CQC report explained · a nursing home
What the CQC found at Vi and John Rubens House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found robust skin risk assessments, timely call bell responses and suitable infection prevention arrangements. The whole Safe key question was not assessed.
- Effective?
- Good
- This key question was not assessed during this targeted inspection.
- Caring?
- Good
- This key question was not assessed during this targeted inspection, although people told inspectors they were happy and well looked after.
- Responsive?
- Good
- This key question was not assessed during this targeted inspection.
- Well-led?
- Good
- Inspectors found quality checks, call bell monitoring and improved oversight of staff supervision and consent. The whole Well-led key question was not assessed.
What inspectors found, March 2023
Vi and John Rubens House was inspected but not rated; inspectors found reassuring arrangements for skin care, call bells, infection control and management oversight.
This was an unannounced, targeted inspection on 14 March 2023. One inspector followed up specific concerns about skin risk assessments, call bells, infection control, staff supervision and consent. The inspector spoke with six people, one volunteer and staff, and reviewed records including five risk assessments.
The home had clear plans for people at risk of skin problems. Records showed pressure relief, repositioning and involvement from health professionals where needed. Staff appeared available, call bells were answered in a timely way, and infection control arrangements were in place.
Management checks were in place for care plans, consent and call bells. Staff supervision records had not been completed regularly in 2022 because of recording problems, but the 2023 records showed more regular supervision and closer monitoring.
The home was inspected but not rated. Its previous rating was Good, published in January 2019, and that rating was not changed because this inspection did not cover the whole service.
Skin care planning
People at risk of skin problems had clear assessments and care plans. Records showed pressure relief, repositioning and advice from health professionals where needed.
“Robust risk assessments were in place for people at risk of skin complications.” from the report
Call bell response
Staff responded to call bells in a timely way. The home had introduced audits and managers checked call bells during daily walk rounds.
“We checked call bells records, which showed staff were responding to calls in a timely manner.” from the report
Infection control
Inspectors were assured that the home had arrangements to prevent and manage infections, including safe use of protective equipment and an up-to-date policy.
“We were assured that the provider was using PPE effectively and safely.” from the report
Management checks
The home used audits to check care plans, consent and call bell response. Staff supervision was being monitored more closely in 2023.
“Audits had been carried out on care plans to ensure people received person-centred safe care.” from the report
Earlier supervision records
needs fixingStaff supervisions were not completed regularly in 2022 because of record-keeping problems. Inspectors said the 2023 records showed improvement, but this is an area to ask about.
“A supervision matrix was in place, which showed supervisions were not being completed regularly in 2022 due to record keeping.” from the report
- 01How are staff supervisions recorded now, and how does management check that they happen regularly?
- 02How often are skin risk assessments reviewed, especially for people at risk of pressure sores?
- 03What were the most recent call bell response times, and what action is taken when a response is delayed?
- 04How does the home check that consent records remain up to date?
- 05When is the next comprehensive inspection expected, given that this inspection did not assess the whole service?
This was a targeted inspection of specific concerns under Safe and Well-led, including infection control; the previous Good ratings were not reviewed and the other key questions were not assessed. This explanation was written from the published report of 23 March 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, January 2019
Vi and John Rubens House was rated Good, with kind and personalised care, but inspectors recommended improvements to medicines guidance, safeguarding knowledge and activities for people in their bedrooms.
Inspectors made an unannounced visit over 11 and 12 December 2018. They spoke with people living in the home, relatives, staff and health professionals. They reviewed care plans, staff records, medicines records, rotas and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, suitable care plans, kind staff, good involvement of people and relatives, and strong management checks.
There were some areas to improve. Staff were not always clear about whistleblowing, there was no guidance for using warfarin, and people staying in their bedrooms did not have enough meaningful activities. Inspectors made recommendations, rather than finding a breach of regulations.
Personalised care
Each person had an up-to-date care plan covering their individual support, wellbeing and nutritional needs. Staff understood that people's care should be different for each person.
“Each person had an individual care plan which contained information about the support they needed from staff.” from the report
Kind and respectful staff
People and relatives said staff were kind and caring. Inspectors saw staff supporting people respectfully, including when someone became upset.
“People and relatives felt that staff were kind and caring.” from the report
Good food and dietary support
People spoke positively about mealtimes. The home offered choices and catered for different dietary needs, including presenting pureed food separately and attractively.
“People spoke positively about mealtimes.” from the report
Strong management checks
Managers used surveys, meetings, audits and unannounced staff checks to monitor the service and identify improvements.
“We found the service had robust quality assurance systems in place to manage and develop the overall running of the service.” from the report
Whistleblowing knowledge
needs fixingStaff were not always aware of what whistleblowing was. Inspectors recommended reviewing best practice so staff knew how to keep people safe from harm.
“However, staff were not always aware of what whistleblowing was.” from the report
Warfarin guidance
needs fixingThere were no guidelines available about the use of warfarin. Inspectors recommended reviewing best practice to make sure medicines were managed safely.
“However, there were no guidelines available about the use of warfarin.” from the report
Activities in bedrooms
needs fixingPeople who stayed in their bedrooms did not have enough opportunities for activities. Inspectors did not see activities taking place for people in their bedrooms.
“We did not observe any activities taking place for people in their bedrooms.” from the report
- 01What guidance do staff now have about whistleblowing, and how do you check that they understand it?
- 02What instructions are in place for safely managing warfarin?
- 03What activities are available for people who spend most of their time in their bedrooms?
- 04How do you make sure each person's emergency evacuation plan reflects their individual health conditions?
- 05How are people's and relatives' views used to check whether care plans and activities remain suitable?
This was an unannounced inspection covering the premises, care provided and all five CQC questions, with an overall rating for the service. This explanation was written from the published report of 23 January 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 Vi and John Rubens House
2 rated inspections over 2 years: the service has held its Good rating throughout.
- March 2023Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
- January 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 12 November 2010.
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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