Archived: Roanu House

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches of regulations described above.

We undertook a focused inspection on the 25 August 2016 to check they had followed their action plan and to confirm they now met legal requirements. This inspection was unannounced.

This report only covers our findings in relation to these requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Roanu House on our website at www.cqc.org.uk

Roanu House provides accommodation for up to six people who require personal care on a daily basis. The home accommodates people who have mental health needs and/or learning disabilities. At the time of our inspection there were six people living at the home. One of the six people lived there at weekends only.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The registered manager had only been in post since February 2016 and had registered with the CQC.

During our focused inspection we found the provider had followed their action plan. Premises safety checks had been completed and were available for us to view. There were systems in place to ensure future checks and audits were completed in a timely manner.

Broken and unsuitable furniture had been replaced. The home was clean and hygienic to help protect people from the risks associated with the premises.

There was now a systematic approach to staff training. The registered manager at Roanu House was able to monitor the training staff had received. Staff training records had been updated and staff training was being refreshed.

Whilst the provider had taken sufficient action to meet the legal requirements that were being breached at the last inspection, we have not improved our rating for the service. As we need to see consistent improvements over time before we are able to change the rating of this service from ‘requires improvement’.

Roanu House provides accommodation for up to six people who require personal care on a daily basis. The home accommodates people who have mental health needs and/or learning disabilities. At the time of our inspection there were four people living at Roanu, three of whom had moved in during the last six months.

The service has 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. The manager had been in post since February 2016 and had become registered with the CQC in recent weeks.

We found a number of shortfalls within the provision of the service at Roanu House. Some safety checks in respect of the premises could not be located or had not been carried out annually within timescales. For example recent gas safety check and Legionella tests could not be located. The kitchen area was not cleaned and maintained adequately to minimise the risk of infection. A kitchen cupboard was embedded with grease, the refrigerator contained liquids that had been spilled some time ago and had not been cleaned and a kitchen table wobbled considerably and was unsteady when someone used it to support themselves when getting up from a chair. In addition, the provider could not supply evidence that all staff had completed training that they considered mandatory. This meant they did not have appropriate arrangements to protect people from the risk of inappropriate and unsafe care.

We identified three breaches of the Health and Social Care (Regulated Activities) Regulations 2014 during our inspection. You can see what action we told the provider to take at the back of the full version of this report.

The newly registered manager was aware of their responsibilities in line with legal requirements. People we spoke with were positive about the registered manager who they considered open and approachable. They felt any issues they raised would be taken seriously and acted upon.

Staff we spoke with were knowledgeable about what they needed to do if they suspected someone was at risk of harm. The provider had recruitment systems in place to make sure only suitable people were employed by the service.

People had access to healthcare services to meet their needs. The home had contact with a number of healthcare professionals as and when people needed them. People received their medicines as they had been prescribed to them.

Care was personalised so it met people’s diverse needs and preferences. People were able to choose a range of activities either in the community or within the home. People were encouraged to maintain links with their relatives.

The provider worked within the framework of the Mental Capacity Act 2005. The Act helps protects people who are unable to make decisions for themselves. Staff had received appropriate training and knew how to work within the Act. People were asked for their consent prior to care being provided.

Staff were knowledgeable about the people they were caring for. They provided care that was respectful of their privacy and dignity. They also showed great patience and compassion to people.

People were encouraged to be as independent as possible and if this was not possible, then risks were identified and strategies developed to assist people as much as they were able to.

This inspection was carried out by a single inspector. There were two people using the service when we visited and we spoke with both people. We also spoke with a representative of the registered provider and two members of care staff.

We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service caring? Is the service effective? 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, speaking with people using the service and the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The provider had taken steps to protect people from the risk of abuse. People told us they felt safe. One person said, 'I feel safe. They look after me well.' Staff received safeguarding training from the local authority. The provider carried out checks on new staff to ensure staff were suitable to care for people. The environment was clean and tidy and there were infection control policies and procedures in place. Cleaning tasks were completed and recorded on a daily basis. People had risk management plans to help protect them from foreseeable risks.

People who use services should only be deprived of their liberty when this has been authorised by a Supervisory Body under the Deprivation of Liberty Safeguards. We confirmed during our visit that this did not apply to either of the people who currently used the service. There were enough staff to allow people to leave the house when they wished.

Is the service effective?

One person told us, 'It's really good here.' Staff received training relevant to their roles, including training specific to the needs of people who used the service. The service supported people to access specialist healthcare and support services when required, such as occupational therapy and continence clinics. People were involved in food preparation and were provided with food that met their dietary needs and preferences.

Is the service caring?

The service used different methods of communication to give people information and gain their consent before care was provided. One person told us, 'I get to choose whether to do things or not. [Staff] ask what you want.' People consented to their proposed plan of care being carried out before it was put in place. People told us they were able to spend their time as they wished and were involved in household tasks so they were kept occupied and did not lose skills they had previously learned.

Is the service responsive?

People were involved in assessments of their needs and in planning their care, which included information about their needs, preferences, history and hobbies. Care was planned according to people's needs and preferences, including specialist referrals when needed. The service planned care in such a way as to promote people's independence and community involvement. At the time of our visit the service had not received any complaints, but the complaints procedure was displayed so people were able to access it if they needed it. Staff felt that the provider responded to their concerns.

Is the service well led?

The provider carried out annual surveys and regular staff meetings to monitor the quality of the service and gather people's views. There was evidence that they responded to feedback and used people's views to improve the service. People told us they were asked for their opinions and they were listened to. Staff knew how to express their views and said they felt comfortable doing so. Records were well maintained, securely stored and up to date, although some policy documents needed updating to ensure staff could access current information. There were systems in place to identify and manage risks to the service.

We found that the provider was taking steps to ensure that people who used the service were protected against unsafe or inappropriate care by completing individual assessments of their needs. People's care needs were reviewed in conjunction with other professional providers and there was evidence that the provider had formal admission and transfer policies in place. People were also supported to access other specialist services when required.

People we spoke with made positive comments about the staff for example, that the manager was "excellent" and that the staff were "helpful." We saw evidence that staffing levels had been adjusted to meet the needs of people who used the service. One person we spoke with commented on the "consistency" of the management. There was a formal system in place to deal with any complaints that may arise and that the complaints system was brought to the attention of people who used the service.