Background to this inspection
Updated
6 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
The inspection was completed by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care [and support] to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
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 not a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last 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. We used all of this information to plan our inspection.
During the inspection
We spoke with one person who used the service and six relatives about their experience of the care provided. We spoke with a health and social care professional who has contact with the service. We spoke with five members of staff including the manager, area manager, area support manager, and two care staff. We reviewed a range of records. This included three people’s care records and multiple medicines records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection we continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
6 October 2022
About the service
Rowan Court provides care and support to people living in ‘extra care’ housing. People using the service live in their own flats within a shared building containing 21 flats. The building also houses the offices used by the registered manager and staff. Not everyone living at Rowan Court received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of this inspection 12 people received personal care from Radis staff.
People’s experience of using this service and what we found
Staff recruitment records did not always demonstrate that thorough processes were followed when checking staff for suitability before being employed by the service. Staff training continued to be an issue with gaps in the training records for most staff and staff overdue for training.
Systems for monitoring and improving the quality and safety of the service were not always effective. A system of audits was in operation but there was a lack of evidence to demonstrate how this was used to monitor and improve the service.
There was mixed feedback from relatives about the effectiveness of raising concerns and getting feedback. This included about being able to contact the office when they needed to.
Improvements had been made to the systems for managing people’s medicines. However, annual refresher training was overdue for most staff.
Staffing levels were determined by the number of people receiving care and support and their needs. People and their relatives confirmed staff turned up on time, stayed the correct length of time, and did not rush people.
Systems were in place to protect people from abuse. Appropriate procedures were in place for the prevention and control of infection.
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. Care needs were delivered in line with their individual assessment and regularly reviewed. People were supported to access health care services.
People and their relatives confirmed staff knew people well, respected people’s daily routines and were flexible to meet people’s needs.
A new manager had recently started and were working alongside management to ensure improvements were in place.
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 4 July 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations and the service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 13 and 14 March 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing, good governance, fit and proper persons employed, and notification of other incidents.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Radis Community Care (Rowan Court ECH) on our website at www.cqc.org.uk.
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.