The Rowans Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated good.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

This service scored 83 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The management team ensured they fully involved people, and their relatives where appropriate or desired, in care planning and reviews.

Care plans were personalised, and detailed people’s health needs, backgrounds and those important to them. Care plans were kept up to date by monthly review, or more regularly if warranted, so they remained reliable for staff to follow. Staff told us care plans helped them to deliver good and appropriate care for people.

Where people lived with a risk of falls, we saw robust risk assessments in place. These detailed assessments considered other factors that might contribute to the falls risk, for example the impact of medicines, hydration levels, infection risks and a person’s balance and gait. Staff understood the importance of encouraging mobility, whilst considering these risks.

People and their relatives told us they were fully involved in planning their care and support needs. They said they were given choices as to how their care and support was provided. People's records reflected their preferences and choices for how and when they received support, considering any specific needs or wishes. Staff understood people's communication needs and how these could be met to best engage with people.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The provider acknowledged their accountability for the delivery of care and, following an assessment of needs, people were offered evidence-based care and treatment that aligned with the latest legislation and standards. We were assured that the care and support delivered by staff reflected the latest good practice and evidence-based research; people were cared for in a consistently evidence-based way.

Where people could not, or struggled to, express pain due to a diagnosis of dementia or other health conditions, the home used an assistive technology application called PainChek. The PainChek application uses the camera of a smart device to see and assess a person's face, analysing it using an Artificial Intelligence (AI) system. The AI system then automatically recognises and documents facial muscle movements that are indicative of pain, scoring this within a range from 1 to 10. Pain relief was offered to the person based on a pain score in excess of 8, providing pain relief had not been offered in the 4-hour window prior to this. The use of Painchek had a positive impact on people as it meant they received timely and effective pain management, contributing in a reduction of symptoms such as depression, anxiety, stress or agitation.

The provider served decaffeinated tea and coffee to people as standard, unless people’s preference was for caffeinated drinks. Caffeine is a stimulant, an irritant and mild diuretic, meaning that it can result in increased frequency and urgency of urination. The provider was aware of several evidence-based studies that had made a correlation between serving decaffeinated drinks to people and a reduction in falls. The provider recognised that the transition to serving decaffeinated drinks was a simple yet effective way to reduce the risk of falls, especially among those individuals who were at a higher risk due to age, frailty or medical conditions. The provider was also aware of other health benefits connected with a reduced caffeine intake, such as improved sleep patterns, better balance and co-ordination; all positive factors that can further reduce the risk of people falling.

People had individualised care plans that had been created with the person and significant others. Care plans had been created following the identification of any new risks, along with corresponding risk assessments; these were tailored to each person. Risk assessments were completed when a person moved into the household, after any changes in need or following any accidents or incidents. Routine updates were both monthly and when the person was the focus for the day.

The provider worked extremely well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Partnerships with external stakeholders were extremely positive and this was reflected in feedback we received. A visiting health professional sent positive feedback about how the service worked effectively with their team and said, “The staff have always engaged professionally and collaboratively. The staff are responsive to concern and communicate appropriately with regards to the resident's care.” The management team worked extremely well with people, healthcare partners and stakeholders in understanding the best way of keeping people safe, whilst not restricting people in how they lived their lives.

The service strived to ensure people had a seamless admission to their new home. At the time of this assessment there were 51 people living at the home; admissions had not been rushed since the home had first opened in late 2023. Before the assessment process began the provider checked any new people being referred to the service were compatible with people already living there; they ensured the staff skill mix was appropriate to meet both new and existing needs. Soon after our on-site assessment one person successfully moved from a home in another borough to The Rowans. Visits by family and friends had been limited due to distance whilst in the other home. Positive feedback sent to the home from professionals who had initiated the move was shared with us, which stated, “Thanks to you and everyone from different teams for all the support towards [their] move. [Person’s name] can now have more visits from family and loved ones because [they] now live in Wigan Borough within reach for them. I really appreciate the support from everyone.” The partnership working in facilitating the move led to extremely positive outcomes for the person; close relatives were now able to visit more regularly and this made the person very happy.

If people required assessment from an external health or social care team, we saw the service had made prompt referrals and followed up on required actions. Staff told us they had extremely good relationships with external bodies such as GP’s and community service providers. The care home had a weekly ward round from a General Practitioner (GP) and staff had access to the Community React Team (CRT) within normal working hours. This responsive service deals with rapid issues requiring response within two hours. The team comprises of different services whose aim is to reduce hospital admissions, ensuring patients are cared for at their place of residence.

Staff respected their colleagues and were keen to share knowledge and good practice for the benefit of people living in the home. Staff had access to champion ‘buddies’ such as skin integrity guardians, hydration and nutrition ninjas and moving and handling specialists. These ‘champions’ were available to guide and mentor staff in their area of expertise to ensure people received person-centred care tailored for them.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The staff used handheld devices to record the care and support people received throughout the day. Food and fluid records showed how much was offered and what people had taken. There were highlights for those requiring additional support or those with special nutritional requirements. These documents were reviewed to identify weight loss or gain, and action taken where needed. Weight loss was reported in meetings at home level with senior staff and in governance meetings with senior leadership team members.

People had clear communication plans in place, detailing any reasonable adjustments required from staff, for example to pronounce words, talk more slowly and not rush the person for a response. Guidance ensured staff understood the individual needs of each person. Staff recognised changes in people’s presentation which might indicate a deterioration in health or wellbeing; advice was sought and appropriate action taken.

Positive comments were received about the food on offer; kitchen staff were fully aware of people’s dietary needs and meal preferences, all of which were regularly updated in communications to the catering staff. Mealtimes were a positive experience; people were supported in a calm environment, and we observed staff to be patient and reassuring when assisting people with their meals.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. Staff took part in daily management meetings where any changes in people's health and wellbeing were discussed, recorded and actioned. Relatives confirmed that staff identified and responded promptly to changes in their family members health. Regular care plan reviews enabled the management team to have full oversight of the health and social care needs of all people. People and their relatives were involved as partners in their care, and this was supported by the comments we received.

The provider had a proven track record of people achieving positive outcomes. Feedback from commissioners included numerous success stories; they outlined how people’s quality of life had improved vastly after moving into The Rowans. There was evidence of the service nurturing people, allowing them to grow and follow their hopes and desires. There were examples of people benefitting from improved sleep patterns, building trusting relationships, having reduced medications and joining in activities.

Commissioners shared how the home had advocated passionately for a person whose placement had been under scrutiny due to their behaviour and risks posed to others. Staff at the home explored ways of better managing these. Instead of implementing further restrictions that might have negatively impacted the individual they worked closely with mental health professionals and medical partners. The person was now settled in the home, engaging in the community and enjoying social interactions both inside and outside the home.

Feedback we received from a professional also demonstrated the lengths staff had gone to and included, “I felt that The Rowans really came together for the greater good of this person to do all they could to support them to remain at The Rowans, as per their wishes and feelings.”

We spoke with 3 relatives who described how placements in other care settings had resulted in a breakdown of care; since moving into The Rowans their family members had experienced more positive outcomes and were well managed. The service was proactive in seeking the opinions of people and their relatives at regular intervals, both formally and informally with surveys, meetings and the manager’s open-door policy.

The management team had ensured they were working within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.

We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty; CQC had been made aware of these via statutory notifications.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We saw decisions were in place to ensure all people’s rights were upheld. People's decisions were respected and actioned. One person had requested a stairgate be fitted to their bedroom door and we saw this had been done. When people lacked capacity best interest decisions involved appropriate parties and were documented within care records.