Rowland House Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The interim manager had a shared vision, strategy and culture. The service had previously experienced a closed culture where staff were frightened to speak up and where care for people, was not always meaningful or person-centred. However, we heard from both staff and relatives that the culture had improved immensely. Staff told us the interim manager had made positive improvements to the service, and they felt the culture within the home had changed for the better. A relative told us, “It seems a more relaxed and happier home since the new manager has joined. She is more available than the previous manager.”

The interim manager told us, “I am investing in and nurturing the staff. They have been through a lot. I have faith in them and I am taking my time with them to ensure I retain them. As a result, people are happier too and the culture is more positive.”

Although positive, it was essential that this new culture was embedded and sustained as the provider employed a new registered manager into post. This was important so the service did not deteriorate and revert back to a closed culture where staff were frightened to speak up.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. However, although the provider had engaged the interim manager to oversee the service and to make the necessary improvements needed, the interim manager had only been in post for 3 months. The interim manager had already made several changes for the better, but a permanent manager would need to sustain and build on these improvements to help ensure that the service was providing high quality, safe care to people.

A relative told us, “The new manager has definitely changed things around and made it better than what it was.”

The interim manager understood the need to improve the care of people to make it more person-centred and what was needed to ensure that the environment in which people lived was suitable for their needs. In addition, they knew the procedures required to comply with relevant regulations, ensuring that improvements were aligned with the relevant standards expected.

Staff were happy working at Rowland House under the interim manager. They told us, “She is inclusive and it is a supportive team. There is synergy amongst the team.”

The provider fostered a positive culture where people felt they could speak up and be heard, although staff were not given formal opportunities to be involved in the running of the service, such as through staff meetings. The interim manager told us, “I speak with the staff every day, even night staff, but I am aware that I need to set up a staff meeting.” Staff meetings are important as they provide a platform for staff to communicate with each other about the needs of people, discuss any concerns and share best practice. This helps ensure that staff are providing consistent care to people.

However, staff did tell us the interim manager was approachable and that they would speak with them if they were concerned about anything. A staff member told us, “Staff are much happier.”

Relatives said they would have no concerns raising a complaint. One relative told us, “I would raise them with the manager. But I haven’t raised any."

Management valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The interim manager told us, “Everyone (staff) is an individual and here on their own merit. We will provide anything staff need culturally, and we have a lovely integrated team. All staff have the same training, and I started cooking lessons to help improve the quality of the food here and all staff have been involved in that.”

Management had clear responsibilities and roles, systems of accountability and there were governance arrangements in place.

Several internal and provider audits were completed on the service regularly. These included infection prevention and control, medication, falls and care planning. However, these had not always identified areas requiring action, for example the medicines storage.But the refurbishment of 1 toilet, the redecoration of some people’s rooms and the installation of a new medicines room had been recognised by the interim manager. Other areas of the service also still needed to improve. This included ensuring people received a consistent approach in relation to accessing the wider community, ensuring people’s care plans were person-centred and contemporaneous and people and staff were given the opportunity to be fully involved in the running of the service.

The interim manager held a service improvement plan which covered all aspects of the service and the provider arranged for a provider quality assurance visit to take place on a regular basis to give an outside perspective of the performance of the service.

Management did not always understand their duty to collaborate and work in partnership with the local community.

The interim manager told us there were no links to the local community for people. People with an acquired brain injury or a neurological illness can experience a sense of isolation or loneliness. Being involved in local community activities helps rebuild a sense of purpose and engagement or a sense of identity and belonging. Yet, management had not yet investigated local support groups or community initiatives which could support such involvement.

However, despite this, staff worked with external professionals in relation to people’s care. This included the provider’s speech and language therapist, the district nursing team and the physiotherapy team. They had also received visits from the local authority quality team in response to the safeguarding concerns. This team told us they had seen good improvements between visits.

The interim manager had focused on continuous learning, innovation and improvement across the organisation and local system. A staff member said, “[Interim manager] has made a lot of improvements.” A relative said, “There have been so many positive changes that it’s hard to list them all. The atmosphere in the home is so different and so welcoming now since [interim manager] has arrived. It’s lovely to see staff look happier and treated better.”

In the time the interim manager had been overseeing the service they had improved the garden, introduced more robust infection prevention and control processes, reviewed and improved staff training opportunities and recruited more permanent staff. A relative told us, “The previous manager used to use so many agency staff but now that’s changed with more permanent staff and I can see a difference.”

In addition, the interim manager told us, “The quality of the food was lacking, so now I’m doing [their name] cooking classes every week. Everything is prepared with fresh vegetables, and staff are learning to make meals from scratch.”