Rowan House Residential Home

The residential service and the domiciliary service each had a manager in place. The residential service had a registered manager in place and the manager on the domiciliary service had applied to be registered. However, both the residential and domiciliary service remain under the same registration of Rowan House Residential Home.

Rowan House Domiciliary Care Agency

Risks were not always identified, assessed and recorded. One person had been exposed to potential financial risk. There were no checks, monitoring or audits of staff financial transactions done on behalf of a person.

One person had specific care needs. There was not sufficient guidance and direction for staff to safely manage all potential risks associated with their care and support.

Recruitment processes were not entirely robust. We have made a recommendation about this in the safe section of this report.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. There was misleading and contradictory capacity assessments seen in two care plans.

People and their relatives spoke positively about staff and told us they were happy with the service they received.

We were told staff were friendly, they were treated with kindness and compassion and their privacy and dignity was respected. Comments included, "They are very nice," "Marvelous," "Such a good agency" and "They are really good."

New staff had sufficient support during their induction before working alone with people.

There were sufficient staff employed to cover the visits required by people. Staff were provided with adequate travel time to enable them to carry out visits at the time of the person's choosing.

Environmental risks to visiting staff were assessed. Care plans were completed for each person and contained details of the person's needs and preferences. Care plans were reviewed regularly to help ensure they were up to date and relevant.

People told us they felt safe when being supported by staff. There were systems to help protect people from abuse and to investigate any allegations, incidents, or accidents.

There were audit processes in place at the time of this inspection. However, these audits had not identified the concerns found at this inspection.

People and staff were regularly asked for their views and experiences of the service.

The service had implemented some quality assurance systems to monitor the quality and safety of the service provided. Spot checks were carried out to monitor staff performance. Staff were well supported and asked for their views.

People were supported by staff who had been appropriately trained and were skilled in their role.

People received support to maintain good health and were supported to maintain a balanced diet where this was part of their care plan.

Staff understood the importance of respecting people's diverse needs and promoting independence. People were always asked for their consent prior to care being provided.

There were clear lines of responsibility which were known and understood by the staff team.

There was a manager who was in the process of registering with the CQC at the time of this inspection.

Rowan House Residential Home

People looked relaxed, happy, and comfortable with the staff supporting them. Staff were caring and spent time chatting with people as they moved around the service.

The environment was safe, and there was equipment available which protected people from harm and supported staff. Health and safety checks of the environment and equipment were in place.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Medicines were ordered, stored, and disposed of safely. However, we did find a discrepancy in the number of medicines held and what was recorded. The registered manager actioned this immediately and put additional audits and monitoring in place.

People were protected from abuse and neglect. The service used a computerised care planning system.

People's care plans and risk assessments were clear. Records were accessible and up to date.

The management and staff knew people well and worked together to help ensure people received a good service.

People were supported by staff who completed an induction and received appropriate training and support to enable them to carry out their roles safely. This included fire safety and dementia care training. Staff were recruited safely in sufficient numbers to ensure people's needs were met. There was time for people to have social interaction, and an outside entertainer was in the service during our inspection. Staff knew how to keep people safe from harm.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People's communication needs were identified, and where they wanted, people had end of life wishes explored and recorded.

Staff told us the registered manager was available, assisted them daily and moved into the service and helped cover shifts when some staff had been absent with COVID-19. They went on to say how the registered manager was approachable and listened when any concerns or ideas were raised. One staff member said, "Very friendly person" and another "Very approachable." One relative said, "Yes, I'm confident in the management, they always let me know how she is and are responsive."