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Rowley House Nursing Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 17 February 2020

During a routine inspection

About the service

Rowley House Nursing Home can accommodate up to 35 older people with nursing care needs. There were 23 people using the service at the time of our inspection. They can accommodate people over two floors. Some rooms are shared.

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

During our inspection we identified several concerns relating to the safety of the environment that could potentially impact on the health and welfare of the people who used the service. These had not been addressed by the provider prior to our visit. The provider took prompt action, during and immediately following the inspection to address these issues meaning that the environment was made safe.

At the time of our last inspection we had concerns that the quality and safety of the service provided for people was not being well monitored and evaluated meaning areas for improvement were not being identified or addressed. Although we saw that systems and process have now been implemented, the provider had not always identified shortfalls or acted to address them to ensure people’s safety.

Care plans did not always accurately reflect people’s needs and people were not consistently supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

Staff were caring and respectful, promoting people’s privacy, dignity and independence.

People were happy living at the home. Relatives were positive about the support their family members received, especially over recent months. There was a complaints procedure in place should people wish to share a concern.

Overall there were enough staff at the home to meet people’s needs in a timely manner. Staff told us that they received training and support to help them be effective in their roles.

The quality of the food had improved, and activities were becoming more structured after the appointment of a member of staff whose responsibility it was to develop this area.

During the inspection the provider and the home manger were open, transparent and keen to make improvements at the home.

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 December 2019). During this inspection the service was found to be in breach of Regulation 17 HSCA RA Regulations 2014 Good governance and Regulation 12 HSCA RA Regulations 2014 Safe care and treatment. The provider sent us an action plan as to how improvements were to be made and we considered this at the time of this inspection.

Why we inspected

This was a planned, unannounced, inspection based on the previous rating.

Enforcement

At the inspection, we have identified breaches in relation to the safety of the environment, recording systems, the assessment and documentation of consent and the governance of the service.

The provider immediately started to address all of our concerns.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.