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We are carrying out a review of quality at Roxburgh House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 14 November 2020

Roxburgh House is a residential care home providing personal to 14 people with a variety of needs. People’s needs include, physical disabilities, dementia, learning disability or long term mental health conditions. The service can support up to 22 people in one adapted building.

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

There was a lack of leadership at the service and the quality of care people received had not improved. The provider and staff did not share a sense of direction or vision and values. Robust plans had not been put in place to drive change and the lack of progress had not been recognised. Checks and audits were not robust and had not identified shortfalls we found.

People’s views and opinions had not been used to improve the service. Some people had raised concerns but these had not been addressed. Others did not raise concerns as they were not confident, they would be addressed.

People continued to be at risk from the spread of infection, including Covid 19. The vacancy for a cleaner had not been filled and the post had not been covered.

Staff were not deployed to a sufficient level to meet people’s needs. People had to wait assistance at times. Care staff were required to completed domestic duties and this took them away from people. Staff had not completed practical refresher training in key skills such as moving and handling. Medicines were not consistently well managed and recorded.

People told us they were bored at times. There was no programme of activities or occupation and people spent their time doing nothing. People had asked to go out but had not been supported to do this.

Preadmission assessments remained inadequate and care had not been planned with people when they began to use the service. Risks had not been identified for everyone and action had not been planned to mitigate risks.

Staff were recruited safely.

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

Rating at last inspection (and update)

The last rating for this service was Requires Improvement (published 25 January 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We undertook this focused inspection to confirm the provider was now met legal requirements because we were not assured they had acted to improve the service. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to inadequate. This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Roxburgh House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to low staffing levels and staff training, risk management, medicines, lack of oversight by the provider and registered manager, not acting of feedback, inaccurate records and failure to notify CQC of significant events at this inspection.

Full information about CQC’s regulatory response to the more se

Inspection areas

Safe

Inadequate

Updated 14 November 2020

The service was not safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 14 November 2020

Caring

Good

Updated 14 November 2020

Responsive

Requires improvement

Updated 14 November 2020

Well-led

Inadequate

Updated 14 November 2020

The service was not well-led.

Details are in our well-Led findings below.