Rodwell House is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rodwell House is a privately-owned service and provides accommodation for people who require nursing or personal care, and treatment of disease, disorder or injury. The service provides nursing care for up to 75 people.

At the time of inspection there was not 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.

On the first day of our inspection visit there was a manager in post who had commenced the registration process. However, during this inspection we were informed that the manager had left their post. This was the fifth change of manager in nine months which meant the service was not consistently well-led.

The service currently has a large number of safeguarding concerns related to people’s care and treatment. These related to a lack of staff, poor staff practice and a number of falls and injuries. These are subject to ongoing investigations by the police. At this time the outcome of this is not known. During our inspection two further safeguarding concerns were identified that had not been reported in line with good practice. One included a person who had unexplained cuts and bruising from June 2018 and another was raised by a relative in June 2018.

Staff deployment at the service at the service was not effective to ensure that people’s needs were met. Staff were allocated to people by the lounges they used and not by the floors they lived on. This meant that staff were allocated to people over the three floors and they would not attend to people’s needs if they were not in their allocated lounges.

Staff were knowledgeable about the people who had been allocated to them but they had insufficient knowledge about other people’s needs so would not attend to them when they had asked for support. This led to delays in care being provided to people. People were not always treated with kindness and respect and their dignity was not always promoted. Staff would only attend to people who had been allocated to them.

People were put at risk of infection as staff had failed to follow the provider’s infection control policy. There was an infestation of flies in two of the three lounges and one member of staff had failed to ensure that personal protective equipment was used when cleaning faeces off a toilet floor. This people at risk of infections. Risk assessments were not always in place in relation to people’s needs.

Some risk assessments required further detail to ensure people were protected from the risk of harm. Accidents and incidents were recorded and analysed but lessons learned had not been recorded.

Quality assurance systems were not robust and did not lead to continuous improvement at the service. Monthly audits had been undertaken and actions were put in place, but they had not identified the issues we found regarding infection control, reporting safeguarding concerns and care plans that lacked sufficient information. Neither had they identified the issues related to daily noted being copied and pasted and the poor standard of English used within them.

People were not always treated with kindness and respect and their dignity was not always promoted. People’s wishes had not always been respected by staff.

Staff had not always received appropriate support, training and supervision as is necessary to enable them to carry out their duties. The environment a required further development to meet the needs of people living with dementia.

The pro

Rodwell House is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rodwell House is a privately owned home and provides accommodation for people who require nursing or personal care, diagnostic and screening procedures and treatment of disease, disorder or injury. It also provides personal care to people who are on a tenancy agreement. The service provides nursing care for up to 75 residents.

At the time of our first inspection visit there was a manager in post who told us that they had commenced the registration process. However, since our last inspection visit of the 20 April 2018 we were informed that the manager had left their post. This was the third change of manager in five months at the home and this meant that the home was not consistently well led. The clinical lead for the home had also left the service since our inspection.

People and their relatives told us they felt the service was safe. They stated that all staff were very kind and they had no concerns about their safety.

Staff had received training in relation to safeguarding and they knew the processes to be followed when reporting suspected or actual abuse. Records of safeguarding were maintained at the home and were discussed with staff. The management at the service had gathered information and contributed to the safeguarding processes as expected by the local authority safeguarding teams.

However, since our inspection visits 11 safeguarding concerns have been raised which include three which the police are at an early stage of investigating. All of the incidents are being considered by the local authority and no outcomes are available at the time of this report. The local authority held a Provider Failure meeting whereby they placed an embargo on future admissions to the home until these concerns have been investigated. We are working with the local safeguarding team and the police and are closely monitoring the service. We wrote to the provider to request an action plan about how and when the provider will address these concerns. The provider had responded and told us that they had employed two clinical leads providing cover seven days of the week whilst they were actively recruiting a full time person for this role. They have employed a Safeguarding Specialist to investigate all the concerns. The provider also informed that they would voluntarily cease new admissions to the service pending the outcome of the Safeguarding Specialist’s report.

The provider had followed the correct recruitment procedures for all but one staff employed at the home. Action was taken to address this immediately.

People and their relatives told us they felt the service was safe. They stated that all staff were very kind and they had no concerns about their safety. Staff had received training in relation to safeguarding and they knew the processes to be followed when reporting suspected or actual abuse. There were sufficient numbers of staff at the home and the manager was monitoring the deployment of staff to ensure that people’s needs were being met at all times. Medicines were being administered and stored safely. People were not prevented from doing things they enjoyed as staff had identified and assessed individual risks for people. Accidents and incidents that occurred had been recorded and analysed .Records showed that staff were taking action in response to falls and incidents and lessons were being learned from these. The environment was clean, tidy and free from malodours. Infection control processes were followed by staff to minimise the risk of cross infection.

Staff had received training, regular supervisions and annual appraisals that helped them to perform their duties. New staff commencing their duties received induction training to help prepare them for their r

This inspection was carried out on 30 August 2017 and was unannounced. This was a focused inspection to look ‘Safe’ and ‘Well Led’ due to concerns raised with the Care Quality Commission.

At the last inspection in January 2016, the service was rated Good.

Rodwell House is registered to provide accommodation for people who require nursing or personal care and supported living. The service provides care for up to 75 people who may have dementia, physical disability and sensory impairment. On the day of our inspection four people were receiving nursing care. The rest of the people at the service were receiving personal care only.

There was 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 and associated Regulations about how the service is run.

People’s needs were met by sufficient numbers of staff. Staff felt there were enough staff deployed at Rodwell House that allowed them to spend time with people when attending to their needs. People told us response times to call bells could be improved. The registered manager was already aware of this and had been monitoring this on a daily basis. Records showed that response time to call bells had improved.

Staff at Rodwell House believed that the home was well managed and that the registered manager had an open door policy. Staff felt they were listened to and actions were taken by the registered manager when issues had been brought to their attention.

The inspection took place on 13 and 21 January 2016.

Rodwell Farm Nursing Home provides accommodation, nursing and personal care for up to 46 older people, some of whom are living with dementia. There were 40 people living at the service at the time of our inspection. A new building was under construction at the time of our visit, which will replace the existing premises once completed. The provider planned for the new building to accommodate 72 people.

There was 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 and associated Regulations about how the service is run.

There were enough staff deployed to keep people safe and to meet their needs promptly. People were supported by staff that had the skills and experience needed to provide effective care. Relatives told us that staff knew their family members’ needs well and provided consistent care. Staff had induction training when they started work and access to ongoing training. Staff shared information about people’s needs, which ensured they received their care in a consistent way.

The provider made appropriate checks on staff before they started work, which helped to ensure only suitable applicants were employed. Staff understood safeguarding procedures and were aware of the provider’s whistle-blowing policy.

Risks to people had been assessed and measures implemented to reduce these risks. There were plans in place to ensure that people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly to keep the premises and equipment safe for use. People’s medicines were managed safely. People were supported to stay healthy and to obtain treatment if they needed it. Staff monitored people’s healthcare needs and took appropriate action if they became unwell.

Staff were kind and sensitive to people’s needs. People had positive relationships with the staff who supported them. Relatives said that staff provided compassionate care and were professional and caring. The atmosphere in the service was calm and relaxed and staff spoke to people in a respectful yet friendly manner. Staff understood the importance of maintaining confidentiality and of respecting people’s privacy and dignity.

The registered manager provided good leadership for the service and led by example in their values and approach to supporting people. People and their relatives had opportunities to give their views about the care they received and told us that the registered manager responded appropriately to any concerns they raised. Staff told us they had opportunities to express their views and raise any concerns they had. The provider had implemented an effective quality assurance system to ensure that key areas of the service were monitored effectively. Records relating to people’s care were accurate, up to date and stored appropriately.

During our inspection we had discussions with nine people who used the service, one relative, four members of staff, the cook and the registered manager.

People who used the service told us that staff asked for their consent before they undertook any tasks with or for them. One person told us, “Staff always ask me if they could help me. They never do anything without asking me first.”

People were complimentary about the food they received at the service. They told us they had a choice of menu and alternative meals were provided if they did not like the choices available.

People told us that the home was always clean and tidy. They told us that they liked their bedrooms. One person told us, “I like my bedroom and I can have my own private time.”

During our discussions people told us there were enough staff on duty at the service. One person told us, “Staff always have enough time to help me, they never rush.”

We found the service was compliant with the five outcomes we looked at.

We visited the service over two days. This was because a staff member raised some concerns with us on the first day which we explored in more detail on the second visit. People told us that staff were “Kind” and “They look after me well”. People told us that they felt involved in how their care was delivered. There were daily activities, for example playing bingo and going out for a meal. We saw records that staff had received training in safeguarding vulnerable adults. One person told us “I feel very safe here”.

We saw that cleaning routines were completed daily. We saw that people’s rooms and communal areas were clean and tidy and the home was free from unpleasant odours. We saw that administering of medication was recorded. People we spoke to were satisfied with the support they received with their medication. We looked at recruitment records for staff and saw that all staff had completed an application form and attended an interview before being appointed. We saw records of all checks required were undertaken for all staff before they started work at the service.

We spoke to staff who told us that they felt there were usually enough staff on duty to provide appropriate care and support to people who used the service. However, one member of staff told us they felt overloaded and had too much work to do. We saw that there was a complaints policy. One person told us “If I had to complain I would speak to my relative and they would speak to the manager”.

During this site visit we had formal discussions with six people who were living at the home.

People who used the service told us that they chose the home. One person stated that they were transported to the home by ambulance from a hospital, but they would certainly have chosen to live at the home had they been offered the choice.

They told us that staff talked with them and listened to what they had to say. They stated that staff would do as they asked them to. They said that their views were taken into consideration by staff, and they could make their views known about how the home was being run during the three monthly residents’ meetings.

People who used the service told us that staff respected their privacy, dignity and religious beliefs, and their personal care needs were always attended to in the privacy of their bedrooms. They told us that staff would always cover them when they were attending to their personal care needs.

They told us that they knew about their care plan, and that it informed staff how to care for them.

We were told by people that they felt very safe living at the home. They stated that if they had any concerns they would talk to the manager, but they had never had the need as they always felt safe and well looked after by the staff.

They stated that staff were very caring and they always talked to them. They told us that staff would knock on their bedroom doors and wait for a response before entering.