Archived: Rowan Lodge

Rowan Lodge Care Home provides accommodation and personal care for up to three people with mental health needs. There were three people using the service at the time of our inspection.

The provider is registered as an individual and as such is not required to have a registered manager in place. The provider runs and manages the service with the assistance of an operations manager who is a family member. 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.

There were activities provided at the service, however these did not always meet the needs of people.

We have made a recommendation in relation to the provision of activities.

People's individual needs had been assessed and recorded but not all care plans were regularly reviewed. Monitoring charts and records were not always updated.

Incidents and accidents were acted upon appropriately. However, records of these were not always fully completed and did not always include a management review and an action plan about how to mitigate the risk of reoccurrence.

Recruitment checks were in place to obtain information about new staff before they supported people unsupervised.

There were systems in place to ensure that people received their medicines safely and the staff had received training in the management of medicines.

There were procedures for safeguarding adults and the staff were aware of these. Staff knew how to respond to any medical emergencies or significant changes in a person's wellbeing.

Feedback from people and stakeholders was positive. People we spoke with said that they were happy with the level of care they were receiving from the service. We saw that people’s needs were met by caring and respectful staff.

People's needs were assessed and support plans were developed from the assessments. People had taken part in the planning of their care and there were regular reviews.

The manager was aware of their responsibilities in line with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).

The service employed enough staff to meet people's needs safely and had contingency plans in place in the event of staff absence. However there was not always enough time for staff on duty to provide meaningful activities for people who used the service.

People's health and nutritional needs had been assessed, recorded and were being monitored.

New staff received an induction and shadowing period before delivering care and support to people. They received the training and support they needed to care for people.

There was a complaints procedure in place which the provider followed. People felt confident that if they raised a complaint, they would be listened to and their concerns addressed.

There were systems in place to monitor and assess the quality and effectiveness of the service, and the provider ensured that areas for improvement were identified and addressed.

People and staff told us that the management team was approachable and supportive. People and staff were supported to raise concerns and make suggestions about where improvements could be made.

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

' Is the service safe?

' Is the service caring?

' Is the service effective?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on speaking with people who used the service, speaking with relatives and other social care professionals, speaking with staff who supported them, observation and looking at records.

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. Equipment at the home had been maintained and serviced regularly. We found there were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies.

We spoke with two people who used the service. They told us they could speak to any member of staff if they had any worries or concerns. One person who used the service told us 'If I had worries about them, I would tell you right now.'

There was a system in place to audit medicines and a staff member demonstrated to us how medicines were accounted for. We checked and the audit count was correct at the time of our inspection.

We looked at the employment records of two staff members. Records showed that the appropriate checks had been undertaken to ensure staff were suitable to work with vulnerable people. Staff personnel records showed that staff either had the experience, skills and knowledge to carry out their role or had undertaken further training when they began work. This meant that staff employed to work at the home were suitable and had the skills and experience needed to support people living in the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Relevant staff had been trained to understand when an application should be made, and how to submit one. At the time of our inspection no applications had been made.

Is the service caring?

We spoke with one relative of people used the service. They told us 'I have no complaints with the way X is looked after, I think X is well looked after by the staff.'

One person who used the service told us 'It's ok here, I like the staff they care about me.'

Staff on duty knew the people they cared for well, including their life history and personal preferences. During our visit we saw frequent and friendly interactions between people who used the service and the staff on duty who were supporting them.

Is the service effective?

We saw that people, their families and their health and social care professionals were involved in making decisions people's care and treatment. Their needs were assessed and care was delivered in line with their individual care plan.

People who used the service were treated as individuals and took part in community activities they liked to be involved in. One person told us, "I love going to the day centre, I attend twice a week'. Another person said 'We have music and singing each week, I enjoy that, the staff arrange it.' The manager and staff told us they encouraged people to do whatever they could for themselves and promoted their independence.

Is the service responsive?

People's health and social care needs were assessed before they moved into the home and reviewed regularly and whenever there was a change in needs.

People were confident they would receive the support they needed quickly should their health needs change. This was demonstrated by the manager and staff on the day of our visit, when they were supporting a person who was unwell and had arranged promptly for this person to be assessed and treated by the GP.

Is the service well led?

There were systems in place to ensure that people were happy with the service they received and to ensure their health and safety was protected.

A relative we spoke with told us 'The manager has always said if there are any problems ring me.' The same relative also told us they had confidence that if they raised any serious issues with the owner, these would be dealt with straight away.

We saw the manager, who had been in post since October 2013, was introducing a number of initiatives to improve services and outcomes for people who use the service.

We spoke with two people using the service and they told us they were very happy with the care they received. People's comments included 'I like my room, it's comfortable and I have all my things' and 'it's not easy to get to church but a visitor comes in to talk and pray with us.'

People had up to date care plans and the care and support they received was recorded daily. Appropriate risk assessments were in place and reviewed regularly.

The service offered a good standard of accommodation and all areas used by people using the service were well furnished and decorated. People's bedrooms were comfortable and personalised.

The manager told us that staff had completed their induction and mandatory training, although some certificates were not available for inspection.

People using the service told us there was a procedure for managing complaints but both people said this had never been necessary.