CQC report explained · a residential care home
What the CQC found at Rookwood Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that staff understood safeguarding procedures, staffing levels were sufficient, medicines were managed safely and risks to people had been assessed. Improvements had also been made to the safety of the building and equipment.
- Effective?
- Good
- The home followed the Mental Capacity Act and had the required authorisations for people deprived of their liberty. Staff training had improved, and people's nutritional and health care needs were being met.
- Caring?
- Good
- People said staff were kind and friendly. Inspectors saw respectful, patient support and found that people could make choices about their routines and independence.
- Responsive?
- Good
- Care plans included people's needs, wishes, preferences and goals. Activities and daily routines were adapted to people's interests, abilities and choices, and there was a complaints process.
- Well-led?
- Requires improvement
- Management was stable and quality checks had been introduced. However, inspectors said a period of sustained improvement and a business improvement plan were needed to show that progress would continue.
What inspectors found, October 2018
Rated Good overall; inspectors found safe, effective, caring and responsive support, but well-led was Requires Improvement after major improvements since the previous inspection.
This was an unannounced inspection on 14 and 16 August 2018. The inspector spoke with five people living at the home, the manager and three staff members. They also reviewed care records, medicines records, staff training and the building.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found that people were protected from abuse, medicines were managed safely, risks were assessed, staff had received more training, and people received suitable food and health care.
People described staff as kind and friendly. Inspectors saw that people were treated with respect, could make choices about their routines, and received activities and support suited to their wishes.
Well-led was rated Requires Improvement. Quality checks had been introduced, but the provider was advised to develop a business improvement plan to show that improvements were sustained. The home had improved from an overall Inadequate rating and was no longer in Special Measures.
Safe medicines management
Inspectors checked the receipt, storage, administration and disposal of medicines and found these systems were safe.
“The management and administration of people's medicines was safe demonstrating people received their medicines as prescribed.” from the report
Kind and respectful staff
People said staff were kind and friendly. Inspectors saw staff supporting people patiently and respecting their preferred names and routines.
“People were referred to by their preferred names and were supported in a patient, unhurried manner.” from the report
Personalised support
Care plans recorded people's current needs, preferences and goals. People were involved in reviews and could choose how they spent their time.
“Care plans contained sufficient information about the current needs, wishes and preferences of people.” from the report
Improved staff training
Training gaps found at the previous inspection had been addressed in the areas checked, including safeguarding, medicines, dementia and moving and handling.
“These included, mental health, dementia and learning disability awareness, managing challenging behaviour and moving and handling.” from the report
Quality monitoring still developing
needs fixingThe provider had introduced checks, but inspectors wanted a business improvement plan to bring audit findings and feedback together and show sustained progress.
“It is recommended that findings from the audits and feedback received are consolidated to inform the development of the homes business improvement plan.” from the report
Some staff supervision was outstanding
minorThe manager acknowledged that some recent staff supervision meetings had not been completed. Plans were in place to address this, and further evidence was provided after the inspection.
“The registered manager acknowledged that some recent supervision meetings had not been completed.” from the report
- 01What is included in the business improvement plan, and how will you show that improvements are being sustained?
- 02Have all staff now completed the supervision meetings that were outstanding at the inspection?
- 03How are risks such as choking, falls, smoking and community safety reviewed for each person?
- 04How will you make sure staff keep up to date with training and understand each person's needs?
- 05How are people's views, complaints and feedback used to improve the home?
This was an unannounced follow-up inspection covering all five key questions and checking improvements required after the December 2017 inspection. This explanation was written from the published report of 3 October 2018 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, February 2018
Rated Inadequate and placed in special measures; inspectors found serious safety, care planning and leadership problems.
The inspection was unannounced and took place on 18 December 2017. Inspectors spoke with 11 people and four staff members. They reviewed six care plans, staffing, training, medicines, incidents, complaints and quality checks.
The home was not always safe or respectful. Staff used punishments called “consequences”, including removing televisions, money, cigarettes and other personal items. Risk assessments and care plans did not always give staff the information needed to manage choking, other behaviours or people's changing needs.
The home had enough staff for people's basic physical needs and people said staff were kind. However, training was incomplete, activities were very limited, some legal safeguards were not followed and checks on the quality of care were not effective. The overall rating fell from Good at the previous inspection in August and September 2015 to Inadequate.
Enough staff for basic needs
Inspectors found enough staff to respond promptly to people's physical needs and observed communal areas were not left unsupervised for long periods.
“During our inspection we observed there to be enough staff to attend to people's physical needs promptly and assist at meals times” from the report
Medicines arrangements
Medicines were stored securely and temperature checks were recorded. As-required medicines had guidance for staff.
“People received their medicines in a way that protected them from harm.” from the report
Kind relationships
People spoke positively about staff, and inspectors saw calm, relaxed interactions and good rapport.
“We found that the atmosphere in the home was calm and relaxed.” from the report
Fire safety planning
Personal evacuation plans, fire alarm checks and regular fire drills were in place.
“This meant the staff knew how to support people in the event of a fire or other emergency so individuals could be evacuated from the building.” from the report
Punishments and loss of dignity
seriousThe home removed personal belongings and money when people broke rules or were judged to be behaving inappropriately. CQC raised a safeguarding concern with the local authority.
“The home was not equipped to manage these behaviours in a safe and person centred way and issued consequences as a punishment.” from the report
Important training gaps
needs fixingFour of 11 staff had not completed mental health awareness training, and other staff had last received it in 2014. There was no training in learning disabilities or managing behaviours that challenge others.
“The home supported eight people who have learning disabilities and we found no training in this area had been provisioned” from the report
Very limited activities
needs fixingThere was no structured activities plan. Most people did not receive enough support to go out or take part in activities, leaving them bored and socially isolated.
“We observed people had little interaction and stimulation throughout the day and found no evidence to assure us people's social needs were met.” from the report
Weak management oversight
seriousQuality checks did not identify important problems with care plans, risks, incidents, activities or people's future goals. The owner did not record audits of visits to the home.
“The quality assurance systems failed to ensure there were adequate systems to monitor the quality and safety of the service” from the report
- 01How do you now manage behaviour that challenges others without removing people's belongings, money or cigarettes as a punishment?
- 02What current risk assessments and eating and drinking guidance are in place for people with choking risks?
- 03Which staff have completed up-to-date mental health, learning disability and behaviour support training?
- 04What regular activities and community support are now available for people who cannot leave independently?
- 05How do you check that care plans, incidents, DoLS applications and people's progress towards independence are accurate and up to date?
This was an unannounced inspection covering all five key questions and the overall quality and safety of the home. This explanation was written from the published report of 7 February 2018 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 Rookwood Residential Care Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2018Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Rookwood Residential Care Home →
- February 2018Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at Rookwood Residential Care Home →
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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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