Archived: Roman Wharf Nursing Home

About the service

Roman Wharf Nursing Home is a residential care home that provides accommodation and personal care, including nursing for up to 50 people, some of whom were living with dementia. There were 36 people using the service at the time of our inspection.

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

Some incidents which took place in the service had not always been identified as safeguarding concerns and escalated to the local safeguarding team.

Systems and processes which had been implemented to monitor potential safeguarding concerns in the service had not been used effectively.

Medicines had improved. However, further improvement was needed. There were occasions where people did not always receive their prescribed medicines. Records were not always up to date with people’s personal information.

Staff understood their responsibility to keep people safe and knew how to report concerns.

Safe recruitment processes were followed to ensure staff were suitable to work with people using the service.

Risks associated with people’s care had been identified, mitigated and monitored.

Infection Prevention Control measures were in place to reduce the risk of infection to people.

The registered manager was no longer in post. A new manager had taken over the running of the service and staff were unsettled but hopeful they would see changes being made. The new manager was in the process of registering with CQC to become the registered manager.

The provider had oversight of the service and carried out regular visits to monitor the quality of people’s care.

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 (published 17 October 2019) and there were breaches of regulation. 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 some improvements had been made and the provider was no longer in breach of one regulation. However, at this inspection we identified a breach in relation to Safeguarding.

This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 22 August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. This was regarding safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed from requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Roman Wharf 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 will continue to monitor the service, we will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified an ongoing breach in relation to governance. We also identified a breach in relation to Safeguarding. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Roman Wharf Nursing Home is a residential care home that provides accommodation and personal care, including nursing for up to 50 people, some of whom were living with dementia. On the day of our visit there were 46 people living at the home.

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

Improvements were needed to ensure people received their medicines as required.

The way staff were deployed did not always ensure people's needs would be met or that people always received personalised care.

The arrangements for monitoring the safety of the environment and ensuring infection control practices were being maintained needed to be further strengthened.

Although staff were kind and caring this was based upon the approach of individual staff and not fully promoted by the culture of the organisation.

People felt safe and there were systems and processes in place to minimise the risk of abuse.

The registered provider and registered manager’s oversight of the management of the home had not been effective in identifying where improvements were needed.

Safe staff recruitment practices were followed. Accidents and incidents were reviewed and analysed to try to prevent future incidents.

Staff received training and had the skills knowledge needed to perform their roles effectively.

People were enabled to have choice and control of their lives and staff supported people in the least restrictive way possible.

Rating at last inspection and update

The last rating for this service was good (published 29 November 2016).

Why we inspected

Since our previous rating was awarded the registered provider of the service has altered its legal entity but all of the facilities and arrangements for care remained the same as when we last inspected. We have therefore used the previous rating to inform our planning and decisions about the rating at this inspection.

We have found evidence that the provider needs to make improvements.

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

Enforcement

We identified breaches in relation to keeping people safe and good governance.

Follow up

Following our inspection visit the registered provider responded and sent us an initial action plan to address immediate concerns we identified. We will request a further formal action plan from the registered provider to show how they will make changes to ensure they improve their rating to at least good.

We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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