Archived: Roxburgh House (Liverpool)

Updated 22 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on 3 and 4 February 2016 and was undertaken by an adult social care inspector.

Before our inspection we reviewed the information we held about the home. This included a review of the Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the notifications the Care Quality Commission (CQC) had received about the service. We contacted the commissioners of the service to obtain their views, as well as the local safeguarding teams.

During the inspection we spoke with four people living in the home, the registered manager, deputy manager, one member of the kitchen staff, three members of the care staff, three relatives and two visiting health professionals.

We looked at the care files for six people living at the home, four staff recruitment files, medicine administration charts and other records relevant to the quality monitoring of the service. We made general observations, looked around the home, including some people’s bedrooms, bathrooms, the dining rooms and lounge.

Updated 22 March 2016

This inspection took place on 3 and 4 February 2016 and was unannounced.

Roxburgh House is a residential care home which offers accommodation and support for up to 38 older people. The single storey building is separated into two areas; a residential care home providing support for up to 23 people and a unit to support up to 15 people with dementia. On the day of inspection there were 37 people using this service.

There was a registered manager in post. 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.

People we spoke with told us they felt safe living in Roxburgh House and we found that there were adequate numbers of staff on duty to meet people’s needs. Staff we spoke with were able to explain different types of abuse, potential signs of abuse and how they would report any concerns. Records showed that staff had completed safeguarding training which helped to support them in maintaining people’s safety and wellbeing. We found that staff were recruited in adherence with safe recruitment practices to ensure staff were suitable to work with vulnerable people.

Medicines were kept secure and systems were in place to ensure effective ordering and disposal. Staff had completed medicine training and a medicine policy was available to help guide staff. Medicine administration charts showed that not all medicines were signed for when administered.

We looked at accident and incident reporting within the home and found that incidents were reported and recorded appropriately. Arrangements were in place for checking the environment to ensure it was safe. On the first day of inspection, we looked at the environment and found that there were some repairs required and the manager ensured that these repairs were completed by the second day of inspection to ensure the environment remained safe.

We found the home to be clean and one person told us, “It’s very clean, they clean everyday.”

Staff had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards. We observed staff seeking people’s consent before providing them with support. When people were unable to consent, an assessment of their mental capacity was completed in line with the principles of the MCA and care provided in their best interest.

Staff were supported through induction, training, supervisions and appraisals. People living in the home and their relatives told us they felt staff were well trained.

People at the home were supported by the staff and external health care professionals to maintain their health and wellbeing, such as the GP.

Catering staff we spoke with were able to tell us about most people’s dietary needs, however no written information was available in the kitchen to ensure that all people providing meals was aware of each persons dietary needs and preferences. The manager agreed to review this and on the second day of inspection diet notification charts had been created and were available within the kitchen.

We observed the environment of the home and found that the manager had taken steps within the unit for people living with dementia to ensure the environment included orientation signs and aids and which enabled people to be more independent.

People living at the home told us staff were kind and caring and treated them with respect. Relatives we spoke with agreed and staff told us they enjoyed caring for the people living in the home and that it was like an extended family.

We observed relatives visiting throughout both days of the inspection. People we spoke with told us they could have visitors at any time and visitors we spoke with agreed. One visitor told us, “At least one family member comes nearly every day and at different times, we are always made welcome.”

Most care files showed that people had been involved in the development of their care plan. Care plans were specific to the individual person and most were detailed and informative. We found however, that not all care plans contained sufficient detail regarding people’s needs and some contained inconsistent information. The manager was made aware of these findings and on the second day of inspection, the manager had updated the care plans to include the relevant information.

Not all risk assessments we viewed had been completed accurately. If accurate levels of risk are not identified, people may not receive appropriate care to meet their needs. On the second day of inspection, the risk assessment had been reviewed and accurately reflected the person’s level of risk.

Staff we spoke with demonstrated a good knowledge of people’s individual care, their needs, choices and preferences.

People told us they enjoyed activities available within the home, such as bingo, music, singing and trips out in the minibus. did exercises, listened to music, sang, went in the garden in the summer and went out in the minibus.

People had access to a complaints procedure and this was displayed on notice boards within the home and was also available within the residents guide which everybody had a copy of in their rooms.

The home had a registered manager in post. People living in the home told us it was run well and relatives told us they felt able to go to the manager with any concerns and were confident they would be listened to and have their concerns addressed.

Staff were aware of the home’s whistle blowing policy and told us they would not hesitate to raise any issue they had. There were processes in place to gather feedback from people and listen to their views.

There were procedures in place to monitor and improve the quality and safety of the service, such as regular audits completed by the manager and operational director.

The manager had notified the Care Quality Commission(CQC ) of events and incidents that occurred in the home in accordance with our statutory notifications.