CQC report explained · a residential care home
What the CQC found at Welcome House - Ruby Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe, and staff knew how to recognise and report abuse. Risks, accidents, incidents, medicines and infection control were managed safely.
- Effective?
- Good
- This key question was not inspected in this focused visit. Its rating was carried over from the previous inspection.
- Caring?
- Good
- This key question was not inspected in this focused visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected in this focused visit. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- The management team used regular audits, action plans, meetings and supervisions to monitor and improve the home. People and staff said they could share their views and raise concerns.
What inspectors found, September 2022
Welcome House - Ruby Lodge rated Good; inspectors found safe, supportive care and improvements since the previous inspection.
This was an unannounced focused inspection. One inspector visited on 12 September 2022 and inspection activity ended on 15 September. The inspector spoke with six people, six staff members and two health professionals, and checked care, medicines, staff and management records.
The home was rated Good for Safe and Well-led. People said they felt safe, staff understood safeguarding, risks were reviewed, medicines were managed safely and there were enough trained staff. The home was clean and infection control arrangements were in place.
The previous inspection rated the home Requires Improvement and found breaches linked to safe care and governance. The provider made improvements through an action plan, including better incident reviews, updated care records and stronger audits. The home was no longer in breach of those regulations.
This was not a full inspection of all five areas. The overall Good rating also used ratings from the previous inspection for the areas not inspected.
Safe medicines support
Staff were trained and assessed as competent to give medicines. Two staff checked and administered medicines, and people said they received them at the right time.
“Medicines were managed safely. People received their medicines by staff who were trained and assessed as competent to administer medicines.” from the report
People have a voice
People were involved in house meetings, keyworker meetings and everyday decisions. They could make suggestions and were supported to maintain independence and go out.
“People were empowered to make decisions and were asked for their opinions on the service.” from the report
Strong knowledge of people's needs
Staff knew people well and care plans included information about mental health relapses and physical health risks. The home worked with health professionals when advice was needed.
“Mental health needs assessments were developed and reviewed with people, people and staff were aware of signs of potential relapses.” from the report
Active management oversight
The management team carried out regular audits and used action plans with named responsibilities and target dates. Staff were kept informed through meetings and supervision.
“At this inspection, the senior management team completed monthly service audits; action plans were developed with the registered manager with lines of responsibilities and target dates to achieve improvements.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure the improvements to accident and incident reporting are being maintained?
- 02How are staff supported to recognise and respond to a person's early signs of a mental health relapse?
- 03How do you check that medicines are given safely and that two-person checks are completed?
- 04How do you use people's feedback from house and keyworker meetings to make changes?
- 05What were the ratings and findings for Effective, Caring and Responsive at the last comprehensive inspection?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 24 September 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 2022
Requires Improvement; inspectors found risks were not always managed safely and quality checks did not identify important care-record problems.
This was an unannounced focused inspection on 18 November 2021. Inspectors looked only at Safe and Well-led because concerns had been raised about risk management. They spoke with six people and three staff, and reviewed care records, incident records, medicines records, staff files and management documents.
People generally said they were happy living at the home. They took part in activities and could personalise their rooms. Medicines were managed safely, there were enough staff on shift, and the home was clean and had infection-control measures in place.
However, risks were not always assessed or updated after incidents. Staff did not always follow safeguarding procedures, and one person did not receive hospital treatment promptly after a fall despite medical advice. Care plans were sometimes incomplete, inconsistent or not personal to the individual.
The overall rating remains Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three questions were not inspected during this visit, so their previous ratings were used in the overall rating. The home has had this overall rating for the last three consecutive inspections.
Positive daily experience
People spoken to by inspectors were generally positive about living at the home. They took part in activities and could make their rooms personal.
“People were engaged in activities at the home and those we spoke to said that they were happy living there.” from the report
Medicines
Medicines were stored, administered and checked using safe procedures. Staff had medicines training and their competence was checked.
“Medicine administration records were correct, and audits took place to highlight any errors.” from the report
Staffing
There were enough staff on shift during the inspection, and the number of support staff on day shifts had increased since the previous inspection.
“There were enough staff on shift to meet people's needs.” from the report
Clean premises and infection controls
The home was clean and tidy, and inspectors found several infection-control arrangements in place, including testing and visiting procedures.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Risks and incidents
seriousRisk assessments and care plans were not always updated after incidents or detailed enough to guide staff. A person was not taken to hospital promptly after being told to do so by a medical professional.
“Systems were either not in place or robust enough to demonstrate safety was effectively managed.” from the report
Care records were not always personal or consistent
needs fixingSome records contained missing, contradictory or generic information. This included information about religious beliefs, personal history, weight and budgeting.
“People's support plans were not always person centred.” from the report
Management checks did not find problems
seriousManagement reviewed incidents and carried out regular audits, but these checks did not consistently identify problems in care plans and risk assessments.
“Monthly quality assurance audits did take place regularly, however, they failed to highlight the issues in people's care plans and risk assessments.” from the report
Some infection-control practice was inconsistent
minorInspectors found that visitors were not asked for vaccination status on arrival, and one staff member was not wearing a face mask correctly. The mask was corrected during the visit and the provider said staff had been reminded about visitor checks.
“On arrival our lateral flow test status and temperatures were taken, however, we were not asked to provide our vaccination status.” from the report
- 01How will you make sure every risk assessment and care plan is updated after a fall, hospital visit or other incident?
- 02What checks now confirm that staff follow medical advice and safeguarding procedures after an incident?
- 03How will you correct generic or contradictory information in care plans, including religious beliefs, personal history and weight?
- 04What action has been taken in response to the CQC breaches, and when will you review whether the changes are working?
- 05How do you check that staff use PPE correctly and that visiting professionals' vaccination status is recorded?
This was an unannounced focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 10 February 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.
Every inspection of Welcome House - Ruby Lodge
6 rated inspections over 7 years: the service has held its Good rating throughout.
- September 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- July 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- August 2018Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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