The Rowans

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good.

Safeguarding procedures were in place and staff knew how to report abuse. People’s finances were protected by daily checks.

Risk assessments were in place and managed appropriately. The service was going through a transition period due to there being a new provider, but all the information we required was available to us.

Lessons were learned when things had gone wrong which had highlighted where improvements could be made. These were implemented to reduce any future risk or reoccurrence.

Medicines were stored and administered correctly. As and when medicine (PRN) protocols were in place and stock count checks were correct.

The environment was clean and tidy. There was work to be done to make the garden accessible and stimulating, but the registered manager was aware of this and plans were in place to facilitate this.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff were aware of the principles of the Mental Capacity Act 2005 and people’s rights were protected.

Staff were knowledgeable around people’s needs and treated them with kindness and respect. People who use the service told us they were happy. We saw that people’s independence and privacy was respected and promoted.

A wide range of meaningful activities were available for people who used the service. Staff helped people achieve goals that were important and relevant to them.

There was an open and positive culture within the home amongst staff and people. Staff said that the manager was approachable and well respected, and her nominated her for an award to recognise this.

The service was proactive in assisting people to access health care and managing their anxieties around this.

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 2008 and associated Regulations about how the service is run.

The home was well decorated and adapted to meet people’s needs. Flooring was smooth and uncluttered to aid with people’s mobility. People had been involved in the decoration of the home, and especially in their bedrooms. The home had a homely feel and reflected the interests and lives of the people who lived there.

The inspection took place on 26 January 2016 and was unannounced. At our previous inspection in September 2013 we had identified no concerns at the home.

There was positive feedback about the home and caring nature of staff from people and relatives. One person said, “I like it here very much.” A relative said, ““Staff are excellent, they have some really lovely people here.”

People were safe at The Rowans. A relative said, “Yes, I do think there are enough staff.” There were enough staff deployed to meet the needs and preferences of the people that lived there. Where people required one to one support from staff, the registered manager ensured staffing levels were sufficient so that other people’s activities were not affected.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building, and keep people safe if they could not return. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. Medicines were managed in a safe way and staff were trained in the safe administration of medicines. People were encouraged and supported to manage their own medicines where possible to promote their independence.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Staff were heard to ask people for their permission before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and could choose what they wanted to eat. Some people were supported to help prepare their own meals and drinks. People were protected from poor nutrition as they were regularly assessed and monitored by staff to ensure they were eating and drinking enough to stay healthy.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. When changes in people’s health were identified by staff, they responded quickly and made sure they received appropriate treatment.

The staff were kind and caring and treated people with dignity and respect. A relative said, ““Staff here are very good.” People looked relaxed and happy with the staff. People could have visitors from family and friends whenever they wanted. Staff knew the people they supported, and took time to sit and talk, or play games with them. When asked what was they enjoyed most about working here, a staff member said, “Supporting the guys, they are my priority, it’s like a family here.”

Care plans were based around the individual preferences of people. People and their relatives were involved in making the care plans, and reviewing the care and support given. Care plans gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans. Details such as favourite foods, interests, or allergies recorded in the care plans matched with what we saw on the day of our inspection.

People had access to activities that met their needs. A large proportion of the activities were based in the community, giving people access to friends and meeting new people. Staff listened to people and relatives and tried out new activities to see if people wanted to do them. People were encouraged to go out, but always had the choice to stay indoors if they wished.

There was a clear complaints system in place. Relatives said they knew how to make a complaint but had never felt the need to. Where a complaint had been received the registered manager had responded quickly to resolve the issue to the complainant’s satisfaction.

The provider and the registered manager ensured that people received a good standard of care and support. Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. The senior management from the provider regularly visited the home to give people and staff an opportunity to talk to them about their experiences. Feedback from people and professionals was used to improve the home for the people that live here.

People and relatives had the opportunity to be involved in how the home was managed. Surveys were completed and the feedback was reviewed, and used to improve the service. A relative said, “They ask us for feedback once or twice a year.”

Summing up the home, a relative said, “They provide a safe environment for people. My family member feels confident that The Rowans is his home, so he feels safe here.”

All the people we spoke with said they liked living there. One person said 'I'm happy here. I get to go to snooker and air hockey, I really like these things.' Staff were seen to interact well with people. For example they encouraged people when they sang and danced in the lounge area, by cheering and clapping. People appeared relaxed and happy.

We saw that systems were in place to ensure staff worked with the consent of people.

People who used the service and relatives had been involved in the planning of care. We saw that risks had been identified to protect the welfare and safety of people.

We looked around the house and saw that it was clean and tidy. People who used the service told us how they helped with the cleaning, for example by washing the door handles and vacuuming the carpets.

We saw that the manager carried out appropriate checks when they employed staff. This ensured staff were of good character and had the necessary skills and experience to do the job.

There was a system in place to record and respond to complaints.

We were unable to speak to all of the people who used the service as they had complex needs which meant they were unable to tell us their experiences. We spoke to two people who used the service and one relative of the people who lived at the service. The people we spoke to told us that they liked living there and did not want to leave.

One relative told us that the service was 'Absolutely first class' and felt that the person who used the service was very happy there.

We observed that people were being treated with respect and dignity. We saw that some people had complex needs and that the staff dealt with this appropriately. For example we saw one person was upset during our inspection and staff supported them in the way that suited their needs.

We saw that each person's room was decorated individually and were told that people could personalise their rooms in the way that they wanted to.

We saw that some people were able to access the rooms in the house in the way they wanted and that they were supported and encouraged to take part in activities.

Staff told us that they liked working at the service and felt supported to do their duties.