Rawreth Court

This CQC report for Rawreth Court details findings from an inspection conducted in September 2023. Overall, the service requires improvement, with specific areas identified across safety, effectiveness, care, responsiveness, and leadership. The inspection aimed to follow up on previous concerns and assess the home's preparedness for infection control. While some positive aspects were noted, including effective infection prevention and control measures, and safe recruitment practices, significant concerns were raised regarding the overall quality and safety of care provided. The report highlights breaches in regulations related to consent, restrictive practices, risk management, medicines, nutrition, dignity, care planning, and quality assurance.

Regarding the safety of the service, there were issues with the recording of individual risks and the safe management of medicines, including missed doses and incorrect administration techniques observed. Moving and handling practices were not always safe, and while people and their relatives generally felt safe, and staff had safeguarding training, not all risks were adequately identified or managed.

In terms of effectiveness, the service was not always operating in line with the Mental Capacity Act 2005, with blanket restrictions observed such as locked bathroom doors and alarmed bedroom doors without appropriate consent or best interest assessments. Staff training was not consistently embedded in practice, and some staff lacked a full understanding of dementia or person-centred care. Nutritional monitoring, particularly for fluid intake, was also insufficient.

The caring aspect of the service was also found to require improvement. While most people and their relatives reported being treated with kindness, there were instances where people were not always treated with dignity and respect, and their choices and control over their lives were not always fully supported.

The responsiveness of the service needs development. Care plans did not always contain sufficient, accurate, or up-to-date information to guide staff in delivering person-centred care. While people were supported to engage in social activities, there were concerns about their ability to access basic facilities like bathrooms without assistance.

Concerning the well-led domain, the leadership and management arrangements did not provide assurance that the service was well-led, that people were safe, or that their care needs could be met. There was a lack of understanding regarding risks and their potential impact on residents, and systems were not robust enough to ensure consistent quality and safety.

The report notes that the overall rating and ratings for several key questions remain Requires Improvement from the previous inspection, indicating a continued need for significant progress. The provider has been informed of breaches in regulations and will be required to submit an action plan to demonstrate how improvements will be made.