Archived: Rockville House

The service provided accommodation for people requiring nursing or personal care on a respite basis. This meant people stayed for different lengths of time depending on their respite needs. For example, some people stayed one night while others stayed for longer periods. We visited the attached Rockville day centre so we were able to meet people who had used Rockville House for respite care in the recent past.

Prior to our inspection the Commission had received information from the local authority’s quality assurance improvement team and safeguarding team. These concerns had been investigated and appropriate action taken. The local authority’s quality improvement team were still working within the service to support the new manager to update and improve care records and other systems including quality audits.

At the time of our inspection the service did not have a registered manager. A new manager had been appointed and would be registering with the Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Since our visit to the service we have been informed the nominated individual had resigned from their post. The nominated individual (NI) is the person registered with us to account for the service at the provider level.

At this inspection we found improvements were needed to ensure the service was responsive and well-led. The provider did not have robust quality assurance processes in place to identify if records were up to date. Systems of auditing aspects of the service had lapsed for example individual care records. Care plans and risk assessments were in place with some already updated and completed to enable people to retain their independence and receive care with minimum risk to themselves or others. Others needed further reviewing to ensure they were up to date. The new manager had already started to incorporate these actions and updates into their plans for the service. One staff member said; “I think that they have drastically improved” while another said; “Some still need more work.” Relatives and staff told us the new manager was approachable. The manager was implementing monitoring systems to enable them to identify good practices and areas of improvement.

People remained safe at Rockville House. Some of the people who stayed for respite care were not able to fully verbalise their views. Relatives and staff felt people were safe. There were enough staff to support the number and needs of people. Some staff worked in both the respite service and the day service and this provided continuity in care. People were supported to take part in activities and trips out. People received their prescribed medicines safely. People responded positively when asked if they liked staying for respite care. A relative said; “We are very happy with the care [their relative] receives.”

People continued to receive care from a staff team that were skilled and knowledgeable to effectively support them. Staff were well trained and competent. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems within the service supported this practice. People's healthcare needs were monitored by the staff and people had access to healthcare professionals when required during their stay.

The staff were very caring and people had built strong relationships with the staff. During our observation in the day service we observed staff being patient and kind. People's privacy was respected. People where possible, or their representatives, were involved in decisions about the care and support people received.

People were able to make choices about their day to day lives. Complaints and concerns were fully investigated, responded to, and appropriate action taken. People attended the day service if they wished during their respite stay and were assisted to take part in a wide range of activities and trips out according to their individual interests.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; you can see what action we told the provider to take at the back of the full version of this report.

Rockville House only provides respite care, this means people stay for different lengths of time. For some people the respite stay maybe for one or two nights, others stay for longer periods, for example a weekend or for a weeks holiday. People who stayed at Rockville House have a wide range of care and support needs which meant they were not all able to tell us their experiences. Because of this we used a number of different methods to help us understand the experiences of people using the service, this included talking to parents or carers, and talking to staff.

We saw and heard staff speak to people in a way that demonstrated a good understanding of people's choices and preferences. We spoke to staff about the care given, looked at records related to them, and observed staff working with people who stayed for respite care. They took time to work at people's own pace. We saw that people's care records described their needs and how those needs were met.

We saw that medicines were administered by suitably trained staff. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to administer and record medication.

All the staff we spoke to said that they felt well supported by their colleagues and management. We saw staff received the training they required to carry out their roles.

We saw that Rockville House held all records securely to protect people's confidentiality.

Rockville only provides respite care, this means people stay for different lengths of time. For some people the respite stay maybe for one or two nights others stay for longer period, for example a weekend or for a weeks holiday. People who stay at Rockville have a wide range of care and support needs which meant they were not all able to tell us their experiences. Because of this we used a number of different methods to help us understand the experiences of people using the service, this included talking to parents or carers and talking to staff.

People were not always in the house during the day but could attend Rockville day centres which are joined to the respite home. Therefore we visited the day care service to meet two people who used the respite centre and spoke to one person via the telephone after our visit.

We saw and heard staff speak to people in a way that demonstrated a good understanding of people's choices and preferences. We spoke to staff about the care given, looked at records related to them, met with two of them, and observed staff working with people who stayed for respite care. They took time to work at people's own pace. We saw that people's care records described their needs and how those needs were met.

A survey returned to Rockville said, 'Always ready to chat when we visit'.