This inspection took place on 9 May 2016 and was unannounced.
There is a requirement for Rowthorne Care Home to have a registered manager and a registered manager was in place in place at the time of this inspection. 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.
The service is registered to provide residential care for up to 40 older people. At the time of our inspection 24 people were using the service. This was because sections of the building were closed for refurbishment.
Systems and processes were not always operated effectively to ensure the quality and safety of services were assessed, monitored and improved. In addition, systems and processes did not always reduce risks to people. Although people had been asked for their views, there was no regular review of people’s views on the quality of care provided, including those views of other professionals and families.
Medicines were not always given to people as prescribed and medicines management and administration did not always follow guidelines for the safe use of medicines. The way staff were organised and deployed, had on occasion, left people waiting for their care and support. As such people did not always receive personalised or responsive care. Staff recruitment processes ensured staff were checked prior to working at the service to ensure they were suitable to do so.
People were supported by staff who were kind and thoughtful about people’s care. People’s choices and decisions were respected by staff. On most occasions, but not all, staff were mindful of respecting people’s dignity and supporting their privacy.
The provider had taken steps to reduce the risk of abuse to people through staff training and awareness in safeguarding people and whistle blowing procedures. Other risks to people’s health were identified and care plans were in place to ensure any risks were reduced. People who required assistance to mobilise were assisted safely by staff who had been trained.
People were asked for their consent to their care and support. For people who lacked capacity to consent to their care and support the provider had procedures in place that followed the principles of the Mental Capacity Act (MCA) 2005. The provider also had procedures in place to apply for assessment and approval of any restraint on a person’s freedom in line with the Deprivation of Liberty Safeguards (DoLS). Staff understood the principles of the MCA and DoLS and staff training in other areas relevant to people’s care needs was well managed to ensure staff retained up to date skills and knowledge.
Staff received supervision and demonstrated knowledge of people’s needs. People were supported to access other health care services as required. In addition, people had expressed their choices and preferences over meals and drinks and received sufficient food and drink that met their nutritional needs.
People, and where appropriate families, were involved in planning people’s care and support. People could share their views in a variety of ways, including meetings with staff. People were able to maintain relationships with those who were important to them. People received support to engage in games and entertainment.
The registered manager was viewed as being approachable and open in their leadership of the service. The registered manager had made improvements to the service and the systems in operation at the service and staff found these improvements helpful. The registered manager was aiming for consistent standards of good quality care and support, however changes to the staff team due to reorganisation and change meant the support to the registered manager was not always consistent.
Records and audits were available to check on the quality and safety of services provided to people using the service. We saw information had been made available advising to people and their families about how to make a complaint or offer feedback. People knew how to raise concerns or make suggestions.
At this inspection 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 the report.