Rowallan House

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 arrange an appointment on specific days to visit and declare if they had any symptoms of Covid-19. Visitors were screened for symptoms of acute respiratory infection before being allowed to enter the home and were required to wear Personal Protective Equipment (PPE) when visiting. Visits were staggered and restricted to 30 minutes and these areas were cleaned between visits. A telecom room was also created with a window for visits by family members.

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

¿ The provider ensured that staff received appropriate training and support to manage Covid-19. All staff had received training on Covid-19, infection control and the use of PPE. Systems were in place to support staff if they became unwell and when they returned to work. Incentives were given to staff to minimise use of public transport.

¿ Adequate supply of PPE was in place and systems were in place to ensure there was not a shortfall of PPE. We observed staff wearing PPE and people were supported to maintain social distancing. People’s temperature was taken twice daily to check they had not developed symptoms. Systems were in place to ensure people were safe if their temperature went above recommended levels.

¿ Systems were in place should people display symptoms or test positive for Covid-19, which included isolating in their rooms. Designated areas had been put in place for people to use if they showed symptoms or tested positive for Covid-19 should they not want to isolate in their rooms.

Rowallan House is a care home registered to accommodate and support up to 41 elderly people. At the time of the inspection, 37 people were living at the home. The service is a two-floor building. Each floor has separate adapted facilities.

People’s experience of using this service

Care plans contained suitable and sufficient risk assessments to effectively manage risks and help keep people safe. Pre-employment checks had been carried out to ensure staff were suitable to support people. People told us they felt safe at the home and staff were aware on how to safeguard people from abuse. There were appropriate numbers of staff to support people when required. Medicines were being managed safely.

Systems were in place to record incidents and take appropriate action. However, analysis of incidents had not been carried out to ensure lessons were learnt and to minimise the risk of re-occurrence. We made a recommendation in this area.

Staff had completed essential training to perform their roles effectively and felt supported in their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received care from staff who were caring and had a good relationship with them. Staff respected people’s privacy and dignity. People were encouraged to be independent and to carry out tasks without support.

People received person centred care. Care plans had been reviewed regularly to ensure they were accurate. People participated in regular activities to support them to develop and maintain relationships to avoid social isolation.

Feedback was sought from people, relatives and staff and this was used to make improvements to the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At our last inspection on 25 July 2017, the home was rated good (published 19 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Rowallan House is registered to provide accommodation for persons who require nursing or personal care for 41 older people, some of whom have dementia. At the time of the inspection there were 34 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff stored, administered and audited medicines to ensure that people received their medicines as prescribed by their doctors. People and their relatives felt that the service was safe. Each person had a care plan and risk assessment, which were regularly reviewed. People could move into the service only if there were suitable facilities to meet their needs. This ensured that people who moved into the service had appropriate facilities to meet their needs.

The staff recruitment processes were robust. This allowed people to be supported by staff who were properly checked and had the right knowledge and experience to deliver care. The training programmes staff attended were varied and relevant to their roles, and included adult safeguarding and Mental Capacity Act 2005. Staff also had support and supervision from management. We noted they had read the provider's policies and procedures and were confident to manage matters relating to adult safeguarding, whistle blowing and complaints.

People were confident that they had access to health care. A GP visited the service at least once a week to review people's medicines. Staff referred people to specialist healthcare providers as and when required. People had nutritious food and fluids.

Staff had good relationships with people living in the service and we observed caring and positive interactions. Staff respected people’s privacy and encouraged them to be as independent as possible. There were arrangements in place to be engaged with various activities.

The service was clean and tidy, and arrangements were in place for controlling infections and using appropriate equipment to ensure people's health and safety was not at risk.

The provider had good systems in place to ensure that people and their relatives' views about the service were listened to and acted on. The feedback the provider sought from people and relatives and the complaints procedure allowed people to share their views to influence the quality of the service.

Rowallan House is registered to provide accommodation for persons who require nursing or personal care for 41 older people some of whom have dementia. At the time of the inspection there were 33 people using the service.

The service did not have a registered manager. However, there was an acting manager who was yet to apply to register with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People told us they felt safe in the service and that staff treated them with respect and dignity. Staff were kind, compassionate and friendly when interacting with providing care. There were various systems in place which promoted people's safety. For example, people's risk assessments were completed and reviewed, equipment was regularly tested and enough staff were provided to ensure people received care that they needed.

Staff supported people to have access to health care. Health professionals came to the service and referrals were made for people so that they could receive medical treatment. The food provided at the service was nutritious and reflected people's preferences.

Staff were supported by the management and received regular supervision and training. They knew what adult safeguarding meant and how they could apply it in practice. They also had good knowledge about the Mental Capacity Act 2005 (MCA) and how to apply it within their role. The provider did not always follow their staff recruitment system in practice. We have made a recommendation to improve this.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We have served a warning notice in respect of this breach. You can see what actions we told the provider to take at the back of the full version of the report.

At this inspection we found that people's needs were assessed and their care and treatment was planned and delivered in line with their individual care plan. People and their relatives told us that their health and welfare needs were met. One person said "they look after me fine." Another person told us "everything is ok. I am fine here." A relative said "they are very respectful and treat her (mother) with dignity. When I leave here I know she is being looked after, I have no worries."

We also found at our previous inspection that the provider had not notified the Care Quality Commission (CQC) of all incidents which had occured in the home as required by the CQC (Registration) Regulations 2009. At this inspection we found that all notifiable incidents were reported to the CQC. Appropriate follow up action had been taken by the manager to ensure the service was safe and effective.

People who use the service and their relatives were satisfied with the care and support provided at the service. A relative said "there is always a happy and caring atmosphere here. Everybody from the care staff, cook handyman and laundry lady are involved in a person's care which is nice to know. It is very homely." People were supported to access health and social care professionals when required. People who used the service and their families told us they were involved in making decisions around their care and support planning. We found that although basic care plans were in place setting out how to meet people's needs there was a discrepancy between information contained in care plans and the actual care provided to people. This meant that people were at risk of not always receiving the care and support they needed. The service had appropriate staff recruitment procedures in place. People told us that they felt safe with the staff and they would raise any complaints or concerns with the manager or their relative. The provider had not notified the Care Quality Commission of all incidents which had occurred in the home as required under the Care Quality Commission Regulations (2009).