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Rowan Court Requires improvement

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Inspection report

Date of Inspection: 1 August 2014
Date of Publication: 29 August 2014
Inspection Report published 29 August 2014 PDF

Overview

Inspection carried out on 1 August 2014

During a routine inspection

At the time of our inspection the registered manager was taking a planned day off. During this inspection we spoke with the three people who were living at Rowan Court, the senior member of staff on duty, three care workers and two relatives.

We considered all the evidence we had gathered under the outcomes we inspected.

This is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were well organised and the information was clear.

We saw that there were risk assessments in place for bathing, tissue viability and fire safety. Where someone was assessed as being at high risk, such as from a diminished swallowing reflex, then control measures had been recorded to state how the risk would be minimised.

We saw there were robust systems in place to assess and check appropriate and safe care was being delivered. These included daily and monthly internal audits. These audits included infection control and mattress quality and suitability.

The provider had appropriate security arrangements in place to protect people who lived at the service. We found that the entrance door was secure and visitors could only enter the building with the knowledge of the staff. People indicated to us they felt safe and secure in the home.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

We spoke with two relatives who told us of their experience of the service. They told us the service was 'fabulous' and perfectly met both the needs of their relative and themselves. They said they felt confident that everything they and their relative needed would be provided.

Staff we spoke with were clear about the needs of the people they supported and what they told us was reflected in people�s care plans.

We spoke with staff who told us they felt well supported by the manager who arranged access to regular training and development to ensure they were able to deliver appropriate care.

Is the service caring?

We saw all people at the home appeared at ease and relaxed in their environment. We saw that people responded positively to staff with smiles when they spoke with them. We observed that staff included people in conversations about what they wanted to do and explained any activity prior to it taking place. We noted staff understood people's non-verbal methods of communication and were able to respond appropriately.

We saw that people were dressed appropriately for their age and the time of year. We noted people had been supported to express their personality, for example by having their nails painted in a colour of their choice or their hair styled in a particular way.

Care staff on duty told us they were responsible for providing people with meaningful activities that they enjoyed. We saw each person had a weekly timetable of activities. A care worker told us that these were guides used by staff to encourage people to participate in activities they might find enjoyable. With the help of staff people told us of activities they had been involved with. These included going to football matches, the zoo and to the horse racing. Smiles and positive body language indicated to us that these activities were greatly appreciated.

Is the service responsive?

We reviewed three people's care records and found they all had complex health care needs and received services from a range of secondary health care providers.

Our discussions with the senior social care officer on duty demonstrated the provider was fully aware of each person's individual care needs. Care plans and risk assessments were in place to be able to respond to frequently changing health care needs.

All people had a health passport which would accompany them in an emergency to hospital. The health passport was a document containing all current relevant information about a person including allergies, communication difficulties, current medication and known diagnoses. This ensured other health care professionals had access to meaningful information to help them act safely in emergency situations.

All care plans contained a specific section on communication. Our observations and scrutiny of care plans demonstrated the provider had explored every avenue of care to ensure people with profound communication problems were not isolated through their inability to communicate by speech.

Is the service well led?

Decisions about care and treatment were made by the appropriate staff at the appropriate level. There was a clear staffing structure in place with clear lines of reporting and accountability.

The staff we met were well trained and competent to make most of the routine care decisions. They said they knew when and how to report any issues or concerns and they were confident management would provide any necessary advice or support.

There was evidence that learning from incidents and investigations took place and as a consequence appropriate changes were implemented.

Our inspection demonstrated the provider had good governance arrangements in place. The provider was recognising its accountability, was acting on lessons learned and was honest and open in seeking the best possible outcomes for people. The service was well led.