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Rockville House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 15 June 2017

The inspection took place on 3 April 2017 and was unannounced. Rockville House provides a respite facility for people who have a physical disability, and accommodation is available for a maximum of three people at any one time. On the day of our visit two people were staying for respite care and were then attending the adjoining day service.

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.

Inspection areas

Safe

Good

Updated 15 June 2017

This service remains safe.

Effective

Good

Updated 15 June 2017

This service remains effective.

Caring

Good

Updated 15 June 2017

The service remains caring.

Responsive

Requires improvement

Updated 15 June 2017

The service was not always responsive.

People’s care records were not always updated to ensure care given was appropriate and as desired by the person.

People had a choice of activities they were supported to participate in if they wished.

There was a complaints policy in place. People’s concerns were dealt with to people’s satisfaction when they arose.

Well-led

Requires improvement

Updated 15 June 2017

The service was not always well led.

The service did not have a registered manager or registered provider in place although a new manager had been appointed.

Some records, risk assessments and audits required updating.

People did not always benefit from robust systems to monitor the quality of their care. Systems of auditing aspects of the service had lapsed.