CQC report explained · a residential care home
What the CQC found at Rowland House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, and inspectors found enough staff, safeguarding training and safe medicines administration. They identified missing risk information for some bedrails and missing second signatures on some handwritten medicines records.
- Effective?
- Good
- People's needs were assessed before they moved in. Staff had relevant training, supported healthy diets and worked with health and social care professionals.
- Caring?
- Good
- Staff were kind, respectful and considerate. People were involved in decisions, supported to remain independent and helped to keep important relationships.
- Responsive?
- Good
- Support plans were personalised and covered people's mobility, communication, eating and drinking, and brain injury needs. People were supported to choose activities and attend local events.
- Well-led?
- Good
- Quality checks, staff competency checks and feedback systems were in place. Inspectors found an open, person-centred culture and good partnership working with other agencies.
What inspectors found, February 2019
Rowland House rated Good; inspectors found kind, personalised care, with minor gaps in bedrail risk records and medicines signatures.
This was a planned inspection on 20 December 2018. One inspector spoke with people, relatives, staff and the manager. They observed care and checked care records, staff files, medicines, safety information and quality records.
The home supported six people, in accommodation for up to seven people with complex physical needs, brain injuries and other neurological conditions. Inspectors found enough skilled staff, safe medicines administration, clean surroundings and good support with health, food, communication and activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found two minor gaps. Bedrail risks had not initially been recorded properly, and some handwritten medicines records did not have a second signature. The manager sent the missing bedrail information after the inspection and said the medicines issue would be addressed.
Kind and respectful staff
People appeared comfortable with staff. Inspectors saw positive relationships, a calm atmosphere and support that respected privacy, dignity and independence.
“We observed people and staff had developed positive relationships and people seemed comfortable in the company of staff.” from the report
Personalised support
Care plans covered individual needs and preferences. People were involved in choices about food, activities and their support.
“Staff made people feel listened to and valued by involving them in decisions about their care and support.” from the report
Skilled and supported staff
Staff received training about brain injury, safeguarding and other care needs. They also received supervision and competency checks.
“Staff were sufficiently qualified, skilled and experienced to meet people's needs.” from the report
Good health support
The home worked with health professionals and supported people with complex needs, including tube feeding and hospital visits.
“People were supported to remain healthy and had access to health care professionals.” from the report
Clean and safe surroundings
The buildings and communal areas were clean, spacious and well maintained. Safety checks and suitable equipment were in place.
“The service was very clean and tidy and people were encouraged to participate with day to day chores if they were able.” from the report
Bedrail risks were not recorded at first
needs fixingSome people were using bedrails, but their care files did not initially explain the risks or why the rails were needed. The manager sent the required information after the inspection and added individual risk assessments.
“care plans did not contain information related to potential risks these may cause or why they were in place.” from the report
Some medicines records lacked a second signature
needs fixingSome handwritten medicines records did not have a counter-signature to confirm that entries had been copied correctly and followed prescribing instructions. The manager said this would be communicated to senior staff.
“We did note hand-written MARs did not always have two signatures.” from the report
- 01How are bedrails assessed for each person, and where can we see the current risk assessment?
- 02How do you check handwritten medicines records and make sure they have the required second signature?
- 03What training do staff receive to support people with brain injuries and complex physical needs?
- 04How will you involve our relative in decisions about their care, communication and activities?
- 05How do you work with health professionals if a person's condition or support needs change?
This was a planned inspection covering all five CQC questions, including the premises and the care provided; the previous overall rating was Good in the report published on 15 September 2016. This explanation was written from the published report of 1 February 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.
What inspectors found, September 2016
Rated Good; inspectors found personalised, safe and caring support, with some medicine audit records needing improvement.
This was an announced inspection on 11 August 2016. One inspector met two of the three people living there, spoke with staff, a relative and community professionals, and reviewed care, medicine, recruitment, training and quality records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe recruitment, appropriate medicine arrangements and care plans that reflected people's needs and wishes.
People were treated with kindness and respect. Staff understood how people communicated, including through gestures and facial expressions, and supported their health, nutrition, independence and activities.
The home had systems to monitor quality and respond to feedback. Inspectors noted that some medicine audit records had been inconsistent, although action had been taken, and that systems for recording comments and complaints were still being developed.
Personalised support
Care was planned around each person's needs, preferences, goals and communication style. People were supported to remain as independent as possible.
“People received care and support that was personalised to them and met their individual needs and wishes.” from the report
Kind and respectful staff
Staff knew people well and treated them with patience, dignity and compassion. They noticed and responded to non-verbal communication.
“Support workers respected people's privacy and dignity and interacted with people in a caring, compassionate and professional manner.” from the report
Skilled staff
Training covered the specific needs of the people living in the home, including acquired brain injury, swallowing difficulties, catheter care and epilepsy.
“Training was linked to the specific needs of people.” from the report
Health and safety support
Staff monitored people's health, supported access to appointments and acted when concerns such as weight loss or deterioration were identified.
“Where the support workers had noted concerns about people's health, such as weight loss, or general deterioration in their health, they had taken action to reduce the risk.” from the report
Medicine audit records
minorQuality checks had found inconsistencies in how medicines were recorded in audits. The home responded with communication, competency checks and extra training where needed.
“inconsistencies found in the medication audits when recording people's medicines.” from the report
Recording feedback
minorThe manager said systems for recording information from comments and complaints were still being developed, so actions taken could be captured more fully.
“The registered manager advised us they were developing their systems for capturing information from comments and complaints” from the report
- 01How do you now check that medicines are recorded correctly and that any errors are acted on?
- 02How are comments, informal concerns and complaints recorded, investigated and used to improve the home?
- 03How will you support my relative's particular condition, communication style and personal goals?
- 04How are care plans and risk assessments reviewed when a person's health or preferences change?
- 05How will my relative and our family be involved in decisions and regular care reviews?
This was an announced inspection of the overall service and all five CQC areas, including care for three people, although the inspector met two people directly. This explanation was written from the published report of 15 September 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 Rowland House
2 rated inspections over 2 years: the service has held its Good rating throughout.
- February 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2015
Registered with the Care Quality Commission on 20 January 2015.
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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Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
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