CQC report explained · a nursing home
What the CQC found at Rowan Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2018
Rated Good; inspectors found safe, kind and responsive care, with some records and improvement planning needing strengthening.
The inspection was unannounced and took place on 3 and 8 May 2018. Inspectors reviewed care plans, staff records, medicines systems, quality checks and other documents. They also observed care and spoke with people living in the home, relatives and staff.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines arrangements, suitable training, kind relationships and personalised care.
The home had improved since its previous inspection in August 2016, when it was rated Requires improvement. Inspectors said the necessary improvements had been made. They still asked the provider to strengthen safeguarding training frequency, complaint investigation records and the service improvement plan.
Safe medicines
Medicines were stored, recorded and given safely. The electronic system helped prevent time-sensitive medicines being given too early and alerted managers to errors.
“There were processes in place to ensure people's medicines were recorded, stored and administered safely.” from the report
Skilled staff
Staff completed induction, training, supervision and appraisals. The home also supported staff to gain health and social care qualifications.
“Staff completed an induction programme before starting work.” from the report
Kind relationships
Inspectors saw staff treating people with compassion and understanding. People and relatives described staff as kind, caring and respectful.
“Staff treated people in a compassionate and kindly manner and were very aware of their emotional needs.” from the report
Personalised records
Care plans included people's backgrounds, preferences, communication needs and health requirements. Electronic records were updated quickly when needs changed.
“Electronic care plans were updated instantly and were 'live' documents that accurately reflected people's needs at the time.” from the report
Learning from incidents
The manager used accident and incident information to look for patterns. After reviewing falls, extra staff were placed in a communal area and falls reduced.
“The registered manager promoted a culture of learning and reflection in the home.” from the report
Safeguarding refresher training
minorSafeguarding training was refreshed every three years. Inspectors said current guidance recommends yearly updates and asked the provider to review the frequency.
“Current guidance recommends that staff receive yearly safeguarding updates.” from the report
Improvement plan
needs fixingThe service improvement plan did not include all the work taking place and did not give clear completion dates or timescales. The provider said it would develop the plan.
“Many actions had been met but as no completion dates were included on the SIP, the timescales and targets for improvements were not clear.” from the report
- 01Has safeguarding training changed from a three-year refresher to yearly updates?
- 02How are complaints now investigated, recorded and used to show learning?
- 03Can we see the current service improvement plan, including completion dates and all outstanding actions?
- 04What progress has been made with making the home more suitable for people living with dementia?
This was an unannounced inspection of the overall service, including the premises and care provided, and it considered all five CQC questions. This explanation was written from the published report of 16 June 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, October 2016
Rated Requires Improvement; inspectors found kind care and progress, but improvements were not yet consistent or fully established.
This was an unannounced comprehensive inspection on 25 and 30 August 2016. Inspectors checked the home’s progress after an earlier inspection in November 2015, when it was rated Inadequate and placed in special measures.
Inspectors found improvements in medicines, risk management, staffing checks, training, care planning and management oversight. People were treated kindly and with respect. They had enough food and drink, and could access health professionals.
The home still needed to make improvements consistent and lasting. Staff training and supervision were not yet complete for everyone. Some care records did not contain enough detail, and there was not always evidence that people and relatives had been involved in care planning.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were also rated Requires Improvement. Caring was rated Good. The home was taken out of special measures because none of the five key questions was rated Inadequate.
Kind and respectful care
People had positive relationships with staff. Inspectors saw caring, patient and respectful interactions, including support that protected people’s dignity.
“Interactions between people and staff were good humoured and caring.” from the report
Better medicines safety
Medicine errors had fallen significantly. Audits and checks had identified problems more quickly, and records showed people received their medicines as prescribed.
“MARs showed that people had received their medicines as prescribed.” from the report
Health and nutrition support
People were supported to eat and drink enough. The home worked with doctors and other health professionals, including specialists for swallowing and nutrition needs.
“People were supported to access specialist health practitioners when needed.” from the report
Improved activities and independence
People could choose activities or spend time alone. The home supported people to remain mobile and offered group and one-to-one activities.
“People were supported to maintain their independence, remain mobile and socially engaged.” from the report
Training and supervision incomplete
needs fixingSome nurses still needed specialist training, and staff did not yet all receive regular supervision. This could affect how consistently staff met people’s needs.
“Records showed all nurses still needed to complete specialist training for example in falls and pressure ulcer prevention, diet and nutrition and the prevention of choking.” from the report
Care plan records
needs fixingSome care plans did not yet give staff the same level of detail about people’s needs. Written evidence of people’s and relatives’ involvement was not always present.
“Sometime was needed to ensure all care plans were reviewed and included all of the information staff required to know how to provide appropriate care for each person.” from the report
Feedback and complaints learning
minorNew meetings and surveys had been introduced, but the home had not yet shown that all feedback was being used to improve the service consistently.
“More time was needed to ensure people's feedback would be taken into account when service improvements were made.” from the report
- 01Which staff still need specialist training, and when will this be completed?
- 02How do you check that medicines are available in sufficient quantities and that any errors are reported?
- 03How will you make sure every care plan contains current, detailed information about the person’s needs?
- 04How are people and relatives involved in monthly care plan reviews, and where is this recorded?
- 05How do you use residents’ and relatives’ feedback and complaints to make and check improvements?
This was an unannounced comprehensive inspection covering all five key questions and checking progress against the previous Inadequate inspection. This explanation was written from the published report of 14 October 2016 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 Rowan Lodge
3 rated inspections over 2 years: the service has improved, from Inadequate to Good.
- June 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2016InadequateSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: InadequateWell-led: Inadequate
- June 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- September 2011
Registered with the Care Quality Commission on 5 September 2011.
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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