Rodwell House

Rodwell House is a care home providing accommodation, personal and nursing care for up to 75 people. The service supports people with a range of nursing needs including people living with dementia. The service is arranged across 3 floors with lift access. People have access to shared lounges and dining rooms and accessible gardens and grounds. At the time of our inspection there were 44 people using the service.

Rodwell House also provides personal care for people living in their own homes, within the same accommodation. These people have a tenancy agreement and a separate agreement for their care provision. There were 34 people receiving personal care in their ‘own homes’. People receiving personal care can choose to have their care provided by another care provider. However, everyone living in Rodwell House had their care provided by staff employed by the service and we included these people within the inspection. We are working closely with the provider to reduce the number of people with tenancies to enable the whole service to be available for people who require accommodation with nursing or personal care.

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

Rodwell House had made a lot of improvements since our last inspection. Activities had increased, but there were still not enough activity coordinators to provide the range of activities and social engagement to meet everyone’s individual needs. People, relatives, and professionals all highlighted this as an area that still needed to be improved.

Improvements had also been made to the menu and food choices and menus were now on display. Changes were based on feedback from people and relatives. Despite the improvements, some people told us their meals were not hot when they received them. People’s care plans were person centred and detailed their preferences. However, some of these preferences were not always adhered to.

People told us they felt safe living in Rodwell House, and staff checked up on them regularly. Relatives told us staff put things in place to help keep their loved one safe, for example, mats beside the bed. There were enough staff deployed in the service and the staff knew the needs of the people they were supporting. Medicines were managed safely; accidents and incidents were monitored, and lessons were learned and shared if something went wrong.

People were assessed before they moved in to Rodwell House to ensure the staff had the necessary skills to meet their needs. Assessments were used to formulate the care plan. Care plans and risk assessments were reviewed regularly. People and their relatives told us the service was kept very clean and tidy.

Since our last inspection the service had made improvements to make the environment more suitable for people living with dementia. Staff had received training and a new practice development team worked alongside care workers to champion best practice. People were supported to see a doctor or other health professional when needed.

People and relatives told us staff were kind and caring and treated people with dignity and respect. One relative said, “The staff are very nice and friendly, and they always take the time to say hello and chat.” People received care which promoted independence and relatives told us they were updated regularly. Another relative told us, “It is clean, it is welcoming, and staff always make themselves available, I am totally involved in all aspects of the care.”

Effective quality assurance processes were in place to monitor the service and regular audits were undertaken. A new registered manager had been appointed since our last inspection and staff told us they found them approachable and supportive with an open-door policy. People and relatives spoke highly of the new registered manager.

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.

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 10 August 2022) and there were 2 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 improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended the provider seek guidance in relation to the environment and activities for people living with dementia, and the provision of compassionate care. At this inspection we found the provider had acted on the recommendations and improvements had been made. The environment had been improved and care was provided in a compassionate way. Improvements had been made to activities and social engagement for people, but there was still room for more improvement in this area.

The service remains requires improvement overall based on the findings at this inspection.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 ask the provider to continue to send us an updated action plan regularly to understand what they will do and by when, 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.

Rodwell House is a care home providing accommodation, personal care and nursing care for up to 79 people. People living at Rodwell House are living with a range of health conditions, this included diabetes, epilepsy and Parkinson’s. There were people living with dementia and a learning disability. At the time of our inspection, 75 people lived at Rodwell House, some of whom had their own tenancies, but received the regulated activity of personal care from staff. This is help with tasks related to personal hygiene and eating.

Everyone lives in one purpose-built building which has a large communal lounge/dining area on the ground floor as well as accessible gardens and grounds.

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

Since our last visit the registered manager had undertaken a lot of work to improve the service provided to people living at Rodwell House. People and relatives told us that overall, they felt changes were positive and things were, “Moving in the right direction.” Despite the positive feedback, there were still shortfalls. This included the environment, documentation, risks to people and activities. We also heard that staff continued to speak in their own language in front of people; something we had been told on previous visits. We were told by staff, people and relatives about a negative culture that had been created in the service by management. This had caused a divide amongst staff and as such had been noticed by people.

People told us they felt safe at the service and we found improvements in staffs recognition of potential incidents of abuse. Reporting and investigations were taking place and staff were learning from incidents. Although we also found care documentation and staff knowledge had improved in relation to potential risks to people, this needed further embedding into practice to ensure that everyone was safe.

There were mixed views on staffing levels at the service from people, relatives and staff. On the day of our inspection, we observed that people did not have to wait long periods to be supported. Although there was little time for staff to spend with people on an individual basis and some people had to wait for their lunch.

Since our last inspection, the environment had improved. However, we have issued a recommendation to the registered provider to continue to work on this.

People were seen participating in activities and some people told us they had been on a trip outside as outings had recommenced. Although, this was an improvement since our last visit further work was needed to ensure that those people who were cared for in their rooms received regular interaction from staff. We have issued a recommendation to the registered provider in this respect.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The service provided care to two people who had a learning disability and since our last inspection had not admitted anyone else into the service who would meet the requirements of Right support, right care, right culture. Since our last inspection, management had spent time with these two people giving them the opportunity to be involved in aspects of everyday living and offering support to give them more independence. Neither person was keen to progress with this; one person was happy living in the service as they were and the other was in the process of moving to another service. Therefore, we felt the service had done what they could to meet the requirements of Right support, right care, right culture.

Right support: Model of care and setting maximises people’s choice, control and independence; People were given the opportunity to have choice and independence and as a result one person had started to go out more often.

Right care: Care is person-centred and promotes people’s dignity, privacy and human rights; People with autism or a learning disability had specific care plans in place around their individual needs.

Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives; Staff had received additional training to enable them to understand the impact a learning disability may have on a person. This had helped in their approach towards people. Management had good knowledge and shared this with staff in an informal way to help change staff attitude and approach.

People were known by staff and staff provided appropriate and responsive care to them. Guidance was in people’s care plans for staff to follow and we read from the daily notes people were regularly checked on throughout the day.

People received the medicines they required and they lived in an environment that was clean and checked for its safety. People were supported to see a health care professional when needed and relatives told us staff were quick to let them know if they were concerned about their family member’s health. People told us the food had improved and they were being provided with more choice.

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.

The service worked with other agencies to help provide appropriate care to people and management looked for ways to improve the care people received.

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 Inadequate (report published 08 February 2022).

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 improvements had been made. However, we found the provider remained in breach of some regulations.

At our last inspection we recommended the registered provider reviewed people’s capacity in line with the principles of the Mental Capacity Act 2005. At this inspection, we found the registered provider had acted on this recommendation.

This service has been in Special Measures since 08 February 2022.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well-led key questions in this report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rodwell House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risks to people and the overall management of the service. Despite many improvements being made since our last visit, these were not consistently embedded into daily practice and there was still further work to complete to ensure there were robust governance arrangements in place, ones which picked up on areas that required addressing.

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.

Rodwell House is a care home providing, accommodation, personal and nursing care to up to 79 people in one purpose-built building. People were living with a range of complex health care needs. This included people living with dementia, diabetes or Parkinson's disease as well as people with a learning disability. At the time of our inspection, 74 people were living at the service.

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

Despite highlighting shortfalls to the registered provider in a number of our previous inspections, they had failed to take action and as such people living at Rodwell House continued to receive a poor level of care.

The registered provider was unable to demonstrate robust governance arrangements and learning had not taken place to improve the service. The service was without a registered manager and there had been a lack of consistent service-based management presence over a number of years. There was a lack of commitment or urgency to ensure people’s quality of care improved and that where shortfalls were identified by management, these were addressed in a timely manner. Infection control practices were not sufficiently rigorous to help ensure people were kept safe from the spread of infection.

People said they were not provided with enough attention from staff as staff were too busy and they told us they were, “Bored”, particularly those people who were confined to their rooms. People said the quality of the food provided to them had deteriorated and that staff did not always demonstrate a kind, caring approach and one that enabled them to make their own decisions. People reported staff continued to speak in their own language which was a concern we had identified at previous inspections.

There was an insufficient number of staff available to meet people’s care needs and ensure people were not at risk of social isolation. We heard how staffing levels had changed and this had impacted on people’s daily lives. Despite the service having a safeguarding procedure, staff did not learn from incidents that had occurred as we received a number of safeguarding concerns over a period of several months. People therefore continued to be at risk of harm whilst living at Rodwell House.

Individual staff were kind, caring and attentive towards people and we heard from some people and their relatives that they were happy living at Rodwell House. However, we were also told by people how they felt staff did not always demonstrate a respectful and compassionate approach. Although people were invited to give their views on the service, their feedback was not always listened to.

People’s care plans were not contemporaneous, and staff were not always able to tell us about people’s individual care needs. Where people were at risk of harm, information was not always in place for staff to give them guidance on how to respond to this.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

• There were insufficient activities staff within the service to provide people with individual, meaningful activities and external trips no longer took place. This meant people did not have the opportunity to access the community.

Right care:

• There was a wide mix of people living at the service and as such people’s individual characteristics and needs were not always recognised by staff. Staff did not always take time to read people’s care plans and were unable to tell us about people.

Right culture:

• The changes within the service meant that there was a constant turnover of staff. This resulted in people receiving care from staff who may not know them well and staff who did not always speak English in front of people. People were admitted to the service without the registered provider considering it was an appropriate setting for them.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We have issued the registered provider with a recommendation in this respect.

Although staff said they received sufficient training and felt supported by the new manager, we heard examples of poor care being provided by staff and where shortfalls or concerns had previously been identified at this service, training had not taken place with staff to help ensure they did not reoccur.

People received the medicines their required and when needed, the input from healthcare professionals. People said they felt safe living at Rodwell House and staff were able to demonstrate their understanding of reporting any safeguarding concerns.

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)

We carried out a focused inspection to this service in December 2020 when we inspected on the key questions of Safe and Well-Led. Prior to that we completed a fully comprehensive inspection in October 2019 covering all key questions. The overall rating for the service at both inspections was Requires Improvement and we found breaches of Regulation. The registered provider completed an action plan after that inspection to show what they would do and by when to improve.

At this inspection we found that not all breaches of Regulation had been met and we also identified new breaches of Regulation relating to staffing, infection control, risk management, safeguarding, training, the premises, respectful and person-centred care and governance. You can see more detailed information about these in all of the key questions in this report.

Why we inspected

This inspection was carried out in response to numerous concerns we had received. These related to staffing levels, poor care, poor quality of food and lack of empathetic management. It was also partially prompted by our data insight which assesses potential risks at services, concerns in relation to aspects of care provision and the rating at the last inspection. The overall rating for the service has deteriorated to Inadequate. This is based on the findings at this inspection.

Special measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least Good. We will work with the local authority to monitor progress.

Rodwell House is a service providing personal and nursing care for up to 79 people. The service is provided in one adapted building set over three floors with a communal lounge, activity and dining area. At the time of our inspection 76 people were living at the service. Support was provided to older people some of whom were living with dementia and people with nursing care needs.

Some people living at the service had tenancy agreements with the registered provider and as such fell under the regulated activity of personal care. However, staff confirmed that everyone living at the service were entitled to the same level of 24-hour care, therefore we have included everyone living at the service in our inspection. The service also provides support to people who have a tenancy for their suite at the service. In this case we would only regulate the personal care people received.

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

People and their loved ones told us they felt safe at the service, however we found shortfalls in how risks to people were managed. People told they had to wait for support and that staff did not respond quickly to call bells. At the last inspection we made a recommendation about staff deployment. This continued to be a concern at this inspection and was impacted by the numbers of new staff. Staff told us they did not always have time to spend with people who needed reassurance due to other tasks or supporting new staff.

Processes used to recruit staff were not always effective in ensuring their suitability for work. We also found that governance at the service had not been effective in identifying all shortfalls or making the improvements needed. There continued to be issues relating to staff from outside the UK speaking their own language around people and struggling to communicate with the people they supported. Some actions had been taken by the provider to address this, they had not been successful in resolving the issue at the time of inspection.

There had been a number of managers at the service since the last inspection which staff told us had limited improvements. Whilst audits had been completed, they had not identified all the shortfalls found at this inspection. When shortfalls had been identified progress was slow in driving improvement.

Staff understood their responsibilities in relation to safeguarding people. People received their medicines in the way they chose from staff who were competent to administer them. Infection prevention control practices were effective, and staff were up to date with all guidance related to COVID.

Staff worked closely with other professionals to meet people’s needs. People and families told us they were invited to give their views on their care and they were listened to. The manager understood their responsibility in relation to informing other agencies such as the local authority or CQC of incidents and this was done in a timely manner.

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 24 November 2019). At that inspection we found three breaches of regulation relating to person centred care, the need for consent and good governance. At this inspection we did not look at evidence related to person centred care of the need for consent.

In relation to good governance at this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We received concerns in relation to people waiting for long periods of time to receive staff support, the number of safeguarding incidents and complaints the service had received. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rodwell House on our website at www.cqc.org.uk.

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation To safe care and treatment, fit and proper persons employed and good governance at this inspection.

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 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.

Rodwell House is a service providing personal and nursing care for up to 75 people. The service is provided in one adapted building set over three floors with a communal lounge, activity and dining area. At the time of our inspection 64 people were living at the service. Some people living at the service had tenancy agreements with the registered provider and as such fell under the regulated activity of personal care. However, staff confirmed that everyone living at the service were entitled to the same level of 24-hour care, therefore we have included everyone living at the service in our inspection.

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

We heard from people, relative’s and staff that things had improved since the new manager and deputy manager had commenced in post. However, there continued to be shortfalls in person-centred care, robust record keeping and staff able to speak a good level of English. Some of this was having a negative impact on people and as such we have issued breaches of regulation to the registered provider.

People did tell us however they were cared for by staff who were kind and caring. They said they felt there was enough going on at the service and they enjoyed the food. We found though that people who remained in their rooms may not always receive social stimulation.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

People lived in an environment that was cleaned to a good standard and was checked for its safety. People were supported to make their own decisions and do things for themselves. Health care professional involvement was sought to help people remain well and people said they felt safe living at Rodwell House.

Although staff were now starting to receive training and supervision and there were sufficient staff on duty to care for people, we have issued a recommendation to the registered provider to address some shortfalls we identified in relation to these areas. We also found that some information around people’s risks was not robust and again have issued a recommendation in this respect.

Quality assurance checks had been introduced to help to improve the service for people. The manager and deputy manager had a drive to move the service forward and people had already noticed a positive change.

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 1 November 2018).

Following the last inspection, we asked the provider to complete an action plan to tell us how they planned to address the shortfalls. At this inspection we found improvements had been made.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvement. Please see the Effective, Responsive and Well-Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Rodwell House is a privately-owned service and provides accommodation for people who require nursing or personal care, and treatment of disease, disorder or injury. The service provides nursing care for up to 75 people.

At the time of inspection there was not 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.

On the first day of our inspection visit there was a manager in post who had commenced the registration process. However, during this inspection we were informed that the manager had left their post. This was the fifth change of manager in nine months which meant the service was not consistently well-led.

The service currently has a large number of safeguarding concerns related to people’s care and treatment. These related to a lack of staff, poor staff practice and a number of falls and injuries. These are subject to ongoing investigations by the police. At this time the outcome of this is not known. During our inspection two further safeguarding concerns were identified that had not been reported in line with good practice. One included a person who had unexplained cuts and bruising from June 2018 and another was raised by a relative in June 2018.

Staff deployment at the service at the service was not effective to ensure that people’s needs were met. Staff were allocated to people by the lounges they used and not by the floors they lived on. This meant that staff were allocated to people over the three floors and they would not attend to people’s needs if they were not in their allocated lounges.

Staff were knowledgeable about the people who had been allocated to them but they had insufficient knowledge about other people’s needs so would not attend to them when they had asked for support. This led to delays in care being provided to people. People were not always treated with kindness and respect and their dignity was not always promoted. Staff would only attend to people who had been allocated to them.

People were put at risk of infection as staff had failed to follow the provider’s infection control policy. There was an infestation of flies in two of the three lounges and one member of staff had failed to ensure that personal protective equipment was used when cleaning faeces off a toilet floor. This people at risk of infections. Risk assessments were not always in place in relation to people’s needs.

Some risk assessments required further detail to ensure people were protected from the risk of harm. Accidents and incidents were recorded and analysed but lessons learned had not been recorded.

Quality assurance systems were not robust and did not lead to continuous improvement at the service. Monthly audits had been undertaken and actions were put in place, but they had not identified the issues we found regarding infection control, reporting safeguarding concerns and care plans that lacked sufficient information. Neither had they identified the issues related to daily noted being copied and pasted and the poor standard of English used within them.

People were not always treated with kindness and respect and their dignity was not always promoted. People’s wishes had not always been respected by staff.

Staff had not always received appropriate support, training and supervision as is necessary to enable them to carry out their duties. The environment a required further development to meet the needs of people living with dementia.

The provider had failed to operate effectively an accessible system for identifying, receiving, recording, handling and responding to complaints. Improvements were required around the recording of the wishes of people’s end of life care. We have made a recommendation around this.

Medicines were stored, recorded and administered to people but other information regarding medicines as required were not in place.

People were protected from unsuitable staff because safe recruitment practices were followed before new staff were employed.

People were supported to ensure they had enough to eat and drink to keep them healthy and people were complimentary about the food. People had access to all healthcare professionals as and when they needed them. People who needed them had wound care plans that aided nursing staff to provide ongoing treatment to aid the healing process.

People’s rights under the Mental Capacity Act (MCA) were respected. People’s needs and choices were assessed before they were admitted to the service.

Staff promoted people’s privacy because they knocked on doors before entering people’s rooms and attended to personal care needs in private. We observed some good positive interactions between staff and people. Currently there was no person living at the service from the lesbian, gay, bisexual or transgender (LBGT) communities. Staff told us that they would treat all people equally.

People had a range of activities they could be involved in. Residents meetings took place at the service where people had the opportunity to have discussions about the service. Regular staff meetings took place and we saw the minutes of these meetings that had been held in May. Topics discussed included creating a positive working environment, responding to call bells, staff sickness and recruitment of staff.

The provider and staff worked with other relevant agencies that were involved in the care of people.

We found six breaches in Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 have made two recommendations. You can see what action we told the provider to take at the back of the full version of the report.

Rodwell House is a privately owned home and provides accommodation for people who require nursing or personal care, diagnostic and screening procedures and treatment of disease, disorder or injury. It also provides personal care to people who are on a tenancy agreement. The service provides nursing care for up to 75 residents.

At the time of our first inspection visit there was a manager in post who told us that they had commenced the registration process. However, since our last inspection visit of the 20 April 2018 we were informed that the manager had left their post. This was the third change of manager in five months at the home and this meant that the home was not consistently well led. The clinical lead for the home had also left the service since our inspection.

People and their relatives told us they felt the service was safe. They stated that all staff were very kind and they had no concerns about their safety.

Staff had received training in relation to safeguarding and they knew the processes to be followed when reporting suspected or actual abuse. Records of safeguarding were maintained at the home and were discussed with staff. The management at the service had gathered information and contributed to the safeguarding processes as expected by the local authority safeguarding teams.

However, since our inspection visits 11 safeguarding concerns have been raised which include three which the police are at an early stage of investigating. All of the incidents are being considered by the local authority and no outcomes are available at the time of this report. The local authority held a Provider Failure meeting whereby they placed an embargo on future admissions to the home until these concerns have been investigated. We are working with the local safeguarding team and the police and are closely monitoring the service. We wrote to the provider to request an action plan about how and when the provider will address these concerns. The provider had responded and told us that they had employed two clinical leads providing cover seven days of the week whilst they were actively recruiting a full time person for this role. They have employed a Safeguarding Specialist to investigate all the concerns. The provider also informed that they would voluntarily cease new admissions to the service pending the outcome of the Safeguarding Specialist’s report.

The provider had followed the correct recruitment procedures for all but one staff employed at the home. Action was taken to address this immediately.

People and their relatives told us they felt the service was safe. They stated that all staff were very kind and they had no concerns about their safety. Staff had received training in relation to safeguarding and they knew the processes to be followed when reporting suspected or actual abuse. There were sufficient numbers of staff at the home and the manager was monitoring the deployment of staff to ensure that people’s needs were being met at all times. Medicines were being administered and stored safely. People were not prevented from doing things they enjoyed as staff had identified and assessed individual risks for people. Accidents and incidents that occurred had been recorded and analysed .Records showed that staff were taking action in response to falls and incidents and lessons were being learned from these. The environment was clean, tidy and free from malodours. Infection control processes were followed by staff to minimise the risk of cross infection.

Staff had received training, regular supervisions and annual appraisals that helped them to perform their duties. New staff commencing their duties received induction training to help prepare them for their role. People and their relatives were complimentary about the choice of food provided. Staff supported people to eat a variety of foods. Those with a specific dietary requirement were provided with appropriate food and nutritional risk assessments were in place for those who had identified issues in relation to this. People had access to external health services and professional involvement was sought by staff when appropriate to help maintain good health.

People were encouraged and supported by staff to be as independent as they were able. People told us that staff respected their privacy and promoted their dignity through attending to their personal care needs in private. People’s religious and cultural needs were respected.

Documentation that enabled staff to support people and to record the care they had received was up to date and regularly reviewed. People’s preferences, life stories, personal care needs, likes and dislikes were recorded. People took part in a variety of activities that interested them. People’s end of life care was attended to in a sensitive and caring way that encompassed their preferences and needs.

Complaints were taken seriously and information about how to make a complaint was available for people and their relatives.

The registered provider had a quality assurance process in place to monitor the service provided to people. People and their relatives had opportunities to give their views about the service through meetings and surveys. The culture of at the service had improved since the arrival of the new manager; staff were more communicative with people and their relatives. There was a relaxed atmosphere at the home.

The provider was aware of their responsibilities with regard to reporting significant events to the Care Quality Commission.

We have made one recommendations to the registered provider. You can see what action we told the provider to take at the back of the full version of the report.

At the last inspection in January 2016, the service was rated Good.

Rodwell House is registered to provide accommodation for people who require nursing or personal care and supported living. The service provides care for up to 75 people who may have dementia, physical disability and sensory impairment. On the day of our inspection four people were receiving nursing care. The rest of the people at the service were receiving personal care only.

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 and associated Regulations about how the service is run.

People’s needs were met by sufficient numbers of staff. Staff felt there were enough staff deployed at Rodwell House that allowed them to spend time with people when attending to their needs. People told us response times to call bells could be improved. The registered manager was already aware of this and had been monitoring this on a daily basis. Records showed that response time to call bells had improved.

Staff at Rodwell House believed that the home was well managed and that the registered manager had an open door policy. Staff felt they were listened to and actions were taken by the registered manager when issues had been brought to their attention.

Rodwell Farm Nursing Home provides accommodation, nursing and personal care for up to 46 older people, some of whom are living with dementia. There were 40 people living at the service at the time of our inspection. A new building was under construction at the time of our visit, which will replace the existing premises once completed. The provider planned for the new building to accommodate 72 people.

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 and associated Regulations about how the service is run.

There were enough staff deployed to keep people safe and to meet their needs promptly. People were supported by staff that had the skills and experience needed to provide effective care. Relatives told us that staff knew their family members’ needs well and provided consistent care. Staff had induction training when they started work and access to ongoing training. Staff shared information about people’s needs, which ensured they received their care in a consistent way.

The provider made appropriate checks on staff before they started work, which helped to ensure only suitable applicants were employed. Staff understood safeguarding procedures and were aware of the provider’s whistle-blowing policy.

Risks to people had been assessed and measures implemented to reduce these risks. There were plans in place to ensure that people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly to keep the premises and equipment safe for use. People’s medicines were managed safely. People were supported to stay healthy and to obtain treatment if they needed it. Staff monitored people’s healthcare needs and took appropriate action if they became unwell.

Staff were kind and sensitive to people’s needs. People had positive relationships with the staff who supported them. Relatives said that staff provided compassionate care and were professional and caring. The atmosphere in the service was calm and relaxed and staff spoke to people in a respectful yet friendly manner. Staff understood the importance of maintaining confidentiality and of respecting people’s privacy and dignity.

The registered manager provided good leadership for the service and led by example in their values and approach to supporting people. People and their relatives had opportunities to give their views about the care they received and told us that the registered manager responded appropriately to any concerns they raised. Staff told us they had opportunities to express their views and raise any concerns they had. The provider had implemented an effective quality assurance system to ensure that key areas of the service were monitored effectively. Records relating to people’s care were accurate, up to date and stored appropriately.

People who used the service told us that staff asked for their consent before they undertook any tasks with or for them. One person told us, “Staff always ask me if they could help me. They never do anything without asking me first.”

People were complimentary about the food they received at the service. They told us they had a choice of menu and alternative meals were provided if they did not like the choices available.

People told us that the home was always clean and tidy. They told us that they liked their bedrooms. One person told us, “I like my bedroom and I can have my own private time.”

During our discussions people told us there were enough staff on duty at the service. One person told us, “Staff always have enough time to help me, they never rush.”

We found the service was compliant with the five outcomes we looked at.

We saw that cleaning routines were completed daily. We saw that people’s rooms and communal areas were clean and tidy and the home was free from unpleasant odours. We saw that administering of medication was recorded. People we spoke to were satisfied with the support they received with their medication. We looked at recruitment records for staff and saw that all staff had completed an application form and attended an interview before being appointed. We saw records of all checks required were undertaken for all staff before they started work at the service.

We spoke to staff who told us that they felt there were usually enough staff on duty to provide appropriate care and support to people who used the service. However, one member of staff told us they felt overloaded and had too much work to do. We saw that there was a complaints policy. One person told us “If I had to complain I would speak to my relative and they would speak to the manager”.