• Care Home
  • Care home

Archived: Roman Wharf Nursing Home

Overall: Good read more about inspection ratings

1 Roman Wharf, Lincoln, Lincolnshire, LN1 1SN (01522) 524808

Provided and run by:
Roman Wharf Limited

All Inspections

28 March 2017

During a routine inspection

We inspected Roman Wharf Nursing Home on 28 March 2017. The inspection was unannounced.

Roman Wharf Nursing Home provides accommodation for up to 24 people who need personal or nursing care. There were 22 people living in the home at the time of our inspection, most of whom required nursing care.

The registered provider’s area manager was acting as the home manager and had applied to be registered with the Care Quality Commission (CQC). Throughout this report we refer to this person as ‘the manager’. A registered manager is a person who has registered with the CQC 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.

At our comprehensive inspection on 26 and 28 November 2015 there were breaches of legal requirements related to staffing levels, the management of risk to people’s health, safety and welfare, nutrition and hydration arrangements and the monitoring the quality of the services provided. At our focused inspection on 8 June 2016 we found that the registered provider had taken appropriate actions to ensure they met the legal requirements. At this inspection we found they had maintained the improvements they had made.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered

necessary to restrict their freedom in some way, usually to protect themselves.

In most cases the manager and staff were following the guidelines of the MCA and DoLS. However we noted that a small number of best interests decisions had not been recorded in the right way. In addition, we found that recent quality assurance checks had not identified these shortfalls. We also found that a small number of healthcare records were not up to date and again recent quality assurance checks had failed to identify this.

Other quality checks had been carried out regularly and had clearly recorded any shortfalls. They had also recorded the action taken to address any shortfalls identified.

Staff knew how to keep people safe. The registered provider had systems and policies in place to help people stay safe from the risk of abuse. Risk assessments were carried out and regularly reviewed in order to avoid preventable accidents.

Medicines were managed in a safe way. There were enough staff on duty to provide the assistance and care that people needed. Appropriate checks had been completed before new care staff had been appointed.

People were supported in the right way. They had enough to eat and drink and could access appropriate healthcare professionals when they had need. They had choice and control over the way they lived their lives and they were treated with respect and dignity.

People were encouraged to pursue their hobbies and interests and there were a range of social activities available for people. The manager agreed to act upon comments we received about access to the community and the amount of social activity available for people at busy times of the day.

People had opportunities to say how they would like the home to develop and were encouraged to say how they would like the home to be run.

People felt confident to raise any concerns they had and there was a system for resolving complaints in a timely and fair way. Staff were also supported to speak out if they had any concerns.

8 June 2016

During an inspection looking at part of the service

We previously carried out an unannounced comprehensive inspection of this service on 26 and 28 November 2015. During the inspection we found that the registered persons were not meeting the standards we expected and there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the systems in place with regard to staffing levels, the management of risk to people’s health, safety and welfare, nutrition and hydration arrangements and quality were not effective. After the inspection the registered persons wrote to us to say what they would do to meet the legal requirements in relation to the breaches.

We undertook this focused inspection on 8 June 2016 in order to check whether the registered persons had followed their plan and to confirm that they now met the legal requirements. At this inspection we found that the registered persons had made improvements in all of the areas we had identified and in line with their plan.

This report 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 Roman Wharf Nursing Home on our website www.cqc.org.uk .

Roman Wharf Nursing Home provides accommodation for up to 24 people who need personal or nursing care. There were 23 people living in the home at the time of our inspection. All of them were older people and most of them were receiving nursing care.

There were arrangements in place to ensure risks to people’s health and safety were identified and managed appropriately. People were assisted to avoid the risks of skin damage and those associated with poor moving and handling practices.

People were supported to have enough to eat and drink in order to promote good health and improvements in recording systems assisted staff to monitor people’s nutrition and hydration more accurately. However, improvements were still needed to the way in which food options and their availability were promoted.

The registered persons had employed enough staff and deployed them appropriately to ensure people’s care needs could be consistently met. Systems were in place to regularly monitor staffing levels within the home so as to ensure they remained appropriate to people's needs.

The registered persons had systems in place to identify shortfalls in the quality of services provided and plan for continuous improvement within the home.

26 and 28 November 2015

During a routine inspection

This was an unannounced inspection carried out on 26 and 28 November 2015. It was our first comprehensive inspection since the service was registered on 1 September 2014.

Roman Wharf Nursing Home provides accommodation for up to 24 people who need personal or nursing care. There were 23 people living in the service at the time of our inspection. All of them were older people and most of them were receiving nursing care.

There was 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.

At this inspection we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There were not enough staff on duty to enable people to promptly receive all of the care they needed. People were not always helped to avoid accidents and stay safe. The arrangements to support people to eat and drink enough were not robust. Quality checks had been completed in a rigorous way and this had resulted in a number of shortfalls not being quickly identified and resolved. These breaches had increased the risk that people would not always safely and responsively receive all of the care they needed. You can see what action we told the registered persons to take in relation to each of these breaches of the regulations at the end of the full version of this report.

Staff knew how to report any concerns so that people were kept safe from abuse. However, the registered persons had not informed us about an incident when someone had been at risk of harm. This had reduced our ability to ensure that suitable arrangements were in place to safeguard the person’s wellbeing. In addition, people had not been fully supported to stay safe by avoiding the risk of unsafe use of medicines. Background checks on new staff had been completed.

Staff had not received all of the support they needed and did not have all of the skills that were necessary for them to reliably assist people in the right way. This included caring for people so that they had enough nutrition and hydration. However, staff recognised when people were unwell and had arranged for them to receive the necessary healthcare services.

The registered persons had not consistently helped to ensure that people’s rights were respected by ensuring that decisions were taken in their best interests. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards are designed to protect people where they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had not taken all of the necessary steps to ensure that people’s rights were being protected.

People were treated with kindness and compassion. Staff recognised people’s right to privacy and they respected confidential information.

People who had special communication needs and who could become distressed had not always been offered the person-centred and responsive support they needed. We recommend that the registered persons explore the relevant guidance on how to enable staff to effectively support people who live with dementia and who can become distressed.

Although people had been consulted about the practical assistance they received, they had not been fully supported to pursue their hobbies and interests. However, people had been helped to meet their spiritual needs and there was a system for resolving complaints.

People had not been fully involved in the development of the service and they had not benefited from staff acting upon good practice guidance. However, steps had been taken to promote good team work and staff had been encouraged to speak out if they had any concerns.