Archived: Roshni

Updated 8 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Before the inspection, we checked the information that we held about the home and the service provider. This included previous inspection reports and statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We also reviewed feedback from healthcare and social care professionals. We used all this information to decide which areas to focus on during inspection.

The inspection took place on 7 and 8 January 2016 and was unannounced. One inspector carried out the inspection.

Some people living at the home were unable to tell us about their experiences; therefore we observed care and support in communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience

of people who could not talk with us. We spoke with five people, three relatives and we spent time looking at records. These included four care records, three staff records, medication administration record (MAR) sheets, staff rotas, complaints, quality assurance audits and other records relating to the management of the service.

During the inspection we spoke with the provider, the manager and four members of care staff.

Updated 8 April 2016

Roshni is a residential care home which provides care and support for up to 16 older people living with dementia. There were 13 people living at the home at the time of our inspection.

The home was managed by the provider who is in day to day charge and worked alongside staff in order to provide care for people. The provider is the person who has the legal responsibility for meeting the requirements of the law. Providers are often the owner of the service and are the ‘registered person’ with the CQC. 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 previously inspected on 24 July 2014 and identified one breach of regulation in relation to respecting and involving people who use the service. We found that the provider had taken action to address these concerns. People were now able to make choices about the care they received. A member of staff spoke with us and told us they tried to encourage people to make choices about their daily routines.

People were cared for by staff who knew how to recognise the signs of possible abuse. Staff were able to identify a range of types of abuse including physical, financial and verbal. Staff were aware of their responsibilities in relation to keeping people safe. The manager was able to explain the process which would be followed if a concern was raised and felt confident that staff would report any concerns.

Risk assessments were in place and reviewed monthly. Where a person was identified as being at risk actions were identified on how to reduce the risk and referrals were made to health professionals as required.

Safe recruitment practices were in place and records showed appropriate checks had been undertaken before staff began work. We asked one person if there were enough staff and were told “there is without a doubt”. There were sufficient numbers of staff on duty to keep people safe and meet their needs.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. We observed medicines being administered and staff doing this safely. The manager completed an observation of staff to ensure they were competent in the administration of medicines.

Consent to care and treatment was sought in line with legislation and guidance. The manager told us that DoLS applications had been made for all people living at the service. Capacity assessments had been completed appropriately for people and were in their care records.

Staff had undertaken appropriate training to ensure that they had to skills and competencies to meet people’s needs. New staff undertook a comprehensive induction programme which included essential training and shadowing of experienced care staff. New members of staff shadowed existing members of staff for two weeks to ensure that they were confident before supporting people.

People were supported to maintain good health and had access to health professionals. Staff worked in collaboration with professionals such as GPs and the falls prevention team to ensure advice was taken when needed and people’s needs were met.

People received enough to eat and drink. People who were at risk were weighed on a monthly basis and referrals or advice were sought where people were identified as being at risk.

Staff knew people well and they were treated in a dignified and respectful way. We were told “I’m quite happy, I couldn’t complain” and “we’re always well looked after”. Relatives also told us “staff are patient when they talk to her” and “I can’t think of one thing I can fault them on”.

Family and friends were able to visit without restriction and relatives told us that staff were always welcoming and happy to spend time speaking with them about their family members. Relatives told us that they felt involved in the care their family member received and that they had regular reviews with the manager, we were told “they’ve always kept us informed” another relative told us “any knocks or stumbles and we’re told about it”.

The care that people received was responsive to their needs. Care plans included information on people’s key relationships, personality and preferences. They also contained information on people’s social and physical needs. The manager told us that following the previous inspection they had updated everyone’s care plans to ensure they reflected people’s needs and contained information on their life history. They told us “the first thing we did were the care plans. There’s been a big change with them. I’m so pleased, there’s a lot more detail. However we saw that at times one person displayed behaviour which may be challenging. We saw that while this was recorded in their daily notes, behavioural monitoring charts were not in place and staff were unsure how often this person displayed this behaviour and whether there was a pattern to this behaviour.

People were able to make choices about the care they received. A member of staff spoke with us and told us they try to encourage people to make choices about their daily routines.

Our last inspection identified concerns that activities were not designed to enable people with dementia to take part in meaningful activities and that there was little in the way of objects or pictures to stimulate people with dementia. We saw that the provider had taken action to address these concerns and improvements had been made. On the second day of our inspection an external entertainer visited the home. The entertainer used music and reminiscence to engaged people and encourage them to talk about their life. We also saw that throughout both days staff interacted with people and supported them to take part in activities which were planned in line with their prefences.

There was a complaints policy in place and the manager spoke with us about how they would respond to a complaint. The manger told us there had been no complaint made in the last 12 months.

The manager spoke with us about the vision for the home and told us “we run as a big family. We offer people the best care we can, they are here to be safe, comfortable and we respect their privacy and dignity. We give them choice”. Staff shared this vision.

People and relatives spoke positively of the care provided and told us that staff knew people well and there was a consistent team within the home. One person told us “it’s a lovely home”. A relative told us “I’m very pleased with the care, it’s excellent”.