Russell House

Updated 25 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector over three days and a specialist advisor was present on day two of the inspection. Their speciality was learning disabilities.

Service and service type

Russell House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with one relative about their experience of the care provided. We spoke with fourteen members of staff including the provider, registered manager, four team leaders, one shift leader, four support workers, two agency staff and the activity co-ordinator. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at six staff files in relation to recruitment, two agency staff profiles and nine staff supervision records. A variety of records relating to the management of the service, including policies, procedures, health and safety and audits were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, recruitment verification, peer audits and meeting minutes. We sought feedback from professionals who work with the service. We spoke with one relative by telephone and received written feedback from two relatives.

Updated 25 October 2019

About the service

Russell house is run by the Epilepsy Society. It is a residential care home providing accommodation and personal care to 20 people. At the time of the inspection 20 people were living there.

Russell house accommodates twenty people in four units, each housing five people. Each unit have their own communal facilities such as kitchens, sitting areas and a bathroom. The registered manager’s office and administration office is located on the ground floor by the entrance to the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 20 people. Twenty people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design of four smaller units.

People’s experience of using this service and what we found

Relatives were happy with the care provided. They had trusting relationships with staff and recognised the improvements and challenges within the service.

Systems were in place to keep people safe. Risks to them were identified and managed. People were supported with their medicines and measures were in place to prevent cross infection. Staff were suitably recruited, and the required staffing levels were maintained. However, there was a lack of consistency in care due to the use of bank and agency staff which the provider was attempting to address through the recruitment of new staff.

People were supported by staff who were suitably inducted, trained and supported. Their health and nutritional needs were met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Relatives confirmed staff were kind and caring. We observed positive engagements between staff and the people they supported. People’s privacy, dignity and independence was promoted.

Person centred care was promoted. People’s care, support and communication needs were identified and met. They had access to activities. For some people end of life preferences were identified, for others family were consulted with on their wishes. Systems were in place to deal with concerns and complaints.

People were supported by a service that was well managed. Improvements had been made to records management and regular auditing was taking place to promptly address any identified issues. Relatives and staff were positive about the improvements the registered manager had brought to the service. They described the registered manager as “accessible, approachable, personable, generous with their time, open, transparent, good listener, supportive, understanding, flexible and efficient”. Staff told us “they felt valued, empowered, motivated and committed to the values of the service”.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published September 2018). We imposed a condition on the provider's registration of this service for them to carry out monthly audits and send monthly reports to us about the outcomes of these. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Russell House on our website at www.cqc.org.uk.

Why we inspected

This was a planned inspection based on the previous rating. This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.