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Inspection carried out on 19 November 2018

During a routine inspection

We inspected this service on 19 November 2018. The inspection was unannounced.

Rowles House provides care and support for up to 24 people who require personal care; some of whom may be living with dementia. There are 22 rooms, two of which are shared rooms which can accommodate couples or people who wish to live together. The service is set over two floors and has been adapted to make the service accessible to people who need to use a wheelchair. At the time of our inspection 23 people were using the service.

Rowles House 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.

At our last inspection we rated the service 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.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 continued to receive safe care. Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. There were detailed risk management plans in place to protect and promote people’s safety. Staffing numbers were sufficient to keep people safe and the registered provider followed thorough recruitment procedures to ensure staff employed were suitable for their role.

People’s medicines were managed safely and in line with best practice guidelines. Systems were in place to ensure that people were protected by the prevention and control of infection. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence.

People’s needs and choices were assessed and their care provided in line with their preferences. Staff received an induction process when they first commenced work at the service and received on-going training to ensure they could provide care based on current practice when supporting people. People received enough to eat and drink and were supported to use and access a variety of other services and social care professionals. People were supported to access health appointments when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

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. The principles of the Mental Capacity Act (MCA) were followed.

People continued to receive care from staff who were kind and caring. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff who had a good understanding of their needs and preferences.

People’s needs were assessed and planned for with the involvement of the person and or their relative where required. Staff promoted and respected people's cultural diversity and lifestyle choices. Care plans were personalised and provided staff with guidance about how to support people and respect their wishes. Information was made available in accessible formats to help people understand the care and support agreed.

The service con

Inspection carried out on 28 July 2016

During a routine inspection

This inspection took place on the 28 July 2016 and was unannounced. When we last inspected the service in June 2015 we rated it as ‘requires improvement’ in the areas of ‘safe’ and ‘responsive’.

Rowles House is a residential home in Luton providing accommodation and personal care for up to 24 older people, some of whom are living with dementia. At the time of our inspection there were 19 people using the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 were kept safe and protected from avoidable risk of harm. They had care plans and risk assessments in place which were person-centred and detailed enough to allow staff to support them effectively. People had their on-going healthcare needs met by the service. There was enough to eat and drink and people enjoyed the choice food available. There was a programme of activities and events which kept people stimulated and engaged throughout the day. People were supported to share views and experiences through residents meetings and a key worker system. People were asked for their consent prior to receiving care, and the service adhered to the principles of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

People were supported to take their medicines safely but there were not always specific protocols in place to enable staff to understand how and when people took ‘as and when’ (PRN) medicines. There were not always clear guidelines in place to consistently manage the risk associated with behaviour that might have impacted negatively upon others.

Staff received a full induction and on-going training that enabled them to carry out their duties effectively. They were supported through supervision, appraisal and observation and had opportunities to contribute to the development of the service through team meetings. Staff demonstrated a kind, caring and committed attitude to supporting people. They treated people with dignity and respect and understood their needs and wishes. Staff recruited to the service had the correct knowledge, skills and experience to carry out their duties safely. Staffing numbers had improved since our last inspection, allowing staff to be more responsive to people’s needs.

The management and culture of the service was positive, and improvements had been made through robust quality monitoring systems. People, their relatives and the staff team were asked to contribute to the overall development of the service through meetings and surveys.

Inspection carried out on 17 June 2015

During a routine inspection

We carried out an unannounced inspection on 17 June 2015.

The service provided care and support to adults, some of whom may be living with a variety of needs including chronic health conditions, physical disabilities and dementia. At the time of the inspection, 21 people were being supported by the service.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

Some areas of the home had an unpleasant smell, and some of the carpets were stained and dirty.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised. There were systems in place to safeguard people from the risk of possible harm.

The provider had effective recruitment processes in place. However at busier times of the day, there was not sufficient staff to support people.

Staff received supervision and support, and had been trained to meet people’s individual needs. They understood their roles and responsibilities to seek people’s consent prior to care being provided.

People were supported by caring and respectful staff. They were supported to access other health and social care services when required.

People’s needs had been assessed, and care plans took account of people’s individual needs, preferences, and choices.

People did not always get support when they wanted it.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people and acted on the comments received to improve the quality of the service.

The provider had effective quality monitoring processes in place.

Inspection carried out on 8 January 2014

During an inspection to make sure that the improvements required had been made

When we inspected Rowles House on 7 November 2013, we found that people were not protected against the risks associated with unsafe or unsuitable premises. We judged this to have a moderate impact on people using the service.

Following our request, the provider submitted an action plan informing us of the measures they would take to make the necessary improvements. We inspected the service again, to check improvements had been made. On this occasion, we did not speak with people who use the service or their relatives due to their positive responses on our last inspection.

We saw that carpets in some bedrooms had been replaced and commodes which had not been fit for purpose on our previous inspection, had been disposed of and replaced with new commodes.

We observed damp areas in the home caused by the flat roofs. We saw confirmation that quotes had been obtained for this to be remedied and work was expected to commence at the end of January 2014.

We saw that improvements had been made to the staff office and storage of records.

Overall, this meant the provider had made appropriate improvements to ensure the premises remained safe for people using the service, staff and visitors.

Inspection carried out on 7 November 2013

During a routine inspection

When we visited Rowles House on 07 November 2013 we spoke with five of the 20 people using the service, four staff members and a visiting health care professional.

People told us they were happy with the care and support they received from staff. One person said; “Staff are always friendly, I’m very lucky here.”

We observed that people were offered support at a level which encouraged independence and assured their individual needs were met.

People experienced effective, safe and appropriate care. Care plans were well documented to promote continuity of care.

We found that people living in the home received their prescribed medication when they needed it and in a way that suited them.

Some areas of the home needed attention and repair.

Suitable arrangements were in place to address people's comments and complaints, and ensure they were listened to.

Inspection carried out on 1 November 2012

During a routine inspection

When we visited Rowles House on 1 November 2012, we found that people were very satisfied with the care and support they received. They told us they felt safe and that staff were polite and supportive. One person said, "It's lovely here, the service we get is very good, I couldn't think of a better place". Someone else told us, "They look after us and I have friends here".

We observed that people were offered support at a level which encouraged independence and ensured that their individual needs were met. Where equipment was required to help people to mobilise and move, it was used confidently and safely. There was a relaxed atmosphere in the home, and the staff were friendly and courteous in their approach to people and interacted confidently with them.

There were systems in place to ensure the staff employed were suitable to work in the care environment. We found they were knowledgeable about the policies and procedures that were in place to protect peoples' health and welfare.

We noted that people were encouraged to express their views and were involved in planning their care and making decisions about their support and treatment, and how they spent their time. One person told us how much they looked forward to the entertainment and activities that were provided for them. Within the care files we saw that care documentation had been signed by the individual or a representative to confirm their involvement and agreement with their particular care needs.

Reports under our old system of regulation (including those from before CQC was created)