Archived: Rock House Residential Care Home

Updated 9 April 2019

The inspection:

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

Inspection team:

• The inspection team included one bank inspector, one adult social care inspector and an expert by experience (ExE). An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. For example, a family carer of people with dementia

Service and service type:

• Rock House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

• Rock House Residential Care Home accommodates 38 people in one adapted building. The building has two floors with a lift between the ground and first floor. People have their own bedrooms with shared bathrooms, some bedrooms have washing facilities within. Gardens have been recently renovated with easy wheelchair access.

• The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

• We did not give the service notice of our inspection.

What we did:

• Before the inspection we reviewed the information we held about the service which included notifications they had sent us. Notifications are sent to the Care Quality Commission (CQC) to inform us of events relating to the service which they must inform us of by law. We looked at previous inspection reports and reviewed the Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

• During the inspection we spoke with nine members of staff including the registered manager; the deputy manager, the assistant manager, the activity organiser/ kitchen assistant, two activity organisers, a senior care assistant, a part-time chef and a care assistant. We observed staff interacting with people and supporting them. We spoke with seven people and two family members. We spoke with one visiting health professional.

• Some people were unable to tell us about their experiences of living at Rock House because of communication difficulties. We therefore 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 looked at records relating to the management of the service including 10 people’s support plans and associated records. We reviewed the medicines administration records for people and inspected four staff files including recruitment records. We reviewed minutes of meetings and a selection of quality assurance audits and health and safety records. Following the inspection, we spoke on the telephone with the registered manager about accidents and incidents, safeguarding and Duty of Candour. Duty of Candour (Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014) states that a registered person must act in an open and transparent way with people about the care and treatment they receive in the carrying on of a regulated activity. We reviewed minutes of meetings and a selection of quality assurance audits and health and safety records.

Updated 9 April 2019

About the service: Rock House Residential Care Home provides personal care for up to 38 older people, who may also live with dementia or mental health issues. At the time of the inspection 34 people were living there.

People’s experience of using this service:

• People and their relatives spoke positively about the service. Improvements had been made in some areas since our last inspection, for example a television had been placed in reception and a new family room had been adapted from a bedroom. However, we found several breaches of regulations.

• Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was breached because medicines were not always correctly recorded or administered. The medicines fridge and trolley temperature checks had gaps in the records. Records related to people’s challenging behaviour was not clear in how staff should have supported the person.

• Records related to incidents involving people’s behaviour had not been reviewed to identify themes. This may have helped people identify useful strategies and help relieve people’s distress.

• We found information related to people’s nutritional and hydration needs were not always available. We observed one person struggling to eat with little help, and information about people’s dietary needs was not always understood by staff.

• People were not always treated with dignity and respect. Records about people and the way staff spoke with them was not always respectful. People were not allowed to leave the dining room at meal times until they had received their medicines. As a result, we found the service had breached Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This also meant people were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

• The registered manager had breached Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. because they had not sent to CQC the required notifications. Furthermore, the registered manager and the provider had not identified the areas requiring improvement that we had found. This meant they had not achieved a clear overview of the service, which was required to ensure they assessed, monitored and improved the quality and safety of the service provided. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

• Activities were available to people, however at the time of the inspection they were not always person centred. We have made a recommendation about training staff in this area.

• Staff had received training in how to identify and report concerns of abuse. Information was readily available to guide staff on how to report concerns to the local authority safeguarding team.

• Safeguarding concerns were dealt with appropriately by the senior staff.

• Checks were made on the utilities and equipment to ensure they were safe to use.

• The premises were kept clean and hygienic, people were protected from infections that could affect both staff and people using services through regular cleaning.

• People spoke positively about the staff describing them as “Caring and Professional”.

• Records showed where people required support from external medical professionals this was sourced.

• Staff received support to carry out their role through training, supervision and staff meetings.

• Both staff and people living in the home were treated as equals, there was anti discriminatory policy in place which was adhered to by staff.

Rating at last inspection:

At our last inspection the service was rated Good. (Report published 31 March 2016)

Why we inspected: We inspected the service as part of our scheduled inspection plan.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

Please see the ‘action we have told the provider to take’ section towards the end of the report

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