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Inspection Summary

Overall summary & rating


Updated 22 December 2017

An unannounced comprehensive inspection took place of Margaret Roper House on 14 & 15 November 2017.

The previous inspection was conducted on 8 March 2017. This was a focused inspection to follow up on two previous breaches for the safe administration and management of medicines. At that inspection although we found some improvements we raised a new concern around the management of medicines for people outside of the care home. For example, people going on 'home leave' or for trips out from the care home. Medicine audits (at service and senior management level) were completed, however, monitoring and audit arrangements for supporting people to receive their medicines when outside of the care home were not robust to assure people's health and wellbeing. The existing audits and governance arrangements had not identified the shortfalls we found during this inspection.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the administration and management of medicines for people who were taking their medicines out of the home to at least good. We found at this inspection that improvements had been made to ensure this practice was adhered to safely to enable people to take their medicines outside of the service. A policy and procedure was in place which staff understood and followed. Medicine audits were completed to ensure the safe management of medicines in and outside of the care home. This breach of regulation was met.

Margaret Roper 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. Margaret Roper House provides nursing care and accommodates people who have mental health care needs. The accommodation is registered for 23 people. The registered provider (owner) is Nugent Care.

There was a new registered manager in post at the time of our inspection. ‘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's needs were recorded in a plan of care. Where a change in a person's needs had been identified their care plan was updated to reflect this. Information was made available to people in an accessible format.

Care records showed that people's health care needs were addressed with appropriate referral and liaison with external health care professionals when needed.

People's medicines were managed safely. Staff received medicine training to ensure they had the skills and knowledge to administer them.

Risks to people’ safety were assessed and risk management plans were in place to support people safely.

The environment and home’s equipment were maintained and subject to safety checks and service contracts.

Staff knew the different types of abuse and how to recognise and report any concerns they had.

Staff were aware of how to respect people’s rights to independence and staff told us how they empowered people to make their own decisions where able.

When people were unable to consent, the principles of the Mental Capacity Act 2005 (MCA) were followed. This included an assessment of a person's mental capacity and decisions made in the person's best interest. This could be further developed by better evidencing assessment around individual decisions for people.

People's consent was obtained prior to the delivery of any care and support though this was not consistently recorded in people’s plan of care.

People told us they were able to make individual menu requests and that their dietary needs were met by the staff. People were complimentary regarding the menu choices

Inspection areas



Updated 22 December 2017

The service was safe

Risks to people�s health were recorded with actions to help keep people safe.

Systems were in place to ensure medicines were administered safely. This is an improvement following the last inspection.

Sufficient numbers of staff were on duty to help ensure people's care needs were consistently met.

Staff described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported.

The environment and home�s equipment was well maintained and subject to safety checks.



Updated 22 December 2017

The service was effective

Staff received an induction, training, supervision and appraisals to enable them to care for people safely and effectively.

Staff sought consent from people before providing support. When people were unable to consent, the principles of the Mental Capacity Act 2005 were followed in that an assessment of the person's mental capacity was made.

Staff supported people with their care needs and reviews were undertaken with external health professionals to help monitor people�s health and welfare.

People told us they received a well-balanced menu and their dietary needs were known by the staff.



Updated 22 December 2017

The service was caring

People we spoke with told us that staff were kind, polite and caring.

Staff communicated well with people and their approach was compassionate and sensitive.

People told us they were involved in the care planning process. Care records showed some evidence of people and /or their families involvement though this was limited.



Updated 22 December 2017

The service was responsive

Care plans were individualised and reviewed to monitor people health and welfare.

People could take part in a wide range of social activities in the home and within the community.

People told us they could were supported to make decisions around their daily life.

A complaints policy and procedure was displayed so that people and visitors to the home had the information they needed should they wish to raise a concern.



Updated 22 December 2017

The service was well led

There was a registered manager in place.

Staff and people living at the home were complimentary regarding the management of the service.

Quality assurance systems and processes were in place to assure the service. Monitoring arrangements were robust regarding the management of medicines. This was an improvement from our last inspection.

The Care Quality Commission (CQC) had been notified of reportable incidents in the home.

Feedback from people living at the home was sought. People told us their views were listened to and staff responded accordingly.