 15 June 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 Russets
4 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- February 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2018Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 2011.
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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