The Rowans

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People received care in accordance with their assessed needs. Care records and risk assessments were amended when people’s needs changed. This ensured people continued to receive care that met their needs. People’s care was provided with their other relevant person’s consent. Two people who had been assessed as having epilepsy did not have detailed care plans and risk assessments in place. However, staff could explain how they would care for the person.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us that they were involved with planning their care. People were confident that their needs were understood by the staff team.

Staff told us that they had time to review care planning documents, so they could keep up to date with people’s changing needs. They told us they knew how to provide the most up to date care that met each person’s individual needs. Staff had good knowledge of how to support people’s needs, and what action to take if the person’s needs appeared to have changed. The manager was confident that staff had the guidance and information needed to provide effective care for all people.

A range of national assessment tools were used, to understand people’s needs and how best to support them. For example, monitoring pressure care, nutritional health, and continence. Staff had access to documents on how to support people. Where people’s needs changed, these care planning documents were updated so staff had access to the most up to date information. We noted two people had epilepsy and their care records made reference to this. However, they did not have an epilepsy care plan in place to guide staff should the person have a seizure. We spoke with staff about these two people. They had a thorough understanding of their needs and were able to explain what they would do should each person have a seizure. Whilst we concluded the risks to the two people were low, failure to have a detailed and individualised care plan to guide staff could result in inconsistent or unsafe care. The manager was made aware of this and has taken action to address it. People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people in the most appropriate and effective way.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

Where able, people told us they were able to give their consent to the way their care and support was provided. A person told us they had discussed the process for them to being able to go out of the home alone, without staff support. They told us they were happy with the way this has been organised and agreed and both they and staff understood what was expected of them.

Staff told us they understood people’s individual needs and how to provide care in their preferred way. They also understood what restrictions people had on their freedoms and when and how to provide restraint safely and effectively. The manager was confident that people received care and support in a way that did not restrict their rights and freedoms to live their lives in their chosen way.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found the MCA and DoLS were being applied appropriately. The manager had a good understanding of the legal requirements to ensure people were able to express their views, and, where unable, how to obtain appropriate consent for decisions about care.