Archived: The Rookery Care Home

During the inspection we considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people who used the service, the staff who supported them and from review of records. We also spoke with the registered manager and the deputy manager.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

During our visit we spoke with six people who used the service and also observed how staff supported people in each part of the home. We saw examples of good care and support during this time. Everyone that we spoke with said they felt safe. One person told us, 'They look after you well here.' We spoke with the relatives of four people who used the service. They all said that, from their observations and experiences, staff met people's needs safely and effectively.

We spoke with a health professional who was visiting the home. They told us that they had no current concerns about the way that people were treated. They told us that staff were, 'Always helpful' and that they worked with them appropriately to ensure the good physical health of the people who used the service.

Is the service effective?

On the day of our inspection we saw that people received prompt and appropriate support to meet their needs. People who used the service told us that they were cared for in ways that they preferred and relatives said that they had been involved in assessments and reviews to ensure staff had relevant and up to date information about people's needs and preferences. One person told us, 'I like it here. They look after me well.'

We saw evidence that people who used the service were involved and consulted in relation to how they were supported.

Individual likes and dislikes were recorded and in discussions staff were able to tell us these. This suggested that care planning and communication was effective to ensure that people's needs were met.

We found that the registered manager and the deputy manager had effective systems in place to ensure staff were providing appropriate support. We saw how staff recorded when they had carried out key tasks. A visiting health professional told us that the staff were providing effective support in relation to keeping people's skin intact. Staff told us that they knew what to look for and had received training to help them understand the importance of regular checks and appropriate equipment.

We saw care plans and risk assessments had been completed to offer guidance to staff in relation to meeting people's personal care needs. Staff told us that these were useful documents enabling them to offer effective and consistent support.

Is the service caring?

We saw people who used the service being supported by staff who were kind and patient. Staff supported people at their own pace and took time to explain what they were doing when offering personal care. One person who used the service told us, 'They are lovely here. They look after us all very well.' A visiting health professional said, 'Staff are caring and kind. They have good intentions.'

Is the service responsive?

We saw evidence that the registered manager actively sought the views and experiences of the people who used the service and their relatives. The latest questionnaires had been analysed and we saw that responses had been overall very positive.

The registered manager and deputy manager told us that they discussed any actions identified from feedback in regular management meetings. We saw evidence that these had taken place. This meant that the service was able to respond to comments and suggestions about the quality of the service provided and were willing to make changes in response.

People who used the service told us how staff listened to them and acted in accordance with their wishes. We saw how the registered manager had worked closely with staff and health care professionals to ensure people remained safe. A visiting health professional told us how staff implemented their instructions to ensure the health and well-being of the people who used the service.

The registered manager told us that they had not received any complaints about the service however there was a procedure in place and relatives told us that they would feel comfortable raising issues and concerns with staff and managers. They told us that they were confident that any required actions would be taken to improve the service.

Is the service well-led?

We saw evidence that the registered manager carried out regular reviews and audits of systems and processes. They told us that they had effective monitoring tools that reassured them that they provided a good service. The registered manager worked closely with the deputy manager to ensure that the home was well led. Staff told us that arrangements worked well and that they always felt well supported.

We saw how the registered manager had taken action following internal and external audits. For example they had an action plan that addressed recommendations made by the local authority infection control team. We saw how improvements had been made following receipt of this report and also following our last inspection.

We saw some risks relevant to people's care needs had been identified. We found that most care plans and risk assessments had been reviewed however reviews were not completed for all identified care needs and risks in every person's care plan.

One staff member told us, 'The home could be cleaner.'

We found clothes, shoes and items for maintaining personal hygiene had been left in bathrooms. We inspected a toilet on the ground floor and saw the floor was wet and stained with unidentified markings. Although the service had a process in place; red bags to separate and wash dirty, soiled laundry were not used by the service at the time of our inspection.

Our observations meant that people were not cared for in a clean, hygienic environment.

Staff members we spoke with were able to describe the storage, administration and recording procedures for medications.

We found in one person's medication administration record chart and found there were discrepancies related to the stock levels for three different medications. We discussed this with the manager but they were unaware that tablets were missing for this person.

During our inspection we toured the home and observed that the premises were not well maintained.

A staff member told us, 'Staffing is ok now. Numbers of people living here have increased and so have the staff numbers.' We saw staff rotas which showed that staffing levels had been in line with the staff numbers identified for people currently living in the home.

We found that improvements had been made following our previous inspection in relation to records.