Archived: Rochell House

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found.

Is the service safe?

We spoke with five people to find out their opinions of Rochell House. All spoke positively about the home.

People told us that they had all the equipment they needed. We found that equipment had been maintained and serviced regularly.

People told us that they were happy living at Rochell House. Safeguarding adults' policies and procedures were in place. We found however, that these procedures were not always followed since the appropriate authorities were sometimes not informed when safeguarding incidents occurred. We considered that people were not fully protected from the risk of abuse because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The manager informed us that no applications had needed to be submitted. One person however, had made repeated requests to leave the home. It was not clear whether this person was being lawfully deprived of his liberty. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

We found that records were not always accurate or fit for purpose. In addition, certain records could not always be located promptly. We have issued a warning notice in relation to the maintenance of records and have told the registered manager that she needs to take action.

Is the service effective?

We found that the process for obtaining people's consent and ensuring that they were able to give their informed consent was not always clear. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

People told us that they were happy with the staff and the care provided. We found however, that care plans and risk assessments had not been formulated for some of people's care needs. One person who was unable to communicate verbally did not have a care plan in place to instruct staff on what communication methods should be used.

We read that another person had made threats to harm himself and on several occasions, another person who lived there. We noted that a care plan and risk assessment was not in place to document the actions staff should take when he voiced these threats. In addition, there was no evidence that the appropriate health and social care professionals had been contacted for advice following some of these incidents.

A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service caring?

We observed that care workers showed patience and gave encouragement when supporting people.

We considered that care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service responsive?

One person who shared a bedroom had requested to have his own bedroom. However, it was not clear what actions were being taken to accommodate his wishes.

A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service well-led?

The manager had been in post for 18 months. She informed us that her working background was older people and not those with learning disabilities. She explained however, that she was learning all the time.

We noticed that the manager carried out regular audits to monitor the quality of the service. However, these checks were not always effective in identifying concerns or issues.

The manager carried out an analysis of accidents and incidents. However, not all accidents and incidents were recorded and therefore the analysis was inaccurate. We considered that learning from incidents did not fully take place and appropriate changes were not always implemented.

Our findings of non-compliance for four other regulations inspected, indicated that the quality auditing of the service was not sufficient to protect the health, safety and welfare of the people who used it.

A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

We found that people's care needs were assessed and their care and treatment was planned. Where necessary external healthcare professionals had been consulted about people's care.

People received care which reduced the risk of poor nutrition and dehydration.

We looked at how the home managed medicines and found there were appropriate arrangements in place for the safe administration, recording, obtaining, handling, storage and disposal of medicines.

We found the provider had a structured staff selection and recruitment policy in place which aimed to ensure staff were suitably skilled, experienced and qualified to deliver care safely.

We saw the provider had a complaints policy and procedure in place and people told us they were confident the manager would deal with any complaints they raised.

People told us staff explained their care and treatment to them. They said staff gave them enough time to consider their options, and respected their decisions. One person told us, "They help me to choose." We viewed documentary evidence which confirmed this.

The manager and staff were aware of the importance of helping people to make informed decisions, and of the importance of obtaining people's consent to care and treatment.

People were happy with the care given to them. One person said, "I love living here" and another person told us, "It's great."

Although care records were not always regularly reviewed, we found that staff were aware of people's up to date care requirements. Care was delivered in a manner which took people's care needs into account and maintained and promoted their wellbeing.

Overall, 12 staff were employed at the service. Most of them had worked there for over two years which meant they had the experience to carry out their role effectively.

Staff told us they had enough time to carry out their duties properly, and we found that sufficient numbers of staff were on duty at any one time given the level of independence people had. This meant the health, safety and welfare of people using the service had been taken into account by the provider when deciding on staffing levels.