Roborough House

Updated 26 January 2023

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 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

Three inspectors, including a pharmacist inspector carried out the site visit of this inspection.

Service and service type

Roborough House is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement dependent on their registration with us. Roborough 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.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was no registered manager in post, however a new manager had been recruited.

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 professionals who work with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service about their experience of the care provided. We spent time with people and observed the interaction between them and the staff supporting them. We spoke with 12 members of staff including the interim manager, nurses and carers and ancillary staff.

We reviewed a range of records. This included 3 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 also reviewed.

Updated 26 January 2023

About the service

Roborough House is a residential care home providing personal and nursing care to up to 44 people. At the time of the inspection 40 people were living at the service. Roborough House supports people with a range of complex needs including their mental and physical health. The service is in a large detached building split into three units with their own communal areas over two floors, and with a lift for people who may have mobility needs. The service is set in its own grounds on the outskirts of Plymouth close to the moors and has an indoor activities space.

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

Many people were not able to tell us verbally about their experience of living at Roborough House. Therefore, we spent some time observing people. The interactions between people and the staff supporting them showed people were happy and relaxed. People told us; “I am happy” and another said; “The staff were kind.”

We last inspected the service in May 2022. At that time, we placed the service into special measures and found breaches of regulation. At this inspection the service had taken action to meet the breaches of regulation.

The manager in post is the third manager in the last 3 years. This manager had been employed as an interim manager to support and improve the service. They will stay for a short time to support the next new manager due to start in the New Year. They had been in post for 4 months. They received regular support from the new nominated individual who visited the service, and also worked with the manager on checking new systems and processes in place were working well.

The last 2 inspections dated November 2021 and May 2022, and the 3 inspections carried out in 2016 all rated the service requires improvement. All these inspections found breaches of regulations and the home has not achieved a good rating since 2018.

The service was placed under whole home safeguarding with the local authority. The healthcare professionals in attendance at a follow up meeting after this inspection all informed us, they had seen recent improvements in the service provided.

The interim manager had clear oversight of the service and had introduced new systems for auditing and updated other systems and processes which had been completed. However, these systems and processes had not yet been embedded into the operation of the service. Another more permanent manager, who would, we were informed, register with the commission, was due to start in 2023. Professionals all agreed that the service had made many improvements and was therefore removed from the whole home safeguarding by the local authority.

At the last inspection, May 2022, and the inspection in November 2021 we had concerns regarding medicine’s management, and that systems and processes in place were not robust enough to identify some areas for improvement. At this inspection we found there had been improvements since our previous inspection. People’s medicines were now managed safely, and they received them in the way prescribed.

At the last inspection we found the service did not have suitable safeguarding systems in place to protect people from abuse. Safeguarding incidents had not been followed up with the local authority’s safeguarding team. Notifications were not sent to CQC when required to report accidents, incidents and safeguarding concerns. We found at this inspection that all safeguarding incidents had been forwarded to the local authority and notifications had been received by CQC.

Infection control procedures were now being followed in line with current government guidance.

Staff now received appropriate training and support to enable them to carry out their role safely, including fire safety and mental health training. Staff employed as carers and auxiliary staff were recruited safely in sufficient numbers to ensure people’s needs were met. However, we found that the nursing posts remained filled by mostly agency nurses. There was time for people to have social interaction and go out into the community. Staff knew how to keep people safe from harm.

Food and fluid charts had been updated and were completed with all necessary information being recorded consistently.

The environment was safe and there was equipment available to support staff in providing safe care and support. Health and safety checks of the environment and equipment were in place.

People and their families were provided with information about how to make a complaint and details of the complaint’s procedure were displayed 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 and update

This service has been in Special Measures since 25 May 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

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, Effective and Well-led which contain those requirements.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.