Rowan/Beech House

Rowan/Beech House comprises of two residential care homes in different locations but within close proximity to each other. Both homes are terraced housing over two floors with a back garden area.

We found the following examples of good practice

•The provider had appropriate arrangements for visiting to help prevent the spread of Covid 19. All visitors were required to have their temperatures taken and complete a Covid 19 risk assessment form on arrival. All visitors were expected to wear a face covering.

• The service had a garden area to facilitate safe visiting for families.

•The provider had appropriate arrangements to test people and staff for Covid 19 and was following government guidance on testing.

•The provider had ample Personal Protective Equipment (PPE) at the service to ensure that staff could provide care safely. We saw that the majority of staff had attended training regarding Covid 19 and the appropriate use of PPE.

• Although the provider was not keeping formal risk assessments for staff, their health and well-being were being discussed in supervision and staff were enabled to access the furlough scheme if necessary.

•Thorough cleaning was done daily of all communal areas and people's bedrooms.

•The provider ensured that people using the service could maintain links with family members and friends. People were supported to keep in touch by phone and virtual technology. Weather permitting the garden area and an external room were available for family visiting.

•All people admitted to the home were required to have a test before admission. The registered manager had developed a protocol to enable the safe admission to the service.

•The provider had a named external clinical lead who was providing regular weekly contact with the service.

We were mostly assured that the service met good infection prevention and control guidelines.

¿Whilst there have been no cases of CV-19 at the service, we were not confident that all staff were wearing PPE at all times at both of the services. The registered manager told us they would ensure additional checks were made f and appropriate use of PPE was discussed at each supervision and team meeting.

¿Whilst we could see the provider had updated policies in March 2020 regarding Covid 19, current written policies did not always reflect current government guidance and best practice. The registered manager acknowledged this was the case. However, the majority of staff understood and were working within best practice guidelines. The registered manager sent us a plan for the provider to update all the policies to ensure they were accurately reflecting current practice.

¿Since the visit the registered manager put further controls in place to ensure full compliance with good infection prevention and control guidelines. One staff member who had not undertaken suitable training has since completed this. There are also additional checks for staff in the use and disposal of PPE.

Further information is in the detailed findings below.

Rowan House and Beech House provides care and support for nine people who have mental health needs. There were nine people using the service when we visited. Rowan/Beech House comprises of two residential care homes in different locations but within close proximity to each other. Both homes are terrace housing over two floors with a well-kept back garden area.

People told us that they felt safe within the service and well supported by staff. We saw positive and friendly interactions between staff and people. People were treated with dignity and respect.

Procedures relating to safeguarding people from harm were in place and staff understood what to do and how to report it if people were at risk of harm. Information on how to report any safeguarding issues was clearly displayed in each home.

The homes were aware of how to ensure infection control when working with people. Staff were supplied with gloves and aprons to ensure that people were safe.

People were supported to maintain a healthy lifestyle and had healthcare appointments that met their needs. These were recorded and monitored on a regular basis. Medicines were administered safely and on time. Staff had completed training in medicines administration.

Staff received regular supervision and an annual appraisal that helped them identify areas for learning and development. Supervisions and appraisals were used as an opportunity for staff to improve care practices.

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.

There were person centred care plans that allowed staff to provide appropriate support to people. Care plans stated people’s likes and dislikes and contained detailed life histories and information regarding people’s mental health and wellbeing.

Staff knew people well and displayed caring and warm attitudes. Staff understood how to work with each person according to their individual needs. People were treated with dignity and respect.

The homes had detailed quality assurance systems in place. Regular audits around medicines, care plans and risk assessments and the environment were completed with action plans to ensure and issues found were addressed.

There were systems in place to identify maintenance issues. Staff were aware of how to report and follow up maintenance.

The homes had an open a transparent management style. There were regular staff meetings and staff felt comfortable raising any issues and felt that they were listened to. Directors and the registered manager held meetings and feedback sessions for staff and people. Surveys sent to people and relatives received positive feedback.

We talked to staff and looked at the storage and record keeping of medication. Staff were able to explain how they administered medication to people safely. We observed staff administering medication and saw that they checked the medication administration record before giving people their medicines. Staff told us and records confirmed that they had completed training on the safe administration of medicines. Medicines were handled appropriately.

There were effective recruitment and selection processes in place. Staff told us that they had been through a detailed recruitment process that included completing an application form and interviews. References were taken up from their former employers. People's personal records were accurate, and had been reviewed and updated at regular intervals. Care records gave an explanation of how people's needs were to be met. This meant that care records supported staff to provide safe and appropriate care to people who use the service.

People said to us that staff were available to help them. A person told us, "there is always enough staff around to give me the help I need." We saw that staff understood people's needs and how to support them. Staff were able to explain how they met the needs of people. We observed that staff kept records relating to people who use the service securely in the office. We saw that staff knew how to communicate with people. They maintained confidentiality by not sharing information when other people were present.