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Reports


Inspection carried out on 30 October 2018

During a routine inspection

About the service: Rocklyn is a residential care home that can provide personal care to up to 11 people. Care is mainly provided to people with learning disabilities. There were seven people using the service when we visited.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service: Rocklyn was a relaxed place to live. People looked very comfortable and at home in their surroundings. They could come and go from the home whenever they wanted. People told us they felt safe and well cared for. Staff were friendly. Most had worked at the service for a long time. People and staff knew each other very well and they looked at ease in each other's company. People were included in planning their care and set goals that they wanted to work towards.

Staff were well trained and knowledgeable about their roles and the care people needed. Relatives told us staff did a good job. One relative told us about the ways their family member's life had improved since they started living at the home. They told us they had more confidence and were much more active than they had been before. People took part in lots of activities in the local town.

Systems and processes were in place and well monitored so the home was safe and run well. Medicines were well managed. We saw improvements had been carried out to the building since our last inspection and that refurbishment plans were still being carried out to further improve the accommodation.

People's rights were upheld. People were given choice and their decisions were respected. Where people did not have capacity to make decisions, they were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible;

Some information had not been written in a way that people using the service could understand. We have set a recommendation that the provider reviews records and written communication with people so that they are easier to understand.

The service was well run. The registered manager knew people well. Staff told us the registered manager was fair, and good at listening to people and staff’s thoughts about how to make the service better. The registered manager carried out lots of checks to make sure that the service was delivering a good service.

Rating at last inspection: Good (Rating provided in August 2016)

Why we inspected: This was a planned inspection. It was scheduled based on the previous rating.

Inspection carried out on 5 July 2016

During a routine inspection

This unannounced inspection took place on 5 July 2016. We last inspected Rocklyn on 12 November 2015 when we found the provider was not meeting Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to good governance. We wrote to the provider and asked them to send us a report confirming the actions they were going to take to meet their legal requirements.

In March 2016 the provider sent us a detailed report and examples of the work they were undertaking to meet their legal responsibilities. This inspection was to check that the provider was carrying out its legal responsibilities and that work had been completed as declared.

Rocklyn provides residential care for up to 11 people who have learning disabilities and at the time of our inspection there were eight people living there. All of the people living at the home were able to communicate with us, although two were not present during the inspection.

Rocklyn was originally two terraced properties which have been combined into one building spread over three floors.

The service had a new manager in post who had worked with the provider organisation for eight years and having been promoted to manager at Rocklyn, took up the post on 1 February 2016. They had applied to become the registered manager and their application was being processed. 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.

The service was generally well maintained and was undergoing further work to improve a recent leak. The provider had agreed to complete some outstanding work at the service, including a new sink and a drafty window in two people’s bedrooms.

Safe management of medicines was followed and people told us they received the correct medicine from staff.

People told us they felt safe. Staff had received suitable training and knew how to report any concerns regarding the people in their care to the appropriate authorities.

Emergency procedures were in place, although we noted that the provider's contingency plan needed more detail specific to the service and the registered manager was in the process of updating the document.

Accidents and incidents were reported and monitored by the manager and provider. This meant that any trends forming would be easily identified and actions taken to stop any reoccurrence.

The provider followed safe recruitment practices and employed enough suitably trained staff to support people. The provider had an on-going programme of support and training for staff with a full induction programme when new staff joined the organisation. Staff told us they felt supported by the new manager.

A variety of food and refreshments were available for people and they told us they were happy with what was on offer.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. MCA is a law that protects and supports people who do not have ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. We found the provider had met their legal obligations.

People had a good rapport with staff and we saw this during our inspection. Staff spoke with people in a caring and kind manner and treated them with respect and dignity.

Care records were tailored around each individual person and were reviewed regularly with people, families and healthcare professionals fully involved.

We saw that people had choice in what they did. People were able to decorate their own personal space how t

Inspection carried out on 12 November 2015

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

This unannounced inspection took place on 12 November. We last inspected Rocklyn on 23 July 2015 when we found the provider was not meeting Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to premises, infection control and governance.

We issued the provider and the registered manager with warning notices in relation to regulation 12 and issued a warning notice to the provider for the breach of regulation 17.

We undertook this focused inspection to check that they had complied with the warning notices in the timescales given and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rocklyn on our website at www.cqc.org.uk

Rocklyn provides residential care for up to 11 people who have learning difficulties and at the time of our inspection there were eight people living at the service. All of the people were able to communicate with us.

The service had 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.

We found there were continuing breaches of regulations in relation to the quality monitoring of the service. The provider was now meeting the regulations with regard to premises and infection control, although an infection control audit was still not in place.

Work had been undertaken to repair and refurbish the property. However, risks relating to the communal step in the shower cubicle on the ground floor required further review in relation to some people who preferred this facility.

Other risks had now been assessed and suitable guidance and plans were in place.

Staff were aware of safeguarding procedures and what to do if they suspected abuse may be occurring.

Accidents and incidents were reported and recorded, although we found procedures were not robust and could not fully confirm whether the provider monitored these.

We found shortfall in records where people’s needs had changed but medical interventions were not adequately recorded or followed up in writing.

There were enough staff to meet the needs of people living at the service and evening hours had been increased due to people’s changing needs. Appropriate recruitment procedures had been followed.

We found the provider had displayed their rating from the previous inspection at the service and the rating was also available on the provider’s website.

We found continuing shortfalls in relation to quality monitoring at the service. The provider had not monitored the quality of the service adequately, resulting in ongoing shortfalls in safety checks which we had to point out to them.

Surveys had been carried out by the registered manager and all the people had responded with positive comments.

We found continued breaches of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Good governance

We have judged these latest findings demonstrate ongoing breaches of regulations. These are being followed up and we will report on our action when it is complete.

Inspection carried out on 23 July 2015

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

This unannounced inspection took place on 23 July 2015. We last inspected Rocklyn on 14 and 20 January 2015 when we found the provider was not meeting Regulations 10, 13 and 15 of the Health and Social Care Act (Regulated Activities) Regulations 2010, which correspond to Regulations 12, 15 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and relate to governance, premises and management of medicines. Regulation 18 of the Care Quality Commission (Registration) Regulations 2009 which relates to notifications of incidents was not being met when we last inspected.

Following our inspection in January 2015, the provider sent us an action plan to show us how they would address our concerns.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rocklyn on our website at www.cqc.org.uk

Rocklyn provides residential care for up to 11 people who have learning difficulties and at the time of our inspection there were eight people living at the service. All of the people living at the service were able to communicate with us.

The service had 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.

We found there were continuing breaches of regulations in relation to the maintenance and cleanliness of the premises, and the quality monitoring of the service. The provider was now meeting the regulations with regard to reportable incidents involving the police. The provider has taken action to improve the safe management of medicines and we were satisfied that appropriate measures were now in place.

Work had been undertaken to repair and refurbish some areas of the property, specifically in relation to windows, roofing, some carpeting and general decoration. However, other areas, such as the communal showers, laundry, kitchen and bathrooms were in a poor and unsatisfactory condition.

Risks to people living at the service had not all been assessed, including while work was on-going in the service. Although the staff were aware of fire and emergency procedures we were concerned about storage in certain areas of the service and reported our findings to the fire authority.

Staff were aware of safeguarding procedures and what to do if they suspected abuse may be occurring.

Accidents and incidents were reported and recorded, although we found procedures were not robust, including actions taken after incidents occurred and whether the provider monitored these.

There were enough staff to meet the needs of people living at the service and appropriate recruitment procedures had been followed.

We found the provider had not displayed their rating from the previous inspection at the service or on their website. We advised the registered manager about this new requirement.

We found continuing shortfalls in relation to quality monitoring at the service. It was not apparent that the provider monitored the quality of the service through their own monitoring visits or via the systems they had in place. During our inspection we found it difficult to gain access to the provider’s electronic monitoring systems due to reported internet failure.

In relation to cleanliness, we found there were still no regular infection control audits being carried out. Various risk assessments had not been undertaken, including Legionella.

At the last inspection we were told by the registered manager that surveys were soon to be sent out by the provider, however at this visit we found that no surveys had been undertaken. The provider told us that it was the registered manager who would lead on this piece of work.

We found breaches of Regulation 12, Safe care and treatment and Regulation 17, Good governance, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We have judged these latest findings demonstrate on-going breaches of regulations. You can see what action we told the provider to take, including enforcement action we have taken, at the back of the full version of this report.

Inspection carried out on 14 and 20 January 2015

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

The inspection took place on 14 and 20 January 2015. This was the first inspection at the home since it was registered with the Care Quality Commission (CQC) on 29 April 2014.

Rocklyn provides residential care for up to 11 people who have learning difficulties and at the time of our inspection there were eight people living there. All of the people living at the home were able to communicate with us.

Rocklyn was originally two terraced properties which have been combined into one building spread over three floors.

The home had a registered manager in post who had worked at the home since the provider registered and also for seven years with the previous provider. 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.

We found significant shortfalls with the maintenance of the premises. We found rotting window frames, threadbare carpets and a need for redecoration throughout the home. Mould on walls was found in a number of areas within the home and electrical testing of portable equipment had not been undertaken since 2013.

Safe management of medicines was not always followed, although people told us they received the correct medicine from staff. Risk assessments were not always completed.

People told us they felt safe at the home and protected by the staff. Staff were aware of their personal responsibilities to report any incidents of potential or actual abuse to the registered manager. People told us there were enough staff at the home to support them and we confirmed this through records. We found emergency procedures, including fire safety were monitored and staff knew what to do in an emergency. Accidents and incidents were recorded and monitored to identify any trends.

People told us they were happy with the food and drink available to them. We found staff were suitably trained and received supervision and appraisal from the registered manager.

Staff followed the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards. MCA assessments and ‘best interests’ decisions had been made where there were doubts about a person’s capacity to make decisions.

People told us staff look after them well. Staff spoke with people in a caring and kind manner and treating them as individuals with respect and dignity. People’s care needs were detailed, recorded and reviewed by staff with input from the person, their families or healthcare professionals.

People had choices in their day to day living and were able to participate in a wide range of activities. Staff encouraged and supported everyone to maintain social links. One relative told us, “They [person’s name] has a better social life than me.” People and their relatives told us they knew how to complain and any issues had been dealt with quickly.

We found quality assurance checks were not always robust, particularly with regard to premises and elements of infection control. The registered manager had not notified us of incidents occurring at the home which had involved the police.

Staff felt supported in a team that worked together for the benefit of people living at the home.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and one breach of the Care Quality Commission (Registration) Regulations 2009. These related to safety and suitability of premises; management of medicines; assessing and monitoring the quality of service provision and notifications. You can see what action we told the provider to take at the back of the full version of this report.