We last inspected the service on 7 and 9 September 2015 when we found the provider was not meeting Regulations 12, 17 and 18 of the Health and Social Care Act (Regulated Activities) Regulations 2014 and related to safe care and treatment, good governance and staffing. Following our inspection in September 2015, the provider sent us an action plan to show us how they would address our concerns.
We undertook this focused inspection on 24 May 2016 to check that they had followed their plan and to confirm they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Housing & Care 21 – Rowan Croft on our website at www.cqc.org.uk
We could not improve the rating for safe, effective or well led from requires improvement because to do so requires consistent good practice over time. We will check these again during our next planned comprehensive inspection.
Housing & Care 21 – Rowan Croft is an extra care service consisting of 45 individual apartments within the building. There is an office base and care staff provide people with a range of services including; personal care, medicines management, shopping and cleaning services. Not everyone in the building receives services from the provider and not all services are regulated by the CQC. At the time of the inspection 33 people lived independently and received care and support from the provider.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Medicines were now being managed in a safe way and following best practice guidelines. Staff had received suitable training in the administration of medicines and received competency checks from their line managers.
People felt safe receiving support from the service. Staff were able to demonstrate a working knowledge of both safeguarding and whistleblowing procedures.
Accidents and incidents were recorded and reported to the registered manager. They were then monitored for any trends forming and if that was the case, referrals to healthcare professionals were made.
Risk assessments were fully completed for individuals where a risk had been identified. For example, those at risk of falling or those with a poor diet. The provider also minimised the risk in the working environment for staff with risk assessments completed for example, lone working, ironing and around pension collection.
People, staff and relatives did not raise any concerns with staffing levels although they stated more staff would be helpful. We observed staff carried out their duties in a calm unhurried manner. We found safe recruitment procedures were followed.
The principles of the Mental Capacity Act 2005 (MCA 2005) were followed and staff understood the meaning of obtaining consent.
Staff appraisals, supervisions and training were up to date. There were sufficient staff to provide care which met people’s needs. Appropriate recruitment procedures were followed to ensure that suitably qualified and experienced staff were employed.
Where staff supported people to eat and drink, this was done effectively and where people required additional support with healthcare professionals, for example GPs appointments or hospital visits; care staff helped them to arrange these.
The registered manager had implemented a range of audits within the service to help them to monitor the quality of the service provided to people; these included checks on care plans and on medicines administered to people. The registered manager was aware these procedures needed to be maintained.