Roebuck Nursing Home

Updated 17 December 2021

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 Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by two inspectors 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. The Expert by Experience made calls to relatives following the site visit.

Service and service type

Roebuck Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who was applying to be registered with the Care Quality Commission. 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. The provider was providing management oversight in the home since July 2021. This was because the registered manager and deputy manager had left the business and had been absent from the home for periods of time prior to their leaving.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 2 November 2021 and ended on 19 November 2021.

What we did before inspection

We reviewed information we had received about the service since our last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection-

We spoke with five people who used the service and 20 relatives about their experience of the care provided. We spoke with the manager, provider and seven staff members. We reviewed feedback professionals had shared with the service. We reviewed a range of records. This included six people’s care records and medication records. We looked at three staff file checklists 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 quality assurance records.

Updated 17 December 2021

About the service

Roebuck Nursing Home is a care home providing nursing care and accommodation for up to 63 older people, including people living with dementia. At the time of the inspection there were 34 people living at the home.

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

People felt they were safe and well supported by the service. Individual risks were assessed in some cases, and staff were aware of these. However more detail was needed to ensure staff could work safely. Some practices in the home placed people at risk of harm from choking or moving and handling practice. Action was taken by the new manager at the time of our visit.

There were monitoring processes in place to help promote a good standard of service and the quality assurance systems identified some areas that needed further development. However, these systems had not identified all areas that needed to be addressed. This included risks, staffing deployments and preventing the risk of social isolation.

The manager was new to the service as had only started the day before our inspection visit, the home had recently been managed by the provider after undergoing significant changes to the management team. The provider had needed to carry out many roles to support the home until such time as the new manager started. People, relatives and staff were positive about the recent management changes and how the provider had managed to keep the service running.

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 in most cases. The policies and systems in the service did not always support this practice as mental capacity and best interest records needed to be more personalised.

People and relatives told us staff were kind, caring and praised the home for the attention they received. Staff enjoyed working for the service and told us the culture was to ensure care was person centred. Staff told us they would be happy to have a relative of theirs living at the service. Care plans included information to help support people safely in most cases. However, some of these plans needed more work to ensure they were reflective of all aspects of the person’s needs. Further checks were needed to monitor the dining experience, to ensure people did not become socially isolated and to ensure people’s dignity was promoted consistently.

Reviews of events and accidents were carried out and any actions needed were completed. Medicines were managed well, and staff knew how to report any concerns about a person’s safety or welfare. People told us staff were kind and helpful, but often busy.

Staff received training for their role and people and their relatives felt they had good knowledge and skills. Staff felt supported by the provider and management team. People told us they felt their needs were met. Relatives also felt care was to a good standard.

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

Rating at last inspection

The last rating for this service was Good. (Published 28 April 2021) This was a focused inspection only reviewing safe and well led.

Why we inspected

The inspection was prompted in part due to concerns received about people’s welfare due to the changes of management and staff in the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive 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.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.