Archived: Roxburgh House

Below is a summary of what we found.

Is the service safe?

We found there were not appropriate arrangements in place to ensure staff managed the risks associated with the use and management of medicines. The management and administration of medicines was not safe.

We found there were low levels of permanent staff employed by the service. The provider had taken steps to ensure appropriate staffing levels were maintained. They had asked staff from their other care homes to work at the service on a short term basis and used agency staff. On the day of our inspection we found there were sufficient numbers of staff on duty to support people appropriately.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We were told nobody who lived at the home was under a Deprivation of Liberty Safeguard.

We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to their management of medicines.

Is the service effective?

We spoke with people who lived at the home and asked them about the care they received. One person told us, 'I think it's fantastic here.'

We saw people's care records reflected their care needs and included risk assessments to ensure risks to people's health and wellbeing were managed.

Is the service caring?

People we spoke with were positive about the care they received. We observed some positive interactions between care staff and people who used the service on the day of our inspection.

Staff we spoke with were positive about their role as care workers and enjoyed supporting people.

Is the service responsive?

We found people were asked for their views about their care. We saw there had been meetings for people who lived at the home and for people's relatives.

We found some incidents relating to people who lived at the home had not been properly recorded or acted upon.

We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to assessing and managing the risks relating to people who use the service.

Is the service well led?

We saw the provider had a system to monitor the quality of care they provided. The system was called a 'perpetual planner', which was a list of checks to be carried out by the manager on a monthly basis. We looked at various audits and found they were not effective because the provider did not have a process in place to follow up any required improvement actions.

We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to their quality assurance systems.

We inspected this service previously on 07 October 2013 and identified that further improvements were required to maintain appropriate standards of cleanliness and hygiene within the home. We found that the provider had made changes since our previous inspection and that improvements had been made in this area of concern.

We found that improvement works had been made to the laundry area and the area was now clean and tidy. The provider had introduced a new laundry policy which staff followed. Staff had received refresher training on infection control following our previous visit.

We found that care staff were aware of the home's policy on abuse. People who used the service and their relatives told us they felt safe.

During our last inspection of this service in June 2013, we identified three areas of concern. We found that the planning and delivery of care did not meet people's individual needs and did not ensure people's welfare and safety. We found that appropriate standards of cleanliness and hygiene were not maintained in the home. We also found that the provider's system to identify, assess and manage risks relating to the health, welfare and safety of people within the home, was not effective.

During this inspection, we found that some improvements had been made to the standards of cleanliness within the home. However there were still areas of concern regarding the systems in place to protect people from the risk of infection.

We looked at people's care records and found that improvements had been made since our previous inspection. We saw that people's care plans had been reviewed and that they reflected people's individual needs.

We found that the systems for monitoring the quality of the service had improved since our previous inspection. We saw that the provider's audits were up to date. We found that complaints were recorded and responded to in an appropriate and timely way. We found that any incidents and accidents were reported and reviewed appropriately.

During our visit we saw several people in the lounge supported by care staff to enjoy an activity. People were laughing and joining in with the activity. We observed people having their lunch, where they were supported appropriately and enjoyed their meal.

We observed moving and handling practice in the home and found that this was satisfactory and we saw staff support people with dignity and respect.

During our visit we saw several people taking part in an activity, 'moving to music' in the big lounge. People were laughing and joining in with the activity. One person we spoke with who lived in the home told us that, 'I come here and meet people, and have a chat.'

During our visit we observed that the care staff were polite and asked people's permission before they helped them to do things. We observed people having their lunch, where they were supported appropriately and enjoyed their meal.

We observed moving and handling practice in the home. Most practice we observed was satisfactory and we saw staff support people with dignity and respect. However not all practice was delivered in a way that ensured people's safety and welfare.

We found that the home had not maintained appropriate standards of cleanliness and that the systems in place to protect people from the risk of infection, were not adequate.

We last inspected the service on 5 July 2012 and found the provider had not been regularly reviewing the care plans to identify any change in people's needs, and measures had not been put in place to ensure people were receiving the appropriate care.

We were told by the provider that systems would be in place by 2 September 2012. During our visit on 9 November we saw care plans for people who lived at Roxburgh House had been reviewed regularly to identify any change in people's care needs. We saw people's weight had been regularly monitored and appropriate action had been taken if a weight change had been identified.

Risk assessments were present in some of the care plans we looked at, but there were still some care plans which did not have a risk assessment for people's nutritional needs.

We found that accidents and incidents had been recorded in people's individual care plans and actions were documented on how to prevent these incidents from occurring again.