Archived: Roclyns Rest Home

We found the following examples of good practice.

People were supported to have visits from their friends and family in various ways throughout the pandemic. When face to face visits had not been possible, people had window/door visits and visits in the garden. The garden was able to be accessed through a separate entrance and the registered manager had bought new garden furniture to support these visits. People receiving end of life support were able to have visitors throughout the pandemic. People also used phone and video calls to keep in touch with their loved ones. Staff provided people and their relatives with a monthly newsletter to keep them informed of what’s happening at the home.

The home was clean and hygienic. The registered manager had bought new dining room chairs and armchairs. The armchair covers could be removed, and machine washed. Personal protective equipment (PPE) stations had been placed throughout the home for staff to access easily.

Communal areas of the home were spacious and there were different areas on the ground floor where people could relax in small groups. People were supported to go out safely and were encouraged to wear a mask and wash their hands when they returned to the home. The layout of the home meant that in the event of an outbreak, people could be supported to safely isolate in small zones around their bedrooms.

Staff had formed strong links with the local community during the pandemic. People and staff had received chocolate donations, free pizzas and a chocolate fountain from various local businesses. The local school had sent people pen pal letters, postcards and cards. When shopping had been difficult, staff had involved people in the buying and sorting of bulk items. This included people’s favourite sweets and toiletries.

Staff had tried hard to keep people’s spirits up during the various lock downs. This included making sure special events such as Birthdays were celebrated by everyone in the home and people’s relatives where possible. Staff had held around the world tasting sessions where people could sample foods from different countries. The registered manager had also arranged for a Shetland pony to be brought into the home to meet people.

The management team supported staff throughout the pandemic. The registered manager had provided staff with an employee assistance programme that focused on health and wellbeing. Staff could access this for support with mental and physical wellbeing and staff could be referred for counselling and talking therapies through this. Staff had also been given small tokens of appreciation throughout the pandemic and the management team had an open-door policy so staff could come and speak to them any time about any worries.

Roclyns Rest Home provides support and accommodation for up to 19 people who require assistance due to frailty of old age and health care needs. There were 17 people living at the home at the time of the inspection; some were living with dementia and others needed support with daily living including washing, dressing and mobilising safely. The home has two communal lounges and a dining area, the bedrooms are on the ground and first floor and a passenger lift enables people to access all parts of the home. There is a large garden to the rear that is accessible to people using walking aids and wheelchairs.

People’s experience of using this service and what we found:

Whilst the registered manager was experienced and was focused on continuously learning and making improvements to the home, some audit processes were not sufficiently robust and had not identified inconsistencies in some documentation and practice which were identified during the inspection. While we found no significant impact on people, this is an area that required improvement to ensure effective monitoring and quality assurance. The registered manager was responsive and took action immediately in response to our feedback.

The registered manager had created an open and positive culture and staff knew people well. Staff felt well supported and the home had a warm and welcoming atmosphere. One member of staff said, “The managers are very approachable, if they're not having a meeting, you'd think they were one of the carers. If something needs doing, they do it. They get their hands dirty.”

People told us they felt safe and knew who to contact if they had any concerns. People remained protected from avoidable harm. There was a safeguarding policy and staff received training. Staff knew how to recognise the potential signs of abuse and knew what action to take to keep people safe.

There was enough staff to support people safely and the registered manager had safe recruitment procedures and processes in place. People received care and support from trained staff who knew them well. People received their medicines safely from staff who were trained and competent to do so.

Risks to people were assessed to keep them safe. This included potential risks related to their health, or risks from the environment. The environment continued to meet people's needs. The home had sufficient room for people to move around safely and the provider had ensured the environment met the needs of people living with dementia. The provider was investing to improve the facilities and environment to ensure the service continued to meet people’s needs as these changed over time.

People were protected by the prevention and control of infection. Staff wore gloves and aprons when supporting people.

People were supported to maintain their health and had assistance to access health care services when they needed to. People had access to services such the GP, speech and language therapists (SALT), chiropodists, opticians, dentists and others. 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.

People continued to have access to activities and people were happy with the variety on offer. People received compassionate and dignified end of life care that respected their wishes. People were proactively supported to maintain relationships with people who were important to them.

Staff knew people well and were able to deliver personalised care that was responsive to their needs. People were able to express their views and were actively involved in making decisions about their care, support and treatment, through reviews and daily interactions. One person said,” They are getting to know me well…. It’s totally up to me.” People received kind and compassionate care. People and relatives told us staff treated them with kindness and we observed warm friendly interactions throughout the inspection.

People were supported to eat and drink a healthy balanced diet to meet their individual needs and preferences. One person said, “The food is fantastic, no complaints about that.”

Systems and processes were in place to record and identify errors and improvements were made when things went wrong. People and relatives knew how to make a complaint and told us that they would be comfortable to do so if necessary. One person said, “I don't feel the need to complain but I'd speak to the boss, she's on it.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection:

The last rating for this service was Good (report published 30 June 2017)

Why we inspected:

This was a planned comprehensive inspection scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection took place on the 16 May 2017 and was unannounced.

The registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (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.

The registered manager used an effective quality assurance system that had reviewed all aspects of the services provided, including care plans and health and safety. They said this had enabled them to identify areas where improvements were needed. Staff told us a number of changes had been made since April 2016 when the provider had registered with CQC and they said the management encouraged people, relatives and staff to be involved in decisions about developing the services provided.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The management and staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and were aware of current guidance to ensure people were protected. People had been supported through best interests meetings and referrals for DoLS had been made to the local authority to ensure people were safe.

People said the staff were very good and provided the support they wanted and needed. Staff encouraged people to be independent and make choices and individualised risk assessments provided guidance for staff to assist people to ensure their safety.

Relevant training was provided to ensure staff understood how to meet people’s needs and they were supported to develop their skills and work towards vocational qualifications.

There was an effective system in place for the management of medicines and people had access to health professionals as and when they were required.

People said the food was very good, choices were provided and the menu was based on people’s individual likes and dislikes. Group and one to one activities were available for people to participate in if they wished and people chose how and where they spent their time.

People, relatives and staff said the management was approachable and the registered manager had an open door policy to encourage them to be involved in developing the services. Satisfaction surveys were used to obtain feedback from people, relatives, staff and health professionals about the services provided.

A complaints procedure was in place. This was displayed on the notice board near the entrance to the building, and given to people, and relatives, when they moved into the home. People, relatives and staff said they did not have anything to complain about.