CQC report explained · a residential care home
What the CQC found at Rutland House Community Trust
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, medicines systems, risk assessments and safeguarding arrangements. Some maintenance work was still needed in communal shower areas and floors.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Good
- Management oversight, staffing monitoring and policies had improved. The manager had applied to register and was successfully registered after the inspection, although further improvements to the premises were still needed.
What inspectors found, May 2023
Rated Good; inspectors found safe, person-centred care, but some premises improvements were still needed.
This was an unannounced focused inspection on 20 January 2023. One inspector spoke with people, staff and a relative, observed care, and reviewed care, medicines, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, suitable medicines systems, risk assessments and safeguarding arrangements. People were supported to make choices and receive care in the least restrictive way.
The home had improved since its previous Requires Improvement rating. Staffing and management oversight were better, and the earlier breaches in staffing and governance were no longer current breaches. However, repairs and improvements were still needed in communal shower areas and floors.
Enough staff
Staffing levels matched people's assessed needs, including one-to-one support where required.
“There were enough staff on duty to meet the needs of people who used the service.” from the report
Safe medicines support
Only trained staff administered medicines. Records were overseen by the manager and medicines were stored appropriately.
“People received their medicines as prescribed. Care plans included information and guidance on how staff would provide safe medicines support.” from the report
Choice and least restriction
People were supported to make choices, with risks managed without unnecessarily restricting their freedom.
“People were supported to have maximum choice and control of their life and staff supported them in the least restrictive way possible and in their best interests” from the report
Person-centred culture
Staff knew people well and care plans reflected their preferences and wishes. Inspectors found that people were supported to achieve good outcomes.
“The culture within the service was centred on people's individual needs.” from the report
Premises repairs
needs fixingThe seals in communal shower areas needed improvement, and damaged floors also needed attention. The manager said improvement works were planned, and later reported that some works had been completed.
“We were somewhat assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
No registered manager at the visit
minorThere was no registered manager in post on the inspection date. A new manager had applied and was registered after the inspection.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Have all the planned improvements to the communal shower areas and floors now been completed?
- 02How do you check that staffing levels continue to meet each person's assessed needs, including one-to-one support?
- 03How are medicines records checked and any errors or missed doses dealt with?
- 04How do people and their relatives give feedback about care and see what action has been taken?
- 05Who is currently responsible for management oversight and quality checks?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous inspection. This explanation was written from the published report of 11 May 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, December 2021
Rated Requires Improvement; inspectors found staffing and oversight gaps that could put people at risk.
This was an unannounced focused inspection on 15 November 2021. Inspectors looked at Safe and Well-led because concerns had been raised about falls risks. They spoke with people, staff and relatives, observed care, and checked care, medicines, staffing and management records.
The home was not always safe. There were not enough staff to meet people's needs, and this reduced the time available for social activities and interests. Medicines records had gaps, infection control checks were incomplete, and one person's records did not show that regular repositioning had taken place.
The home was also not always well-led. Audits and quality checks did not identify all the problems found by inspectors. The provider breached regulations on staffing and good governance. The overall rating fell from Good at the previous inspection to Requires Improvement.
Staff knew people well
The manager and staff were described as passionate about person-centred care. Care plans reflected people's preferences and staff offered choices during the inspection.
“The registered manager was passionate about providing person-centred care and knew people well as they were involved in care delivery.” from the report
Risk knowledge
Staff understood people's risks and how to support them. Inspectors saw safe support for people with choking risks, and staff knew what to do after a fall.
“Staff had good knowledge of people's risks and the support they needed.” from the report
Safe recruitment
The required recruitment checks had been completed to help protect people from unsuitable staff.
“Safe recruitment checks had been undertaken to ensure people were protected from being supported by unsuitable staff.” from the report
Action after concerns
The manager responded to issues raised during the inspection, including mask use and infection control. Staff also received regular supervision and felt supported.
“They took immediate action to address the infection, prevention and control concerns we identified.” from the report
Too few staff
seriousThere were not enough staff available or deployed to meet people's needs. Care staff also had to do cleaning and domestic work, leaving less time for people's hobbies and social activities.
“There were not enough staff employed or deployed to meet the needs of people living at Rutland House Community Trust.” from the report
Weak quality checks
seriousImportant audits were missed or incomplete, including fire, health and safety, medicines and infection prevention checks. The systems did not find all the problems inspectors identified.
“Systems and processes were not always in place to demonstrate the quality and safety of the service was effectively monitored and managed.” from the report
Medicines records
needs fixingThe electronic medicines record had gaps, and one missed medicine was not identified for 24 hours. A new system was planned.
“There were gaps in the eMAR recording.” from the report
Infection control checks
needs fixingStaff were sometimes seen wearing masks below their chins near people. Visitor screening did not include all required checks, and the cleaning schedule did not cover high-touch areas during the day.
“This increased the risk of transmission of COVID-19.” from the report
Repositioning records
needs fixingOne person's care records did not show that they had been supported to change position every two hours to help a wound heal.
“We found care records for one person, did not evidence they had been supported to change position every two hours to assist with the healing of a wound.” from the report
Reduced activities
needs fixingPeople were not always able to take part in hobbies and interests as they wished. One person said they could not go out as much because there were not enough staff.
“People were not always able to be supported with hobbies and interests in the way they wished.” from the report
- 01How many care staff are normally on duty for each shift, and how do you calculate that number from each person's needs?
- 02What has changed to make sure people can take part in their hobbies, interests and outside activities?
- 03Has the new electronic medicines recording system been introduced, and how do you check for missed or incorrectly recorded medicines?
- 04How are visitor COVID-19 symptom and close-contact checks now recorded?
- 05How do you now make sure audits identify problems with staffing, medicines, fire safety and infection control?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 8 December 2021 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 Rutland House Community Trust
4 rated inspections over 7 years: the service has held its Good rating throughout.
- May 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Rutland House Community Trust →
- December 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Rutland House Community Trust →
- March 2019Goodstayed GoodSafe: GoodWell-led: Good
- August 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 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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