All inspections: Rowley House Limited - Care Quality Commission

This inspection took place on 2 March 2017 and was unannounced. At our last inspection in October 2015 we had concerns that the service was not consistently safe, effective, responsive or well led. At this inspection we found that some improvements had been made, however we had concerns that the service was still not consistently safe or well led.

Rowley House provides accommodation and nursing care for up to 36 people. At the time of this inspection there were 30 people using the service.

There was a registered manager in post. 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.

People's medicines were not always managed safely. The provider could not be sure that people had their medicines as medicine records did not correspond with the balance of stock.

The systems the provider had in place to monitor the management of medicines were not effective. The home's rating from the last inspection was not displayed in a way in which people could see it clearly.

People were safeguarded from the risk of abuse as staff knew what constituted abuse and who to report it to if they suspected abuse. The registered manager referred safeguarding concerns to the local authority for further investigation.

Risks of harm to people were assessed and action was taken to minimise the risk of further harm. Staff knew people's risks and how to keep them safe.

There were sufficient numbers of suitably trained staff to keep people safe. New staff were employed using safe recruitment procedures to ensure they were of good character and fit to work with people.

People were cared for by staff who were supported by the management team and trained to fulfil their roles.

The principles of The MCA 2005 and DoLS were being followed to ensure that people who lacked mental capacity were being supported to consent to their care at the service in their best interests.

People were encouraged to maintain a healthy diet. If people lost weight or they became unwell, professional health care advice was sought in a timely manner.

People were treated with dignity and respect and their right to privacy was upheld. People were able to make choices about their care and be as independent at they were able to be.

People received personalised care that met their individual needs and preferences. People knew how to complain if they had any concerns about their care.

People, their relatives and the staff liked and respected the registered manager and management team. Some improvements to the quality of the service had been made since the last inspection.

This inspection took place on 6 October 2015 and was unannounced. Rowley House provides nursing care for up to 36 people. This includes nine people who are on a health supported programme aimed at helping people to return to live at home. At the time of this inspection 31 people used the service. The last inspection was completed in September 2013 and was compliant with the Regulations we looked at.

The service had a registered manager. 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.

People told us they felt safe and were comfortable; however staffing levels were not always in sufficient number to support people individually and in their preferred way. People told us they experienced delays in obtaining staff support and help.

People and their relatives were not always involved in planning their care and treatment. The care plans did not accurately reflect the care and support needs of people.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLs) and to report on what we find. Some people were not involved with important decision making. The manager told us that they had raised several DoLS referrals with the local authority.

Where people were identified as being at risk of harm, assessments had been completed. Action was not consistently taken to reduce the risks to people and the guidance in the assessments not consistently followed.

People’s medicines were administered to them by staff; arrangements were in place for the safe storage, administration and management of medicines.

Staff were trained and were supported to fulfil their role. The provider had a recruitment process in place. Staff were only employed after all essential pre-employment safety checks had been satisfactorily completed. Staff received regular supervision with their line manager.

Recreational and leisure activities were arranged throughout the week. People were given the opportunity to participate in the group activities if they wished to do so.

People were aware of the complaints procedure and knew how and to whom they could raise their concerns.

People’s nutritional and health care needs were met. People were treated with kindness, compassion and respect and staff promoted people’s independence and right to privacy.

People told us the registered manager and senior staff were supportive and helpful. Checks were made on a regular basis to ensure the quality and safety of the service, however, not all checks completed by the manager and staff identified gaps, shortfalls or omissions in the records.

This was an unannounced inspection. The service did not know we were visiting. During the inspection we spoke with people that lived there, relatives, staff and with the general manager. People told us they were satisfied with the care they received. One person told us: "They are very good here". Another person said: "Whatever you want you have".

People were involved in decisions about their care. Records confirmed that people or, if appropriate, their relative signed records to confirm their agreement to their care.

People received care that met their needs. Plans of care were personalised and included information about people's health and social care needs. People's needs were evaluated monthly. Where people needed specialist health support this was provided. People were dressed in an individual style in line with their preferences. We saw that the home provided people with opportunities to take part in both group and individual activities.

The home sought the views of people about their care and when issues were raised these were addressed. There was an effective complaints procedure in place. The home completed a number of audits to check and monitor the care it provided to people and where necessary took action to improve the service.

We visited Rowley House Care Home to inspect the home as part of our routine scheduled inspections. The visit was unannounced, which means the provider and the staff did not know we were coming.

Rowley House had 35 beds, 21 nursing beds and 13 intermediate care beds sited in a separate unit. The intermediate care patients were supported by a team of staff including physiotherapists, liaison staff and occupational therapists that assisted people to return to their own home.

To help us to understand the experiences people have we used our Short Observational Framework for Inspection tool (SOFI). The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences. Some people using the service were able to tell us about their experiences and we also spoke with visitors to the service and other health professionals.

We spoke with a relative that told us 'Mum is doing very well here, she is forgetful at times but the staff are patient with her. The staff are approachable and listen to any concerns we have. I visit most days and I am always met by welcoming staff. The home is very clean and tidy.'

One person told us 'I am settled here now, it wasn't easy to start with but I am used to it now. The meals are good, sometimes too big, but always well cooked. I enjoy looking at the birds in the lovely garden.'

One person told us 'I chose to come here. The staff look after me very well and I enjoy the food. My family visit when they can, but there is plenty of activity going on to keep us occupied if we wish to join in.'

The home has an activities co-coordinator who arranges afternoon activities in the home. There is an activities board which displays planned activities for the week and previous events. People told us they enjoy the afternoon activities which include crafts, music, quizzes and baking.

These older reports are from our old approaches to inspection, including those from before CQC was created.

Archived: Rowley House Limited

All Inspections

2 March 2017

During a routine inspection

6 October 2015

During a routine inspection

5 September 2013

During a routine inspection

1 June 2012

During a routine inspection

Reports under our old system of regulation