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Inspection carried out on 19 August 2020

During an inspection looking at part of the service

Rowallan House is a care home registered to accommodate and support up to 41 elderly people. At the time of the inspection, 25 people were living at the home. The service is a two-floor building. Each floor has separate adapted facilities.

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.

Inspection carried out on 21 January 2020

During a routine inspection

About the service

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.

Inspection carried out on 25 July 2017

During a routine inspection

The inspection was unannounced and took place on 25 July 2017. At our previous inspection in March 2017 the service was not meeting legal requirements relating to Safe care and treatment. Following that inspection the provider had sent us their action plan and at this inspection we found that significant improvements had been made.

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.

Inspection carried out on 2 March 2017

During a routine inspection

The inspection was unannounced and took place on 2 March 2017. At our previous inspection on 15 July 2015, we rated the service Good. However, we identified one area that required an improvement. This was in relation to the recording and safe administration of medicines. Following that inspection the provider sent us their action plan which set out how the intended to make improvements. During this inspection, we found that medicine recording, administration and storage remained issues which put people's health and wellbeing at risk.

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.

Inspection carried out on 15 July 2015

During a routine inspection

This unannounced inspection took place on 15 July 2015. At our previous inspection on 18 September 2013 we judged the provider was not meeting required standards relating to care and welfare of people and was not sending us notifications of events that affect the service, as required. We went back to check this on 26 February 2014 and found that the provider met the required standards in care and welfare of people, and sending notifications.

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 had a registered manager. 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.

We found people were mostly safe living in Rowallan House. Staff were checked before starting work at the service and had access to a range of training programmes including the Mental Capacity Act 2005 (MCA). The MCA is a law designed to protect and empower people who may lack the mental capacity to make their own decisions about their care.

People's medicines were not always appropriately managed. Staff wrote "not required" instead of "refused", in medicine administration record sheets (MARS), to indicate three people were not taking their medicines. There was also no evidence to show that the registered manager had taken any measures to address the issues associated with refusal of the medicines.

Staff received support, supervision and annual appraisals. They had opportunities to talk to the registered manager and the deputy manager. There was good team work at the service and staff attended team meetings. This showed there was transparency and good communication amongst staff.

Staff promoted independence and people told us the support they received was good and met their needs. Relatives were all positive about the quality of care and support. People and their relatives knew how to make complaints and there was a system in place for recording and investigating people's concerns.

The care plans were detailed and unique to each person's needs. This showed that the care and support provided was personalised.

A clear management structure was in place with staff knowing their roles. The registered manager monitored the safety and quality of the service and ensured improvements were made when necessary.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and you can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 26 February 2014

During an inspection looking at part of the service

At the last inspection of this service which took place on 18 September 2013, we found that people's care and treatment was not planned and delivered in a way which met people's needs.

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.

Inspection carried out on 18 September 2013

During a routine inspection

People told us that they were treated with respect by the staff. One of the people we spoke to told us "I like living here.The staff are nice and helpful." Others told us that the staff were "kind" "helpful" and "joked" with them.

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).

Inspection carried out on 13 November 2012

During a routine inspection

People were supported to access health and social care professionals when required with their consent. A relative said "the home have tried to take her for various treatments, to see the dentist, optician and chiropodist but she refuses to go sometimes and they can't force her." People were happy with the care that they received. One person told us �the staff are very kind and helpful.They care about us and we have choice." People said they were involved in making choices about their care and the choice of food and drink that was provided. They told us that they got enough to eat and drink and that the food was of a good quality. We observed people having lunch at the home which was a relaxed and social event with staff discreetly offering assistance to people if needed. A relative said, "They spend time with people and seem quite kind and genuine." Another said "I have no worries about dad, knowing he is at Rowallan has taken a weight off my mind otherwise I would have found it difficult to cope." A healthcare professional said "it's the best home we go to in the area and that is due to the staff."

Inspection carried out on 25 October 2011

During a routine inspection

People living at the home told us that they were happy with the carers and the care they provided. Some of the comments received included, "I can�t fault them at all.� �The staff are kind and they look after us well.� �They respect us and come to help us whenever we press the buzzer.� �The food is really good and I have put on weight since I came here.�

A relative spoken to said, �I can�t speak highly enough of the home, his room is clean, they always accommodate his needs and wishes.� �I haven�t got any complaints.�

Another relative said, �Good staff, good food, good care. We can�t fault anything and we have peace of mind.�