Archived: Rowan House

Rowan House accommodates up to nine people and is designed to meet the needs of people with a learning disability. On the day of our inspection nine people were using the service.

We inspected the service on 19 June 2018. Our visit was unannounced. This meant the registered manager and staff team did not know we would be visiting.

At the last inspection in November 2015, the service was rated ‘Good’. At this inspection, we found the evidence continued to support the overall rating of ‘Good’ and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

The service had a registered manager in place at the time of our inspection. 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 registered manager was also the provider and worked across two services which were in close proximity to each other.

The service had been developed and designed in line with the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. The aim is that people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People told us they felt safe living at Rowan House. Their relatives agreed with what they told us. The registered manager and the staff team knew their responsibilities for keeping people safe from avoidable harm and knew what to do if they were concerned about anyone.

People’s care and support needs had been assessed prior to them moving into the service and the risks associated with their care and support had been reviewed and managed.

People were supported with their medicines effectively and staff competency had been checked to make sure people were supported in a safe way.

People spoken with felt there were enough staff members available to meet people’s care and support needs, Whilst the majority of the support workers we spoke with felt there were enough support workers on shift to meet people’s needs, comments were made regarding the extra tasks they were expected to perform whilst on duty.

Plans of care had been developed for each person using the service and the staff team knew the needs of the people they were supporting well.

Appropriate recruitment processes had been followed when new staff were employed to make sure they were suitable and safe.

People received support from a staff team that had the necessary skills and knowledge. New members of staff had received an induction into the service when they were first employed and training relevant to their role had been provided.

People were provided with a comfortable place to live and there were appropriate spaces to enable people to either spend time with others, or on their own. The staff team had received training in the prevention and control of infection and the necessary protective personal equipment was available.

The staff team supported people to make decisions about their day to day care and support. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people's human rights were protected. Where people required additional support to make decisions, advocacy support was made available to them.

People's food and drink requirements had been assessed and a balanced diet was being provided. People were supported to maintain good health. They had access to relevant healthcare services and they received on-going healthcare support.

People told us the staff team were kind and caring and treated them in a friendly and respectful way. Observations made during our visit confirmed this.

People knew who to talk to if they had a concern of any kind. A formal complaints process was in place though this was not displayed. People were confident that any concerns they had would be taken seriously and acted upon by the registered manager and staff team.

Systems were in place to monitor the quality of the service being provided and a business continuity plan was available to be used in the event of an emergency or untoward event.

The registered manager and the management team were aware of their registration responsibilities

including notifying CQC of significant incidents that occurred at the service.

Further information is in the detailed findings below.

Rowan House is a residential care home providing care and support for up to nine adults with a learning disability. It is situated in a residential area of Hinckley. Accommodation is on the ground and first floor which is accessed by stairs. Rowan House has a communal dining area and lounge.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The service provided a homely setting for people using the service. This was evident from outside the home by the absence of any sign that it was a residential care home. It looked like every other residential property in the area.

People using the service were protected from harm because staff understood and practised their responsibilities under the providers safeguarding procedures. People spent a lot of time outside Rowan House during the day when they attended various activity venues in the community. They were taught how to stay safe and report any concerns they had about their safety and welfare whilst out. People also participated in activities at Rowan House and were supported to maintain their hobbies and interests.

People were supported to be as independent as they wanted to be. Risks associated with their care and support and activities they participated in were assessed and managed. This meant that restrictions about what they couldn’t do were kept to a minimum.

The provider deployed enough suitably skilled and experienced staff to meet the needs of people using the service.

People received their medicines on time and understood what they were for. Only staff who were trained in medicines management handled medicines.

Staff had the right knowledge and skills to be able to support people using the service. Staff were supported through effective supervision, training and appraisal. They were supported to acquire further qualifications and develop their career in adult social care.

The registered manager had practical working knowledge of the Mental Capacity Act 2005. Staff were aware of the MCA and Deprivation of Liberty Safeguards (DoLS), though some more than others. Staff provided people with information to enable them to make informed choices.

People were able to choose what foods they had. Staff advised people about healthy eating options and respected people’s choices.

Staff understood and were attentive to people’s health needs. They supported people using the service to access health services when they needed them.

People using the service and staff developed caring relationships because staff had a very good understanding of people’s needs. People were involved in decisions about their care and support and they had access to independent advocacy services when they needed them.

Staff treated people using the service with dignity and respect. They respected choices people made. People’s views were listened to and acted upon. People’s privacy was respected. They were able to spend time alone when they wanted.

People received care and support that was centred on their needs. People’s care plans were individualised and contained information about things that were important to them. Staff used that information to provide and arrange activities people enjoyed.

The provider had procedures for the reporting on incidents and accidents. Reports were investigated and when necessary action was taken to prevent similar events happening again.

People using the service, their relatives and staff were involved in developing the service. Their suggestions were listened and, where practical, acted upon to the benefit of people using the service and staff.

The service was well led. People using the service, relatives and staff all felt well supported by the registered manager.

The provider had procedures for monitoring and assessing the quality of service. Regular checks were carried out by the registered manager and they were well supported in this area by an administrative person. A key element of the quality assurance was providing people using the service and relatives the opportunity to express their views about the service. People’s views were acted upon by staff.

People were offered a choice of meals that met their dietary needs and preferences. Meal times were an enjoyable experience. One person said: 'Tonight's a treat night. We have a take away meal that we like because everyone has different taste buds.'

Effective recruitment processes were followed when new staff were appointed and appropriate checks carried out before they commenced their new roles. All new staff completed a period of induction and training for their job role.

Information about the people who live at Rowan House was kept in their individual care files and stored securely. Staff were aware of their responsibilities to maintain accurate records. Other records relating to the staff and the management of the service were accurate, kept secure and could be easily accessed when required.

People received care and support from staff who were trained and supervised to ensure people's health and safety.

People had opportunities to make comment about the quality of service they received. One person said 'It's a brilliant place to live, I love it here.'

The provider had an effective quality assurance system, which monitored the day to day running of the service and received feedback from people using the service about the quality of service provision. Health and safety checks were carried out on the environment and audits carried out on the management of medicines, care plans and the service provision.