Rockdale House

Rockdale House is a residential care home providing accommodation and personal care to up to 50 people. The service provides support to people aged 65 and over, some of whom were living with a dementia. At the time of our inspection there were 38 people using the service.

People’s experience of using this service and what we found:

People told us they felt safe living at the home and were happy with the care provided by staff. Relatives gave positive feedback about the service. A relative told us, “We’re absolutely delighted we got her into Rockdale. The staff are always lovely and friendly. She’s very happy. She’s enjoyed it. [Person] is always vocal about the nice staff. She’s treated with respect, e.g. when she asks for female staff. They do all the right things.”

People were safe living at the service and were protected from potential abuse. The home environment had improved and there was a calm, relaxed and pleasant atmosphere. People, relatives and staff were positively engaged by the registered manager.

Medicines were managed safely and there was appropriate clinical oversight in place. Risks which were not related to continence care or skin integrity, were well managed and there were detailed assessments for staff to follow to keep people safe.

Staffing levels had been reviewed regularly to make sure people's needs were met. Staff were recruited safely and provided with on-going training and support.

There was an effective quality and assurance systems in place. Checks and audits identified areas for improvement by the registered manager, who was already taking action to change processes.

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.

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

Rating at last inspection

The last rating for this service was good (published 18 October 2018).

Why we inspected

We received concerns in relation to risk management around pressure damage and skin integrity issues. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has not changed based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rockdale House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

The manager provided personal protective equipment to visitors and residents.

An enclosed meeting room was created for people to meet with family and friends. This had a separate entrance, minimising the risk of infection spread. A visitor coordinator role had been created to facilitate visits and communicate with family and friends.

People, staff and visitors were supported with testing for COVID-19. A dedicated member of staff was deployed to facilitate testing at the home.

There were risk assessments in place for people and staff who fell into high risk groups.

A comprehensive cleaning schedule was in place in the home to minimise the risk of infection spread, this included visitor and high touch areas.

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

Rockdale House is registered to provide support with personal care and accommodation for up to 50 people. There were 46 older people using the service at the time of the inspection.

At our last inspection we rated the service as Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People living at Rockdale House were happy. One person told us, “They are kind and caring and they look after me well. They show they care by remembering how you like things and doing things for you gently and calmly.”

There continued to be enough staff who had the skills and knowledge they needed to support people living in the service. Staff were appropriately supervised. Safe recruitment practices were followed to help ensure potential staff were of good character. Staff received regular support which included individual supervisions and team meetings.

People continued to be protected from abuse. Risks were appropriately assessed and mitigated to ensure people were safe. Staff understood how to identify and report concerns. Medicines were managed safely and people received their medicines when they needed them.

People were treated with dignity and respect by staff who were compassionate and caring. People could make decisions about how their care was provided, and were involved in reviews of their care along with people who were important to them. Staff treated people's private information confidentially.

People were happy with their care and support. People received care that was personalised to their individual preferences. Staff knew people's needs and personal histories well. People knew how to complain and felt confident to do so if needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had choices of food at each meal time. People were supported and encouraged to have a varied and healthy diet which met their needs.

The provider and registered manager had good oversight of the service. Effective systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service.

The service was clean and the environment was clean and welcoming.

The registered manager had informed CQC of significant events at that had happened at the service, so we could check that appropriate action had been taken.

Services are required to prominently display their CQC performance rating. The provider had displayed the rating in the entrance hall. The rating can be found on their website.

Further information is in the detailed findings below.

There was a manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

There was a system to record and monitor accidents and incidents to identify how the risks of recurrence could be reduced. There were sufficient staff on duty to meet people’s needs. Staffing levels were calculated and adjusted according to people’s changing needs. There were safe recruitment procedures in place which included the checking of references.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

All fire protection equipment was serviced and maintained.

People’s bedrooms were personalised to reflect their individual tastes and personalities.

Staff knew each person well and understood how to meet their support needs. People told us, “All the staff here got to know me well and I know them too” and, “They [the staff] understand me.”

Staff received essential training and had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular one to one supervision sessions and an annual appraisal. This ensured they were supporting people to the expected standards.

The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. There was a system to submit appropriate applications to restrict people’s freedom considering least restrictive options as per the Mental Capacity Act 2005 requirements.

Staff sought and obtained people’s consent before they helped them.

The service provided meals that were in sufficient quantity and met people’s needs and choices. Staff knew about and provided for people’s dietary preferences and restrictions.

Staff communicated effectively with people, responded to their needs promptly, and treated them with kindness and respect.

People were satisfied about how their care and treatment was delivered. Relatives told us, “The staff are very attentive, they are always ready to help” and, “This place is definitely caring, I would recommend it without hesitation.”

People were involved in their day to day care. People’s care plans were reviewed with their participation and relatives were invited to contribute.

Clear information about the service, the facilities, and how to complain was provided to people and visitors.

People were able to spend private time in quiet areas when they chose to. People’s privacy was respected and people were assisted in a way that respected their dignity.

People were promptly referred to healthcare professionals when needed. Personal records included people’s individual plans of care, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.

People’s individual assessments and care plans were reviewed monthly with their participation and updated when their needs changed.

People were involved in the planning of activities and told us they were satisfied with the activities provided.

The service took account of people’s feedback, comments and suggestions. People’s views were sought and acted on. The registered manager analysed the results of satisfaction surveys and acted upon them. Staff told us they felt valued under the registered manager’s leadership.

The registered manager notified the Care Quality Commission of any significant events that affected people or the service. The registered manager kept up to date with any changes in legislation that may affect the service and carried out audits to identify how the service could improve. They acted on the results of these audits and made necessary changes to improve the quality of the service and care.

During this inspection we set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff told us that the culture of the home was 'open' and they were confident that any concerns would be addressed. People who lived at the home told us they felt safe and they would be listened to if they raised a concern. One person said 'They do listen. I would be listened to if I had a problem'.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made and how to submit one.

Is the service caring?

People were supported by staff who were kind and attentive. We saw positive interactions between staff and the people they supported. One person said that staff were 'Friendly and encouraging'. Relatives we spoke with were positive about the support their family members received at the home. A relative we spoke with said the service was '100% brilliant'.

Is the service effective?

People told us that they were happy with the care that had been delivered and their needs had been met. We saw that the care that was delivered reflected people's assessed needs. Two people told us that the care was 'Excellent' and one person described the home as a 'Wonderful place'.

Is the service responsive?

We found that systems were in place to allow people to express their views and people told us that their views were listened to and acted on. People attended residents' meetings and they were able to make requests and suggestions. Staff told us they were clear about their role and responsibilities.

Is the service well-led?

Staff we spoke with told us that the managers at the home were approachable and they were listened to when they had any suggestions. One staff member told us that the home was 'Organised' and all of the staff we spoke with told us they felt well supported. Relatives we spoke with expressed confidence in the management of the home.

We found the provider had an effective system in place to assess and monitor the quality of service that people receive.

We found that the provider did not have an effective complaints system available.

People we spoke to told us that they were happy living at the home. Comments included 'I love it here, this is my home' and 'The staff are wonderful and so kind to me' and 'I really like the food'.

People we spoke to told us there were enough of activities on offer. Comments included 'I can join in the activities if I want to'.

Staff we spoke to told us they liked working at the home. Comments included 'This is the best home I have ever worked in' and 'It's like being part of a big family'.

On the day of our inspection there were 30 people living at Rockdale House. When they were asked about their level of satisfaction with the home comments included, "I like living here, the staff are good to me." And, "I feel safe here. I can talk to the staff or the manager at any time if I have any worries."

We found that Rockdale House was entering a period of transition. We were told that the existing care home premises were to be closed during 2013. We saw that a new 48 bedded care home was being built behind the existing premises and was nearing completion. The majority of people who used the service were looking forward to moving into the purpose built premises. We were told that the new home would offer greater space and more modern, en suite facilities.