CQC report explained · a residential care home
What the CQC found at Roman House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2021
Rated Good overall; inspectors found kind, safe and responsive care, but leadership and oversight still require improvement.
This was an unannounced follow-up inspection after the previous Requires Improvement rating and several breaches. Inspectors visited on 6 and 27 August 2021, spoke with people and staff, observed care, and checked care, medicine, recruitment and management records.
The home had improved in all four care areas. People were safe, treated kindly, supported to make choices, and helped to follow their interests and keep in touch with people important to them. Medicines were managed safely and the home was clean.
The home was not always well-led. Some staff said the registered manager was not consistently available or approachable. Inspectors also found that delegated tasks, recruitment checks and staff supervision were not always overseen consistently.
The overall rating was Good. Safe, Effective, Caring and Responsive were rated Good, while Well-led remained Requires Improvement. The home was no longer in breach of regulations at this inspection.
People's safety
Risks were assessed with clear plans, and inspectors found safe medicine systems and appropriate safeguarding arrangements.
“People's risks were assessed and there were clear management plans in place which were least restrictive of people's rights.” from the report
Choice and independence
People were supported to make decisions, shape their daily lives and be as independent as they wished.
“People were empowered to take control of their own health and wellbeing and were supported to be as independent as they wished.” from the report
Kind and respectful care
Staff knew people well and treated them with compassion, dignity and respect.
“Staff were caring and treated people with kindness and compassion.” from the report
Personalised support
People could follow their interests, maintain hobbies, access local amenities and keep in touch with people important to them.
“People were supported to do activities which interested them, and maintain hobbies.” from the report
Improvement since the last inspection
The provider had addressed the earlier problems. The home was no longer in breach of regulations at this inspection.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Leadership availability
needs fixingSome staff felt the registered manager was not always approachable or available because of responsibilities outside the home. They said the support they received varied.
“Some staff felt the service was not consistently well-led and that the registered manager was not always approachable or available due to other responsibilities outside the service.” from the report
Oversight of delegated work
needs fixingTasks carried out by other teams or delegated to others were not always properly checked by the registered manager. This could allow quality or safety issues to be missed or delayed.
“Some tasks, such as recruitment checks, which were undertaken by a different team or which were delegated, were not always properly overseen by the registered manager.” from the report
Weekend staffing and activities
needs fixingSome staff said staffing was often low at weekends, making activities and outings more difficult. The manager was working to stabilise staffing.
“Some staff told us that staffing levels at the weekend were "often" low and this made it difficult to do activities or take people out if they wanted to go.” from the report
Staff supervision
needs fixingFormal supervision had become less consistent, so staff did not always have a planned opportunity to review their performance and support needs.
“Formal staff supervisions had been less consistent in the months prior to the inspection and staff told us they did not always get formal supervision to review their performance and identify what support they needed.” from the report
- 01How will you make sure there are enough staff at weekends for the activities and outings people want?
- 02How does the registered manager check recruitment records and other work completed by outside or delegated teams?
- 03How often will staff receive formal supervision, and how will missed supervision be followed up?
- 04What actions are being taken to make the manager more available and approachable to staff and families?
- 05How are you developing the detailed dietary, independence and end-of-life plans mentioned by inspectors?
This was an unannounced planned follow-up inspection that assessed all five CQC questions and checked whether improvements had addressed the previous breaches. This explanation was written from the published report of 26 October 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2019
Rated Requires Improvement; inspectors found fire risks, poor access and inconsistent respect, activities and management.
This was an unannounced routine inspection on 13 and 14 March 2019. Inspectors spoke with people using the home, managers and staff. They reviewed care records, staff records, medicines, incidents, complaints, audits and the building.
The home was not always safe. Fire risk assessment actions had not been completed, some risks were not fully assessed and cleaning was inconsistent. Medicines were managed safely, but the home relied heavily on agency staff and some people experienced frequent changes of staff.
People did not always receive respectful, personalised care. Some people lacked meaningful activities and chances to build life skills. The building was large, noisy and not always accessible, which affected people's independence and quality of life.
All five areas were rated Requires Improvement. This means the inspectors found important shortfalls and limited assurance that people were consistently safe and receiving good care. The provider was required to take action, and the CQC issued a warning notice about safety.
Medicines
Staff were trained and checked before giving medicines. Medicines were administered in pairs, and audits and stock checks were carried out.
“Staff administered medicines in pairs and undertook checks beyond the minimum requirements before administering medicines.” from the report
Safeguarding
There was a safeguarding policy, a knowledgeable safeguarding lead and staff training. Concerns were reported and investigated.
“There was evidence that concerns were reported and were being investigated.” from the report
Personalised records
Care plans included people's physical, religious, health and social needs, as well as preferences and goals.
“People's care plans were reflective of their physical, religious, health and social needs and included their preferences and goals.” from the report
Healthcare support
People could access healthcare services such as opticians, GPs and dentists. Health risks and outside services were recorded in support plans.
“People had access to healthcare services that they needed, such as opticians, GPs and dentists.” from the report
Fire safety
seriousThe main building was not fully protected from fire. Actions from a fire risk assessment, including work around fire doors and detectors, had not been completed.
“People were not safe from the risk of fire.” from the report
Risk assessments
seriousSome people's risks were not fully assessed. This included risks linked to bed rails, diabetes and epilepsy.
“People's risks were not always assessed and there were not always detailed support plans to keep them safe.” from the report
Respect and communication
needs fixingInspectors found that some staff did not always treat people with respect. Not all staff could use people's communication methods, including Makaton.
“Although some staff were respectful and spoke with people as equals and were compassionate, this was not the case for all staff.” from the report
Activities and independence
needs fixingSome people had few activities, felt bored and were not always supported to develop life skills. The building also made it difficult for some people to move around independently.
“People did not always have access to meaningful activity and people were not always supported to develop life skills to meet their needs and ambitions.” from the report
Cleanliness
needs fixingInspectors found dirty and smelly equipment and carpet. Cleaning records were not completed consistently.
“We observed equipment and the carpet were dirty and smelt of faeces.” from the report
- 01Have all the actions from the fire risk assessment been completed, including the fire doors and automatic fire detectors?
- 02How do you now assess and manage risks for people using bed rails, particularly where someone has epilepsy?
- 03How do you ensure each person has regular activities, develops life skills and has their future and end of life wishes recorded?
- 04How do you limit the effect of agency staff changes on people's routines, communication and care?
- 05What checks now show that cleaning, repairs and other safety concerns are identified and followed through?
This was an unannounced routine inspection that assessed all five CQC questions and the overall quality of the home. This explanation was written from the published report of 4 September 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Roman House
2 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- October 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2019Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2018
Registered with the Care Quality Commission on 30 April 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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