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Rowley House Nursing Home Requires improvement

The provider of this service changed - see old profile

We are carrying out a review of quality at Rowley House Nursing Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 1 December 2020

During an inspection looking at part of the service

About the service

Rowley House Nursing Home provides accommodation for people who require nursing or personal care and can accommodate up to 35 people across two floors. At the time of our inspection, there were 19 people living at the service.

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

Risks were not always managed in a safe way. Care plan documentation was not always kept up-to-date. Information to guide staff to safely support people was inconsistent placing people at risk of harm.

Medicines were not always stored safely, and some recording of medicine administration was incomplete.

Some of the governance processes were not robust or consistent enough to sustain and drive improvements.

There were sufficient numbers of staff to meet people’s needs. Staff were trained to keep people safe from the risk of abuse and/or harm.

The home was clean, and staff adhered to strict infection prevention control practices to mitigate the risk of the spread of infection. Staff had received specific training about how best to protect people from the Covid-19 virus.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager had implemented some practices which had led to some positive outcomes in the home. The people, staff and relatives we spoke with shared this view.

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

Rating at last inspection and update

The last rating for this service was Requires Improvement (Inspection date 17 February 2020, Published 25 November 2020).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had not been made and the provider was still in breach of regulation 12 (safe care and treatment) and regulation 17(Good governance).

Why we inspected

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 coronavirus and other infection outbreaks effectively.

We received concerns in relation to the risk management of people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rowley House Nursing Home on our website at www.cqc.org.uk.

Enforcement

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 have identified breaches in relation to safe care and treatment and good governance.

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

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider

Inspection carried out on 13 December 2018

During a routine inspection

This unannounced inspection took place on 13 and 14 December 2018. This was the first time the home had been inspected under this provider. At this inspection we found some breaches of regulations. You can see what action we asked the provider to take at the back of the full version of this report.

Rowley House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Rowley House Nursing Home can accommodate up to 35 people, based in one building. There were 24 people using the service at the time of our inspection, with one other person also living there who was in hospital.

There was no registered manager in post, although there was a manager who was in the process of applying to register with us. 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.

Quality assurance systems in place to monitor the service were not always effective at identifying concerns and prompt action was not always taken to ensure people’s care improved. Feedback sought from people and relatives was not always acted upon promptly. Feedback from other professionals was also not always acted upon quickly enough, so concerns identified continued to be an issue.

Medicines were not always managed safely and we could not be sure people were always getting them as prescribed. Risks were not always assessed and reviewed sufficiently to ensure lessons were learned. However, people felt safe and staff understood their safeguarding responsibilities. Staff were safely recruited to help keep people safe.

There was mixed feedback about staffing levels and the skills mix of staff had not always been considered. People were protected from possible infection by measures in place and the building was appropriately maintained.

People were not always supported to have maximum choice and control of their lives as the principles of the Mental Capacity Act 2005 were not always being followed, although staff did offer choices. Decisions made in people’s best interest were not always recorded. We could not be sure that all necessary Deprivation of Liberty Safeguarding (DoLS) referrals had been made as capacity assessments were not always undertaken or reviewed.

People did not always find the choice of food sufficient and felt the food needed improving. Staff received training and were supported in their role to care for people. People had access to other health professionals to help keep them well. The building was suitably adapted for the people living there and improvements to the décor were ongoing.

People found that staff were kind and caring and they were encouraged to be independent and to be involved in decisions about their care and support. People could personalise their bedrooms and there were no restrictions on visiting times for relatives.

People were not always sufficiently supported to partake in enough activities as staff were not always available. People and relatives felt that staff knew their preferences well, although further consideration of people’s protected characteristics would be beneficial. People felt able to complain and thought their feedback would be dealt with. Consideration had been given to people nearing the end of their life and arrangements made to ensure medicines were available so they would be pain-free.

People, relatives and staff were positive about the manager and felt the manager was approachable. Staff felt supported.