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Roland Residential Care Homes - 231 North Circular Road Good


Inspection carried out on 25 October 2017

During a routine inspection

Roland Residential Care Homes – 231 North Circular Road is a residential care home for six people with mental health needs and drug and alcohol addiction. At the time of this inspection there were six people using the service.

This inspection was carried out on 25 October 2017 and was unannounced.

At the last inspection on 22 July 2015 the service was rated ‘Good’.

At this inspection we found the service remained ‘Good’.

People told us that they felt safe living at the home and with the care and support that they received from care staff. Care staff demonstrated a good understanding of how to safeguard and keep people safe and how concerns should be reported.

Risk assessments identified and assessed people’s individual risks associated with their care, support and health needs and provided guidance on how care staff were to support people to mitigate or reduce risks.

Medicine records confirmed that people were supported with their medicines safely and appropriately. Systems were in place to ensure medicines were handled and stored securely.

Safe recruitment practises were noted to ensure that only care staff suitable to work with vulnerable people were recruited.

Appropriate staffing levels were in place to ensure people were supported according to their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Records confirmed that all care staff received an induction followed by on-going training in a variety of topics to support care staff in carrying out their role effectively. Staff confirmed that they were supported appropriately through regular supervision and an annual appraisal.

We observed people had developed caring relationships with care staff that were based on mutual respect. Care staff knew people well and were aware of their needs, preferences as well as their personalities and how they wished to be supported.

Care plans were detailed and person centred and were reviewed on a monthly basis through key worker sessions in partnership with the person.

People participated and were supported to take part in their choice of activities as and when they so wished. People were supported to maintain their independence and took active roles in taking care of their home and environment.

The service had not received any complaints since the last inspection. Systems were in place to address any complaints received.

The registered manager and provider had a number of systems in place to monitor the quality of care that was being delivered.

Further information is in the detailed findings below.

Inspection carried out on 22 July 2015

During a routine inspection

This inspection took place on 22 July 2015 and was unannounced. Roland Residential Care Homes - 231 North Circular Road provides care and support to a maximum of six adults with mental health needs and drug and alcohol addiction. At the time of our inspection, there were five people using the service.

At our previous inspection on 19 June 2014 the service met the regulations inspected.

There was a registered manager in post at the time of our inspection. 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.

People who used the service told us they felt safe in the home and around staff. Representatives of people who used the service told us that they were confident that people were safe in the home. Systems and processes were in place to help protect people from the risk of harm. These included careful staff recruitment, staff training and systems for protecting people against risks of abuse.

There were enough suitably trained staff to meet people’s individual care needs and this was confirmed by staff we spoke with. Staff spoke positively about the training that they had received.

Staff had the knowledge and skills they needed to perform their roles. Staff spoke positively about their experiences working at the home. Staff told us that they felt supported by management within the home and said that they worked well as a team.

There were arrangements for the recording of medicines received into the home and for their storage, administration and disposal. However, we found that medicine audits were not documented and therefore there was no evidence that these took place. We spoke with the registered manager about this and he confirmed that in future all medicine audits would be documented.

Positive caring relationships had developed between people who used the service and staff and people were treated with kindness and compassion. People were being treated with respect and dignity and staff provided prompt assistance but also encouraged people to build and retain their independent living skills.

Care plans were person-centred, detailed and specific to each person and their needs. People were consulted and their care preferences were also reflected. People’s health and social care needs had been appropriately assessed. Identified risks associated with people’s care had been assessed and plans were in place to minimise the potential risks to people. People had monthly key working sessions with staff to discuss their care and progress and people’s care plans were updated accordingly.

Staff had assessed people’s preferences and their daily routine and arrangements were in place to ensure that these were responded to. The home had monthly residents’ meetings where people were encouraged to express their views about the service and make suggestions regarding their weekly schedule. People could participate in a range of activities they liked and these included shopping, going to the day centre and doing household tasks.

Staff were able to demonstrate a good understanding of the Mental Capacity Act 2005 and how to obtain consent from people. Staff we spoke with understood they needed to respect people’s choices and decisions if they had the capacity to do so.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes DoLS are in place to protect people where they do not have capacity to make decisions and where it is deemed necessary to restrict their freedom in some way, to protect themselves or others. The service had systems in place to follow the requirements of DoLS.

The service had a positive culture. There was an open and transparent culture where people were encouraged to have their say and staff were supported to improve their practice. We found the home had a clear management structure in place with a team of care staff who were supported by the registered manager. There was a system in place to monitor and improve the quality of the service which included feedback from people who used the service, staff meetings and a programme of audits and checks.

People told us they felt free to raise issues with the staff or management and were confident they would be addressed. The home had a complaints policy in place and there were procedures for receiving, handling and responding to comments and complaints.

We found the premises were clean and tidy. The home had an Infection control policy and measures were in place for infection control. There was a record of essential safety inspections and maintenance carried out.

Inspection carried out on 19 June 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to gather evidence to answer five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

During this inspection we spoke with two people who used the service and one relative of a person who used the service. We also spoke with five members of staff who included the registered manager, senior manager, who was responsible for overseeing the registered manager and care staff.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Two people who used the service told us that they felt safe in the home and that staff treated people with respect and dignity. One person said, “Staff are marvellous. They are very polite and respectful”. People who used the service told us that they felt safe living in the home.

The home had a safeguarding policy which included guidelines on how staff should respond and act if they suspected abuse was taking place.

We looked at the training records for four members of staff and noted that the records indicated that they had received in-house safeguarding training. When we discussed safeguarding with staff, the majority of staff were aware of the signs of abuse. All staff we spoke with were aware of the action to take when responding to allegations or incidents of abuse and were also aware that they could report allegations to the local authority, the Care Quality Commission (CQC) and the police.

We saw evidence that necessary employment checks had been carried out to ensure that people were cared for by suitably qualified, skilled and experienced staff.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. There was evidence that staff had received appropriate supervision and appraisals which enabled them to perform their work appropriately and ensure people using the service were safe and protected.

We saw that people were able to move around the home freely. We also noted that people living in the home were not subject to continuous supervision and control by staff.

Is the service effective?

People we spoke with said that they were satisfied with the care provided in the home and felt that people's needs had been met. One person said, "Staff listen to me. I like it here”. People were positive about staff and said that they were helpful and listened to them.

We looked at three care files and saw that people's care needs had been assessed and care and treatment were planned and delivered in line with their individual care plan. Risk assessments had been carried out where necessary and there was evidence that these were reviewed. Care plans included information about people's preferred routines and healthcare needs.

All the staff we spoke with told us that they were well supported by the registered manager and felt able to ask the registered manager questions. One member of staff said, “I am very well supported. The staff are friendly and helpful”.

Staff had received appropriate training in various areas to meet the needs of the people living in the home.

Staff, family members, healthcare and social care professionals were involved in decisions about people's care and we saw evidence of this. Relatives of people who used the service told us that they were kept informed about people's progress.

Is the service caring?

People told us that they had been treated with respect and dignity in the home.

During our inspection, we found that people who used the service approached staff without hesitation and people appeared comfortable around members of staff. There was good interaction between staff and people who used the service. People looked well cared for and we saw that the atmosphere in the home was relaxed.

Staff we spoke with said that they were aware that all people should be treated with respect and dignity and were able to give us examples to demonstrate how they ensured this.

Is the service responsive?

People who used the service and a relative we spoke with told us that if they had any concerns or complaints, they would feel comfortable raising them with staff or the management at the home.

We saw that the home had a complaints policy and procedure and we noted that the home had not received any complaints since our last inspection.

People's care and health progress were monitored closely. People's care plans and their health needs were regularly reviewed.

The senior manager confirmed that they completed regular audits which included audits of health and safety, care plans and staff files and we saw evidence of this.

Is the service well-led?

We found that adequate arrangements were in place for monitoring and reviewing the quality of the service provided to people.

At the time of our inspection, the provider did not have a quality assurance policy. Following our inspection, the provider sent us evidence of their quality assurance policy and procedure.

Resident's meetings were held monthly which enabled people to discuss issues regarding the running of the home. This encouraged people to raise queries and concerns with management and members of staff.

Staff meetings were held every two months and we saw evidence to confirm this.

All staff we spoke with told us that they felt able to consult the registered manager if they had concerns or queries and said that they felt supported. Staff were positive about working at the home.

Inspection carried out on 26 September 2013

During a routine inspection

People we spoke with were positive about the home and comments included "the staff have spent so much time reassuring me which is helping my condition a lot." We looked at two people's records and around the home. We saw that care was planned and delivered to ensure people's safety and people were supported to have regular health checks of their physical and mental health.

Systems were in place to ensure people were able and supported to take their own medications safely. We saw that people's rooms and all communal areas were well maintained. People were asked for their views about the home, these were listened to and action taken where the service needed to make improvements.

Inspection carried out on 8 March 2013

During a routine inspection

The registered manager was on leave on the day of the inspection and we spoke with the covering senior manager. We spoke with three people who used the service. One person told us they "never felt so healthy and happy." Most of the people we spoke with felt that they were given regular opportunities to discuss their care and were asked to give their consent for all aspects of the care provided. Care planning processes included consideration of people’s capacity to make decisions. We found that care plans and assessments of risks to people who use the service were regularly reviewed.

The provider had systems in place to protect people from the risk of abuse. We found that staffing levels were sufficient for the needs of people who use the service. The provider had an effective system in place to acknowledge concerns and complaints and dealt with them promptly.

Inspection carried out on 3 November 2011

During a routine inspection

People using the service told us about the opportunities they had to make choices. Some people told us they had specified days when they cooked their own meals.

We saw that people’s rooms had been personalised and many had bought their own televisions, pictures and personal items. The provider confirmed that people’s bedrooms were going to be redecorated according to peoples’ individual tastes.

We asked people who use services about the care provided. People told us that they received the support they needed and that their care plan had been agreed and discussed with them.

People who used the service told us that they felt safe in the home. People said they knew who to speak to if they had concerns. A number of people said they would speak with the manager if they did have concerns.

We asked people their views on the staff supporting them. People said the staff could meet their needs. One person said, ‘the staff are good and very supportive’. Another said, ‘staff are kind’.

We asked people using the service whether they were satisfied with the service provided. People said they were happy at the home. One person said it was the longest they had lived in one place. They were satisfied with the choice and quality of the food provided saying, ‘you can help yourself’.

Reports under our old system of regulation (including those from before CQC was created)