Roland Residential Care Homes - 27 Bush Hill

Updated 19 October 2022

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 Health and Social Care Act 2008.

Inspection team

One inspector and two Experts by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. One Expert by Experience spoke to people during the inspection site visit and the other Expert by Experience contacted people's relatives by telephone to request their feedback.

Service and service type

Roland Residential Care Homes - 27 Bush Hill is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Roland Residential Care Homes - 27 Bush Hill is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 12 May 2022 and ended on 27 May 2022. We visited the location’s service on 12 May and 19 May 2022 and provided inspection feedback on 27 May 2022.

What we did before the inspection

We reviewed information we had received about the service and formal notifications that the service had sent to CQC. Notifications are information that registered persons are required to tell us about by law that may affect people's health and wellbeing. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service and six relatives. We spoke with six members of staff including the registered manager, a senior manager, team leader and three support staff. We undertook observations of people receiving care to help us understand their experiences. We reviewed a range of records. This included four people's care records and seven people's medicines records. We looked at three staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service and quality assurance were reviewed including accident and incident records. We sought feedback from the local authority and professionals who work with the service.

Updated 19 October 2022

About the service

Roland Residential Care Homes - 27 Bush Hill is a residential service providing personal care for up to 10 people with mental health support needs. The service consists of one adapted building, which includes individual bedrooms and communal spaces spread over two floors and an accessible garden. At the time of our inspection there were 9 people using the service.

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

People and their relatives told us they felt safe with the care and support they or their relative received. Despite this positive feedback, we found risks relating to the premises were not being safely managed. We found concerns with the management of medicines and incidents which placed people at increased risk of harm.

The provider had systems in place to monitor the quality and safety of the service, however they did not identify the issues we found during the inspection. We found CQC had not been notified of several incidents as required.

We have made a recommendation around safeguarding adults.

We have made a recommendation around staff training and support.

We have made a recommendation around offering food choices to people.

We have made a recommendation around managing complaints.

People were supported by staff who had been assessed as safe to work with vulnerable adults. People were kept safe from the risk of infection and COVID-19.

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.

People were supported by kind and caring staff who supported their independence. People were supported by staff who knew them well and understood their likes and dislikes.

Staff told us they were well supported by the management team. People and their relatives told us they were satisfied with the service provided.

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

Rating at last inspection

This service was registered with us on 5 February 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.