Rookery Cottage

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

People were cared for safely. Risk assessments were in place and reviewed regularly, and as people’s needs changed. Staff understood safeguarding procedures. Safe recruitment practices were followed to ensure staff were suitable for their roles.

There were consistently enough staff to meet people’s care needs. People were supported with their medicines and good infection control practices were followed. Accidents, incidents and falls were recorded and followed up appropriately. Lessons were learned when things went wrong.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The providers had embedded an open and learning culture in their family run service. They were passionate about people experiencing a caring, home from home service and this was at the heart of the values of the service.

All of the feedback from people, relatives and staff was positive about the approachability, availability and responsiveness of the providers, and the friendliness and warmth of the staff team. Staff told us they were happy in their roles and felt valued as part of a strong and effective team.

The providers were committed to investing in the training and continuous learning of their experienced staff team for the benefit of people living in the service. Staff felt they had opportunities to progress in their roles and took on mentoring of others and specialist areas of care, as part of their ongoing development. A high number of staff were involved in studying for care qualifications, supported by the provider.

The providers worked in an open and transparent way and staff knew how to raise concerns should they have any. The providers had effective oversight of the running of the service. An electronic care planning system had recently been introduced and was embedded into practice. This helped staff have easy access to care records and gave the management team instant access to oversee people's care.

The views of people and relatives were regularly sought and used to drive continuous improvements of the service. Communication within the staff team was effective and staff felt their opinions mattered.

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 good (published 28 March 2019).

Why we inspected

We received some concerns in relation to the care people received. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We did not find any evidence to substantiate the concerns.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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 COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rookery Cottage on our website at www.cqc.org.uk.

Follow up

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

Rookery Cottage is a small residential care home providing personal care and accommodation for up to 13 people, some of whom have dementia. There were 10 people living in the home at the time of our inspection.

People’s experience of using this service:

• There were sufficient staff to meet people’s care and support needs. Staff had been recruited safely and improvements had been made with regards to retaining proof of staff identity.

• The management team had developed and implemented comprehensive audits to monitor the quality and safety of the service..

• People, relatives, staff and healthcare professionals told us Rookery Cottage had a homely atmosphere and a strong emphasis on the importance of family and community connections.

• The environment had recently been refurbished to a high standard; people had a comfortable and clean place to live.

• Staff felt a strong sense of ownership and pride in the service and felt well supported by the management team. Any concerns raised were effectively responded to and acted on appropriately.

• Plans of care had been developed and reviewed with people and their relatives, and the staff team knew people they were supporting well.

• People’s personal preferences had been identified and they were supported to attend a diverse range of activities.

• People and relatives fed back they were happy with the care provided.

• Risks associated with people’s care and support had been appropriately assessed and managed. People told us they felt safe living at the service and with the staff team who supported them. The team were aware of their responsibilities for keeping people safe and had received the relevant safeguarding training.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• People received kind and compassionate care at the end of their lives.

More information about the inspection is in the full report.

Rating at last inspection:

At our last inspection, the service was rated Requires Improvement in Safe and Well Led and Requires Improvement overall. Our last report was published on 23 March 2018.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received and assess if improvements have been made.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

Rookery Cottage provides personal care for up to thirteen older people, some of whom are living with dementia. At the time of our inspection there were thirteen people living at the home.

At the last inspection, on the 8 December 2015, the service was rated ‘Good’. At this inspection we found that the service ‘Required Improvement’.

There were two registered managers in post at the time of the inspection, they were also the provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The quality assurance processes in place to monitor the quality and safety of the service and drive improvement required strengthening to ensure the provider had sufficient oversight of the service.

Staff did not consistently follow the procedures in place to ensure the safe handling of medicines. People did receive their medicines as prescribed; however, improvements were required to ensure sufficient oversight of medicines administration.

Safe recruitment processes were in place, however, the provider needs to ensure that appropriate documentation is retained after staff have started work at the service.

People continued to receive safe care. Staff understood their responsibilities to keep people safe from harm. Safeguarding procedures were in place and staff understood their duty to report potential risks to people’s safety.

Risk assessments were in place to manage risks within people’s lives. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

Staffing levels ensured that people's care and support needs were safely met. Staff induction training and on-going training was provided to ensure that staff had the skills, knowledge and support they needed to perform their roles. Staff were well supported and supervised by the provider.

People’s diverse needs were met by the adaptation, design and decoration of premises and they were involved in decisions about the environment. Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing personal care.

People were encouraged to make decisions about how their care was provided and staff had a good understanding of people's needs and preferences. Staff treated people with kindness, dignity and respect, and spent time getting to know them and their specific needs and wishes.

Staff supported people to access support from healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.

The service had an open culture, which encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and this was used to drive improvement.

People told us that Rookery Cottage was a homely place and that they loved living there.

We spoke with four people that used the service. A person said, 'This is a happy and comfortable home and I would not live anywhere else.' Another person told us, 'The staff frequently discuss with me how they would support me to be as independent as possible. That way they make sure they give me the right support.'

We found that the provider had made the improvements we required at our last inspection. We saw that the home had introduced a system that ensured people's care plans had been updated and reflected the changed needs of people that lived at the home. Where possible the provider had agreed the updated plan with the person that used the service or their representative. That meant people that used the service and or their representatives were aware of people's care and support needs and care was given to them in a way that met their individual needs.

Everyone we spoke with told us that care staff had provided them with the support they had needed and were always polite and respectful. We found people were able to make choices with their care, and treated with dignity. One person we spoke with told us, 'I am very comfortable here and the care staff respect my wishes. The religious minister was here earlier and I asked to be excused and that was fine.'

We found that care staff interacted with people in a friendly and polite manner. Although health care plans were in place for people that used the service we found these lacked details of the care to be provided.

Care staff we spoke with told us that they felt supported by the manager and received the training they needed to carry out their roles. One staff member we spoke with said, 'We work well as a team and support each other.'

People told us that the food was good and they always had enough to eat and drink. One person we spoke with said, 'today the salmon was delicious, I had double portions.'

The provider had adequate procedures in place to ensure the quality of the services provided.