CQC report explained · a residential care home
What the CQC found at The Rubens
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found kind, person-centred care but important safety, consent and management systems were not reliable.
This was an unannounced inspection on 30 August and 1 September 2022. Inspectors spoke with people, relatives, staff and visiting health professionals. They reviewed care records, medicines records, staff recruitment files and management documents.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were also rated Requires Improvement. Risks, falls, care records, infection control, staff training and quality checks were not always managed well.
Inspectors found that medicines were handled safely, staffing levels were sufficient and people generally felt safe and listened to. Staff were described as kind and person-centred, and people had choices about food, drinks and where they ate.
The previous overall rating was Good, published in February 2019. The provider acted quickly during and after the inspection, including submitting DoLS applications, arranging training, improving records and increasing cleaning. CQC said these changes would be checked at the next inspection.
Medicines
Medicines were given at the right time, stored safely and administered in a private and dignified way.
“Medicines were managed safely. People received their medicines at the right time.” from the report
Staffing and recruitment
Recruitment checks were completed, and people and relatives said there were enough staff to meet people's needs.
“Staff were recruited safely. Recruitment files showed all pre-employment checks had been made to ensure only staff who were suitable to work with people were employed.” from the report
Kind and respectful care
People and relatives described a person-centred culture. Staff supported people's choices and treated them with dignity.
“I have witnessed patience and kindness from the staff towards the residents.” from the report
Food and choice
People could choose meals, have snacks and drinks when they wanted, and choose where and with whom to eat.
“The mealtime experience was a very sociable event. People could choose where they wanted to eat and who they wanted to sit next to.” from the report
Working with health professionals
Records showed that staff worked with health and social care professionals and followed their recommendations.
“Records showed collaboration with numerous health and social care professionals.” from the report
Consent and restrictions
seriousFive people had restrictions in place without DoLS applications being submitted. Mental capacity assessments and best-interest decisions were not always completed.
“Five people were identified as having restrictions in place. However, DoLS applications had not been submitted with the local authority.” from the report
Falls and risk records
seriousSpecific risks were not always assessed, and falls were not consistently recorded or monitored. This could mean important patterns or hazards were missed.
“Falls were recorded and identified as accidents. However, not all falls were identified as incidents and incident forms were not always completed.” from the report
Outdated care information
needs fixingSome care plans and risk assessments did not reflect people's changing needs. This could cause confusion or mistakes, especially for new or agency staff.
“Care plans and risk assessments were not always updated following changes in people's care and support needs.” from the report
Training gaps
needs fixingSome refresher training was overdue, and training about specific conditions such as diabetes was needed.
“Training records confirmed staff received induction and training. Although, there were gaps in records and prolonged periods of time between some refresher courses.” from the report
Cleanliness and furnishings
needs fixingSome areas needed more cleaning, and furniture and fittings were worn or damaged. The provider started arranging improvements during and after the inspection.
“There were areas of the home which needed additional cleaning and furniture such as chairs and blinds needed replacing.” from the report
Ineffective quality checks
seriousAudits did not consistently find the problems identified by inspectors. This meant risks and areas needing improvement could be missed.
“Systems to monitor the quality and safety of the service provided were not always effective in identifying shortfalls or driving improvements.” from the report
- 01Have mental capacity assessments now been completed for everyone who needs one, and have all required DoLS applications been submitted?
- 02How are falls now recorded, reviewed and used to identify patterns or hazards?
- 03How do you make sure care plans and risk assessments are updated promptly when someone's needs change?
- 04Which staff have completed refresher training and training about conditions such as diabetes?
- 05What checks now confirm that cleaning, furnishings and care records meet the required standard?
This was a focused inspection of Safe and Well-led, widened to include Effective; Caring and Responsive were not inspected and their ratings carried over from the previous inspection. This explanation was written from the published report of 26 October 2022 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, February 2019
The Rubens is rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced planned inspection on 22 January 2019. One inspector and an expert by experience spoke with people, relatives and staff, observed care, and checked care records, staff files and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable recruitment checks and systems to protect people from abuse and avoidable harm.
People were treated kindly and with dignity. Their care was personalised, their choices were respected, and they had access to activities and health professionals. The home had improved since the previous inspection, including its governance systems, fire safety, medicines storage, dementia-friendly environment, and involvement of people in care reviews.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs and saw that medicines were administered safely and on time.
“There were sufficient numbers of staff available to keep people safe over the 24-hour period.” from the report
Kind and respectful care
Staff were observed treating people in a friendly and caring way. People's privacy, dignity and independence were respected.
“Staff interacted with people in a kind, pleasant and friendly manner.” from the report
Personalised support
Care plans reflected people's communication needs, preferences, faith and individual strengths. People were supported to make choices about their care.
“People had choice and control over the way their care was planned.” from the report
Improved management
The home had strengthened its systems for checking quality and identifying problems. Audits covered areas such as medicines, safeguarding, complaints and care records.
“Systems and processes for assessing and monitoring the quality of the provision were robust.” from the report
Earlier concerns addressed
The report says improvements requested after the previous inspection had been completed, including work on fire safety, medicines storage and the dementia-friendly environment.
“At this inspection we found that improvements had been made and this regulation was now met.” from the report
Inspectors raised no specific concerns in this report.
- 01Who is responsible for running the home day to day when the registered manager is not present?
- 02How do you check that staffing levels continue to meet each person's changing care needs?
- 03How are medicines audits used to identify and correct any problems?
- 04How are people and relatives involved in reviewing care plans and making changes?
- 05What activities are available for someone who prefers one-to-one support rather than group activities?
This was an unannounced planned inspection covering the overall service and all five CQC key questions, including follow-up of concerns from the previous inspection. This explanation was written from the published report of 8 February 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 The Rubens
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- October 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 25 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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At least 100 live-in carers within about an hour of Telford and Wrekin
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,200 a week. 88 can care for a couple. 10 years' experience on average.
“Knowing Mum was in Corina's care made an enormous difference to us and we knew she was in safe hands.”
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.