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Keychange Charity Romans Care Home Good

The provider of this service changed - see old profile


Inspection carried out on 6 June 2017

During a routine inspection

The inspection took place on 6 and 7 June 2017 and was unannounced.

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 fel

Inspection carried out on 3 and 17 March 2015

During a routine inspection

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.

Inspection carried out on 20 September 2013

During a routine inspection

During our inspection we spoke with five people who used the service and four relatives and a GP. We also spoke with five staff members, three of which were care staff. The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us "I really like living here" and, "They pamper me and always come when I ring my bell�. Staff told us, �I like that we can talk to the people and no day is the same�. Staff we spoke with said that they had undertaken safeguarding vulnerable adults training, and people we spoke with told us that they felt safe and knew who to talk to if they had any concerns.

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.

Inspection carried out on 14 January 2013

During a routine inspection

During our visit we spoke with five people who lived in the home and five visitors. We spoke with four members of staff, including the manager, the deputy manager, the cook and a care assistant. We looked at the responses to recent satisfaction surveys which gave us additional information about the views of people who used the service.

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.