Baldock - The Rowans

Updated 10 May 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 Care Act 2014.

Inspection team

The inspection was completed by one inspector.

Service and service type

Baldock – The Rowans is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Baldock – The Rowans is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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 a registered manager in post.

Notice of inspection

This inspection was unannounced

What we did before inspection

We reviewed information we had received about the service since their registration. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually 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 two people who used the service and two relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, team leader, quality monitoring team and support workers.

We reviewed a range of records. This included two people’s care records and two medication records. We spoke with one professional. 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 10 May 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Baldock – The Rowans is a residential care home providing personal care to four people with a learning disability at the time of the inspection. The service can support up to five people.

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

Right support

People did not always have full access to all information about their care, in an accessible format. We recommend the provider looks at ways to ensure the systems and information is accessible to people they support and consider ways to ensure people are able to understand all the information that is captured about them.

People were encouraged to do what they wanted and to make informed decisions and this was done in a kind and considerate way.

The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. Staff supported people to play an active role in maintaining their own health and wellbeing

People were supported by staff to have choice of their lives and staff supported them in the least restrictive way possible and in their best interests.

Right Care

People were not always supported by a service that had systems were in place to report and respond to accidents and incidents. We found instances where there were allegations of abuse and these were not notified to CQC. Leadership was not always effective and did not identify that people were put at risk or subject to potential abuse.

Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People could pursue interests that were tailored to them.

Right Culture

People had risk assessments in place, which identified risks which people faced and how staff should manage these. However, staff were not always knowledgeable about the content of these risk assessments. When risks to people were identified actions to mitigate the risk were not always resolved in a timely manner which put people at risk of harm.

Staff turnover was high at the time of the inspection, which meant that at times people did not have the consistency from staff who knew them well.

People and those important to them, including advocates, were involved in planning their care.

People’s quality of support was not always enhanced by the providers quality assurance system the provider had in place. Actions were not always documented, and it was unclear if actions were completed. This meant improvements that were highlighted were not always implemented to improve the care of people.

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

Rating at last inspection

This service was registered with us on 17 December 2020 and this is the first inspection.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

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.

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 safe care and treatment, safeguarding issues and the lack of clear and effective governance systems in place 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 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.