The Rowans Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

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

This meant people’s needs were met through good organisation and delivery. Good quality person-centred care was delivered by well trained staff.

This service scored 75 (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 always made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Care plans showed a high level of person-centred detail, showing staff had worked with people and their families to ensure their wishes and feelings were recorded. People and those important to them were actively involved with decisions about the care and support which they received. The service ensured people were at the centre of their care and treatment choices. Any changes in people’s needs were responded to and reflected in relevant electronic systems.

Care plans we reviewed were very person-centred and written in corroboration with the person and others who were important to the person. One person’s care plan stated how they loved to dance and sing, using equipment to support them whilst dancing; they also enjoyed arts and crafts and being in the company of others. The individual looked forward to the activities co-ordinators had planned in advance. Care plans outlined people’s enjoyment of activities and went into detail how staff might get the best responses from individuals.

Staff had spent time with people and their relatives to gain real insight; care plans we viewed plus speaking with staff demonstrated this. People were encouraged to have goals and aspirations for the future, and staff worked hard to help people achieve these.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Assessments were undertaken before people moved into the service and individuals’ needs were fully reviewed to ensure suitability within the service. Good links were made with other care providers to facilitate a smooth transition from one service to the other.

Ongoing risk and care plan reviews were undertaken to manage complex needs, and we saw examples of when people had been moved from one household to another, to better meet their needs.

We saw records of people having input from other services; for example, speech and language therapy records were present and clear, there was input from a physiotherapy team and a weekly GP ward round. During our visits, we noted a local authority staff member who had attended the home to complete a Deprivation of Liberty Safeguards assessment; no concerns were raised regarding the home.

The local authority spoke positively regarding the care provision and shared examples of how the Rowans had made positive impacts on people. Admissions were planned gradually to manage the process of onboarding both people and staff to minimise any risk to people.

The home regularly interacted with relatives, took on board feedback and implemented changes when required. They also interacted with the local community; we had examples of the local school being involved in the naming of the households, local church interaction within the home and planned activities.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service ensured support plans and records captured ways that met people’s requirements for meaningful communication and decision-making. This enabled people to be active participants in their care if this was their wish. The service was compliant in meeting the Accessible Information Standard, (AIS).

A representative from the Blind Society had been engaged to help guide staff better support a person with poor periphery vision. Staff were aware to chat to the person, describe what they were doing and what was going on around them. Things like glasses and baby wipes were put in front of the person so they were readily accessible. They were trialling a talking book for the blind; the person could choose the genre of audio books they preferred to listen to.

Person centred care plans detailed people’s individual communication needs, such as language, aids such as glasses or hearing aids, and any additional resources that staff might use to help with communication, for example pictures, flash cards or technology. The service produced literature for people in different font sizes, easy read documents or audio versions to assist in sharing information with people.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

There was a policy and procedure in place that set out the steps someone would need to take if they had a complaint, and information on how to complain was contained within a service user guide. The manager explained these were also provided in easy-to-read formats that explained the process people could take if they wanted to raise an informal concern or to make a formal complaint.

People were able to raise concerns or complain and then be listened to. For people who could not verbally communicate or understand written documents, we found there were appropriate advocates involved in people’s lives. Residents’ meetings were held regularly to support people to be actively involved in shaping the service.

Relatives we spoke with told us they knew how to raise concerns or make a complaint and felt confident to do so. They told us they would talk with staff or the manager if they had any complaints. They were aware of relative meetings they could attend. One relative told us, “There are meetings for relatives once a month. They keep us informed about new initiatives being introduced in the home. It is a time when people can raise concerns if they have any.”

The provider regarded any feedback, including complaints, as an opportunity to develop and improve the service. As part of the auditing process concerns and complaints were reviewed and analysed to ensure lessons could be learnt and improvements made where needed.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People had nothing negative to say and felt they were treated fairly.

Bathrooms were fitted with equipment to help support people with physical needs, such as handrails and bath hoists. People had the option to use auditory monitoring, where staff would receive an alert on handheld devices should somebody verbally request help. Handrails were along the length of all the corridors in the home.

We saw arrangements made for people with capacity who wanted to keep room doors open but did not want people to enter their space. This was managed by a gate across the door to provide that assurance.

Out-of-hours interactions were generally emergency actions; staff told us about the use of 111 or 999, depending on the emergency level. The Reactive Emergency Assessment Community Team (REACT) could also be contacted by staff. This local team of skilled professionals was set up to help reduce admissions into hospital. Staff told us they would challenge any decisions made by other health professionals if they felt they were unfair or not reflective of the person's needs.

People's care records demonstrated that where people required the support and intervention of external health care professionals, this was provided. This demonstrated that people had access to the care they needed.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Relatives told us their family members had access to health care when needed and did not experience inequalities. There were multi-disciplinary records in place and regular reviews of people’s care plans and risk assessments to ensure they were a true reflection of people’s current and changing needs.

The service continued to engage well in the safeguarding process, raising safeguarding alerts in line with the local framework,and working well with local safeguarding professionals. Any lessons learnt throughout this process were identified and shared with all stakeholders to evidence positive outcomes for people.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

As the home had dual registration people received high quality clinical care from qualified nurses. People had choices around remaining in the service if this was their wish, without the potential need for a distressing move. People had the opportunity to express their wishes around advanced care. People’s advanced decisions and what mattered to them at the end of life was recorded within electronic care plans.

The service worked well with external health and social care teams to ensure any palliative care preferences and wishes were implemented and fully respected. The staff team had received training in dying and bereavement and understood the importance of people’s needs being met. Staff we spoke with showed empathy and understanding of caring for people at the end of their lives.