This inspection took place on 19 December 2016 and was unannounced. This meant the staff and registered provider did not know we would be visiting.

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. At the time of the inspection 31 people were receiving care and support from the provider.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Housing & Care 21 – Rowan Croft was last inspected by CQC on 7 and 9 September 2015 and was rated as Requires Improvement. A focused inspection took place on 24 May 2016 to follow up on the issues identified at the previous rating inspection and found the issues had been addressed by the registered manager.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place and described potential risks and the safeguards in place. Staff had been trained in safeguarding vulnerable adults. Procedures were in place to ensure people received medicines as prescribed.

Staffing levels were sufficient and staff were suitably trained to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff received regular supervisions and appraisals.

The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA).

Staff supported people at meal times as required. Care records contained evidence of visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Housing & Care 21 – Rowan Croft and staff treated people with dignity and respect.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person centred way.

Activities were available for people who used the service based on their likes and interests and to help meet their social needs.

The registered provider had an effective complaints procedure in place, and people who used the service and family members were aware of how to make a complaint.

Staff felt supported by the registered manager and were comfortable raising any concerns. People who used the service and family members told us the management were approachable and understanding.

People who used the service, family members and staff were regularly consulted about the quality of the service.

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.

The unannounced inspection took place on 7 and 9 of September 2015. This was the first inspection since the service registered with the Care Quality Commission (CQC) on 9 October 2014.

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 34 people lived independently and received care and support from the provider.

The service had a manager in post who had joined the organisation in April 2015. 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.

We found some shortfalls in the safe management of medicines. For example, medicine administration records were not completed correctly as per current guidance and ‘as required’ medicines had not been recorded correctly.

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 dealt with appropriately but not formally monitored by the provider to help them identify any trends. We also noted that risk assessments were not always completed.

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 not all up to date, although the manager was striving to rectify this. 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.

People were supported to eat and drink sufficient amounts to ensure their dietary needs were met. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals, as required.

People and their relatives told us the staff team were caring in their approach to them and respected their dignity.

Care and support plans needed to be revised and additional work put into them to ensure they were up to date and contained person centred, relevant information.

A new manager was in post and they were addressing some of the shortfalls they had identified. However, additional issues were identified as part of the inspection process that needed to be reviewed.

The provider admitted that robust quality check and audits were not always in place and that measures were to be taken to rectify this.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to medicines, staffing and good governance. You can see what action we told the provider to take at the back of the full version of this report.