15 June 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was undertaken by one adult social care inspector on the 3 April 2017 and was unannounced. We also spoke to three relatives and four staff via the telephone after the inspection.
The provider completed a Provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed information we held about the service. This included previous inspection reports and notifications. A notification is information about important events, which the service is required to send us by law.
During the inspection we met and spoke with six people who had regularly used the service for respite care, the new manager and four members of staff who worked in the respite service. We also spoke to three relatives and spoke to one health care professional and received feedback from the local authority quality assurance improvement team (QAIT). We also spoke to a member of the board of trustees.
We looked around the premises and observed and heard how staff interacted with people during our visit to the day service. We looked at records of three people who regularly stayed for respite care which related to their individual care needs, three records which related to administration of medicines, four staff recruitment files and records associated with the management of the service including quality audits.
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.