We carried out a review of the data available to us about Keychange Charity Romans Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Keychange Charity Romans Care Home, you can give feedback on this service.
We found the following examples of good practice.
The home had been impacted by an outbreak of Covid-19 early in 2021. The home had introduced and maintained effective systems and processes to prevent the spread of infection. For example, any new admissions to the home were assessed to include any risks posed by Covid-19. People had to isolate in their rooms for 14 days following admission.
Following the outbreak, the home was now clear of Covid-19 and open to visitors from 8 March 2021. Any visitors were subject to checks at the front door before being allowed in. Visitors were required to undertake a lateral flow device (LFD) test; if the result was negative, they were allowed into the home and directed to a separate room adjacent to the front door. A ‘pod’ in the garden, made of clear plastic, enabled people to meet their relatives safely and at a social distance. The visiting room and pod were cleaned after each visit. Masks and hand-gel were supplied to visitors. The provider had an admissions policy which was followed by staff.
Staff were tested weekly for Covid-19 through polymerase chain reaction (PCR) tests and at the start of their shift using LFD tests. Some staff and people were exempt from testing having contracted Covid-19 previously.
Risk assessments had been completed for people and staff. For example, one person made a weekly visit to their relatives’ home, and measures had been taken for these visits to be undertaken safely.
Effective infection prevention and control systems had been implemented. Staff had completed training in infection prevention and control. Personal protective equipment (PPE) was provided and staff knew how and when to use this in line with government guidance. There were PPE stations located around the home, so staff could easily access masks, gloves, aprons and hand-sanitiser. Spot checks had been completed and demonstrated that staff employed hygienic hand-washing practices.
Observations made around the home evidenced that laundry, including soiled washing, was managed safely. Kitchen staff did not have direct contact with care or housekeeping staff. When people were in isolation, their food was delivered on different coloured trays from those people not having to isolate. The red or brown trays in use were handled separately to prevent the risk of spread of infection. The home was seen to be clean and hygienic, with ‘high touch’ areas being cleaned regularly. Regular cleaning schedules, including deep cleaning, had been implemented.
Staff were encouraged to take their breaks separately and anyone who smoked went outside to a designated area.
The registered manager felt supported by the provider and by local health professionals, such as the GP who offered counselling to staff.
Keychange Charity Romans Care Home is registered to provide accommodation and care for up to 30 older people with a variety of health and support needs, including some people living with dementia. At the time of our inspection 23 people were living at the home, including one person who was staying for a short break. Keychange Charity Romans Care Home is a large detached house close to amenities in Southwick. Communal areas include a main lounge, dining room and large conservatory adjacent to the dining room. A secure, fenced garden is located at the rear of the premises. Accommodation is provided for people over three floors, with lift access.
At the time of our inspection, the registered manager had left the service and had applied to de-register with the Care Quality Commission; plans to recruit a new manager had not yet been put in place. 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. The day-to-day management of the service was being undertaken by two deputy managers.
Robust systems were not in place to monitor and measure the quality of the service overall at the home. Some monthly checks had been completed, but there was no audit in place for the management of medicines.
Staff had a good understanding of the Mental Capacity Act 2005 and associated legislation. However, one person, who had bedrails, did not have the necessary consent or best interests decision in place. This was discussed with management who stated appropriate steps would be taken to rectify this.
Relatives and people spoke highly of the care they received and written comments were positive. People felt they were involved in developing the service through residents’ meetings and formal monthly surveys about different aspects of the home. Staff felt supported.
People felt safe living at the home. Staff had been trained to recognise the signs of potential abuse and knew what action to take if they had any concerns. Risks to people were identified, assessed and managed safely with appropriate guidance for staff. Staffing levels were sufficient to meet people’s needs, although comments from people were mixed. Some people felt there were enough staff and others said there could be a shortage, especially at busy times of the day. Safe recruitment practices were in place. Medicines were managed safely.
Staff had been trained in a range of areas, received regular supervisions and attended staff meetings. People felt that staff were well trained and approachable. Training was delivered to staff in an electronic format. New staff followed the Care Certificate, a universally recognised qualification. People had sufficient to eat and drink and were offered a range of choices in their meals. Drinks were readily available throughout the day and night. People had access to a range of healthcare services and were supported by healthcare professionals.
People were looked after by kind and caring staff who knew them well. People spoke positively about the caring nature of staff and that staff responded promptly to their needs. People’s spiritual needs were catered for. People were encouraged to express their views and to be involved in all aspects of their care. They were treated with dignity and respect.
Care plans provided information about people and guidance for staff on how they wished to be cared for. Care plans were in the process of transferring from written records into an electronic format. Detailed information had been drawn up on every aspect of people’s care. A range of activities was available to people which were planned by an activities co-ordinator. People felt there was enough to keep them busy. Complaints were managed in a responsive manner.
This inspection was carried out on 3 and 17 March 2015 and was unannounced. Keychange Charity Romans Care Home is a service which is registered to provide support and accommodation for up to 30 older people some of whom were living with dementia. Accommodation is provided over three floors and there was a lift available to access all floors. There were a total of 34 members of staff employed plus two deputy managers and the registered manager. On the day of our visit 23 people lived at the home.
The service had a registered manager in place. 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 and associated Regulations about how the service is run.
People told us they felt safe. Relative’s told us they had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of harm.
Care records contained risk assessments to protect people from any identified risks and helped to keep them safe. These gave information for staff on the identified risk and guidance on reduction measures. There were also risk assessments for the building and emergency plans were in place to help keep people safe in the event of an unforeseen emergency such as fire or flood.
Recruitment checks were carried out on newly appointed staff to check they were suitable to work with people. Staffing levels were maintained at a level to meet people’s needs. People told us there were enough staff on duty and this was also confirmed by staff.
People told us the food at the home was generally good. However some people said there could be more variety and one person told us they liked a cooked breakfast but they had only had this once in three months. Four people told us they were disappointed that their access to fresh fruit at all times had been stopped recently. There were facilities for people using the service and their visitors to prepare their own drinks when required.
People were supported to take their medicines as directed by their GP. Records showed that medicines were obtained, stored, administered and disposed of safely. The provider’s medicines policy was up to date. There were appropriate arrangements for obtaining, storing and disposing of medicines
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. There were no people living at the home who were currently subject to DoLS. We found the manager understood when an application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS. People were able to make day to day decisions for themselves. There were no restrictions imposed on people. The manager and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) regarding best interests decisions should anyone be deemed to lack capacity.
Each person had a plan of care which provided the information staff needed to support people and staff received training to help them meet people’s needs. Staff received regular supervision including observations of staff carrying out their duties. Monitoring of staff performance was undertaken through staff appraisals which were conducted every six months.
Staff were supported to develop their skills by receiving regular training. The provider supported staff to obtain recognised qualifications such as National Vocational Qualifications (NVQ) or Care Diplomas (These are work based awards that are achieved through assessment and training. To achieve these awards candidates must prove that they have the ability to carry out their job to the required standard). All staff completed an induction before working unsupervised. Staff had completed mandatory training and were encouraged to undertake specialist training from accredited trainers.
People’s privacy and dignity was respected and staff had a caring attitude towards people. We saw staff smiling and laughing with people and offering support. There was a good rapport between people and staff. Regular competency checks were carried out on the standard of care provided.
Staff were knowledgeable about people’s health needs and knew how to respond if they observed a change in their well-being. Staff were kept up to date about people in their care by attending regular handovers at the beginning of each shift. The home was well supported by a range of health professionals. We contacted a GP practice who provided a service to some of the people at the home. They told us that the manager and staff were very approachable and had good communication skills; they said the staff were open and transparent and worked well with them to meet people’s needs
The registered manager operated an open door policy and welcomed feedback on any aspect of the service. There was a stable staff team who said that communication between all staff was good and they always felt able to make suggestions and confirmed management were open and approachable.
The registered manager acted in accordance with the registration regulations and sent us notifications to inform us of any important events that took place in the home of which we needed to be aware.
The provider had a policy and procedure for quality assurance. The registered manager was visible and the area manager visited the home regularly and visits from trustees also took place from time to time. The registered manager operated an open door policy for both staff and people using the service and their relatives. Weekly and monthly checks were carried out to help monitor the quality of the service provided. There were regular residents meetings and their feedback was sought on the quality of the service provided. There was a complaints policy and people knew how to make a complaint if necessary.
The staff also told us they felt valued and supported by the management and had their training needs met. The staff told us they felt confident that the quality of individualised care delivered in Romans Keychange was of a high standard. We found care plans, staff records and other records relevant to the management of the home were accurate, reviewed regularly and fit for purpose.
The home had systems in place to assess and continually review the service that it provided and had made improvements where needed. We found that people were involved in all aspects of their care, and in any changes to the service that may have affected them.
We also looked at other records to help us understand the needs and views of the people who used the service. These included residents, relatives and health professional satisfaction surveys, resident's meeting minutes, staff personnel files, the home's incident and complaints log, the communication book and the home's operational policies.
We found people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.
We looked at the records of three people and found that people's care was assessed, and planned and delivered on this basis.
Everyone we spoke with said they were looked after well by staff. One person said "They've been very good to me". We spoke with visitors to the home. Their comments included "Everyone seems happy and there's always a good atmosphere" and "The home is really good and the staff are all very friendly".
We looked at messages of thanks from people who lived at the home and their families. One relative wrote, "Staff at the Romans have been unstinting in their help, advice and support ... they continue to provide safe, kind, caring support ... and their professionalism is outstanding". Another relative had written, "I cannot express how kind and caring all the staff are at Romans ... they gave us all the help that was needed - and more - both physically and emotionally".
We saw that staff had a good understanding of the needs of the people who lived at the home, and received the training and support they needed.
There were systems in place to assess and monitor the quality of service that people received.