Background to this inspection
Updated
15 April 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection team consisted of two inspectors.
Service and service type
Rowley House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Rowley House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with eight people and three relatives about their experience of the care provided. We spoke with eleven members of staff including the provider, registered manager, deputy managers, nurse on duty, care workers and a cook.
We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to review the information sent to us by the provider. This included staff training records and staff rotas. We also spoke with multiple professionals that work with the service.
Updated
15 April 2022
About the service
Rowley House Nursing Home is a residential care home providing personal and nursing care to people aged 65 and over. The service can support up to 35 people in one adapted building. At the time of our inspection there were 31 people using the service.
People’s experience of using this service and what we found
People were not supported in a safe way by enough skilled staff who understood their needs and risks. People were not supported by staff who understood safeguarding and had raised concerns with the local safeguarding team as required. Action was not taken in response to accidents and incidents to reduce the future risk of harm to people.
People were not supported by staff who understood infection control and COVID-19 government guidance and were adhering to this. People were not supported to receive their medicines safely. People did not have access to external professionals in a timely way.
The registered manager and provider had not ensured there were effective oversight at the service to identify where improvements were required and to implement these. People did not feel listened to and their feedback was not acted upon. The provider and registered manager had not notified CQC of all potential incidents and safeguarding concerns at the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 27 July 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found the provider remained in breach of regulations.
The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection .
Why we inspected
The inspection was prompted in part due to concerns received about people’s safe care and treatment, medicines management, safeguarding, staffing and the oversight of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.
We have found evidence that the provider needs to make improvements.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to people’s safe care and treatment, safeguarding, staffing staff training and competency and the oversight of the home at this inspection. This is the home's fifth consecutive rating of less than good and fifth consecutive breach of regulations in relation to people's safe care and treatment and the oversight of the service.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.