Rotherlea

Updated 4 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 10 February 2022 and was unannounced.

Updated 4 March 2022

About the service

Rotherlea is situated in Petworth, West Sussex and is one of a group of homes owned by a national provider, Shaw Healthcare Limited. It is a residential ‘care home’ for up to 70 people some of whom are living with dementia, physical disabilities, older age and frailty. At the time of the inspection there were 57 people living in the home.

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

The provider had not always fully considered people’s assessed needs when allocating and deploying staff. People, relatives and staff told us that there was insufficient staffing to meet people’s needs and our observations and findings confirmed this. Medicines management had improved and people received their medicines as prescribed. People received safe care and treatment to meet their assessed needs. There was good oversight of people’s hydration and nutrition to ensure they maintained good health. People were safeguarded from abuse and improper treatment and risks were managed. When there were concerns the registered manager had liaised with external health and social care professionals. People were protected from the risk of infection and staff ensured good infection control was maintained. Incidents and concerns found at the previous inspections were used as opportunities to learn and improve practice.

There are concerns about the provider’s abilities to sufficiently improve the service. The provider’s values were not always demonstrated through their practice. Decisions that had been made had not always considered the impact on people's experiences and the quality of care they received. People, relatives and staff were complimentary about the registered manager and management team. They told us the home was well-led and they had confidence in the registered manager's abilities. The registered manager and her team had worked hard to make improvements to people’s experiences and had plans to improve this even further. They had worked alongside health and social care professionals to improve staff’s understanding and the quality of care that they provided.

We recommended that the provider continued to seek support from reputable sources to ensure that they provided accessible information to meet peoples needs.

Work was on-going to further improve person-centred care and people’s access to sources of stimulation and interaction to occupy their time. Some people spent extended periods of time without interaction or stimulation with others. The provider and registered manager had embraced support they had received from external professionals to help ensure that people’s needs were appropriately assessed and planned for. People had received appropriate end of life care to maintain their comfort.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported by skilled and experienced staff who demonstrated good practice when supporting people. People had access to external health care professionals and were supported to maintain their health. People had access to sufficient food to ensure they received a balanced diet.

People’s privacy and dignity was maintained, and they were treated in a respectful way. People told us that staff were kind and caring and they were complimentary about staffs’ compassionate nature. Observations showed staff knew people well and they were considerate and caring.

Rating at last inspection and update

The last rating for this home was Requires Improvement. (Published 10 August 2019). There were breaches of regulation. We served two Warning Notices and the provider was required to become compliant. At this inspection, significant improvements had been made in relation to people’s safety and the provider was no longer in breach of one of the Regulations. We continue to have concerns about the provider’s leadership and management and not enough improvement has been made by the provider. They are in continued breach of the Regulation.

Why we inspected

This was a planned inspection based on the previous rating. We had planned to undertake a focused inspection to check the registered manager’s and provider’s progress and the improvements made since we had served Warning Notices at the last inspection for breaches of two Regulations. We found significant improvements in some of the key questions had been made and therefore undertook a comprehensive inspection.

Enforcement

We have found evidence that the provider needs to make further improvements. We have identified a breach in relation to staffing and the provider’s leadership and management. You can see what action we have asked the provider to take at the end of this full report.

Follow-up

We will continue to monitor the intelligence we receive about this home. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and the local authority to monitor progress. We plan to inspect in line with our re-inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Rotherlea on our website at www.cqc.org.uk.