Rowena Court is registered to provide accommodation for persons who require nursing or personal care for up to six adults aged over 60 who experience a long term mental health condition. At the time of our inspection there were five people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post when we inspected the home. 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.

People were at ease around care staff that understood how to keep people safe and had received training. Staff understood people’s individual circumstances. Staff understood who to report concerns to as well as the risks to people’s health. Staff understood people’s health needs and the risks to their health. Recruitment processes for staff included background checks. People accessed support from staff when needed. People’s support with medicines was reviewed and checked to ensure people received their medicines in line with guidance for that person.

Staff were supported through training and supervision. Staff supporting people understood the importance of obtaining their consent. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff supported people to maintain a healthy diet and encouraged to make healthy choices in the food they chose. People were also supported to attend appointments with healthcare professionals and could seek additional help if needed.

People knew and liked the staff supporting them and had known them for some time. Staff understood people’s individual care needs, preferences and understood people’s cultural backgrounds. Staff involved people in their care by explaining choices and supporting people to make decisions about their care. People were supported by staff who understood what it meant to support people with dignity and respect.

Staff understood people’s needs and how to support them. People’s that were new to the home were supported so that staff could gradually get to know them and provide the support they needed. People understood they could speak with staff and the registered manager about their care if they had any concerns.

People knew and liked the registered manager. Staff spoke positively about working at the home and felt part of a team that was well supported. Staff felt able to seek help and guidance if they required it. Regular reviews of people’s care and quality audits ensured people’s care planning was timely and up to date. The registered manager worked with other stakeholders to ensure people received the care they needed.

Further information is in the detailed findings below

This unannounced inspection took place on 9 December 2015. At our last inspection in April 2013, we found that the provider was meeting the regulations that we assessed.

Rowena Court is registered to provide accommodation for persons who require nursing or personal care for up to 6 adults aged over 60 who experience a long term mental health condition. At the time of our inspection there were 5 people using the service.

The manager was registered with us as is required by law. 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 that safe medicines storage, staff competency checks and guidance for staff in relation to ‘as required medicines’ were lacking. Staff were provided with training and were knowledgeable about how to protect people from harm. The service had a suitable amount of staff on duty with the skills, experience and training required in order to meet people’s needs. Recruitment systems ensured that the staff who were recruited had the right skills and experience to support people safely.

Staff were well trained, received a comprehensive induction and were provided with on-going supervision for their development. People were supported to access the nutrition they needed and were monitored for any changes in their dietary needs. The service ensured that people had access to a wide of range of healthcare professionals to maintain their health and well-being.

We observed staff interacting with people in a positive and respectful manner. People spoke to us about how genuinely caring and kind staff were towards them. People told us they were encouraged to remain as independent as possible by staff. We observed staff ensured people’s privacy and dignity was maintained.

People were consulted about all aspects of the planning of their care and in relation to the daily activities they were involved in. Activities available within the service were centred on people’s individual abilities, preferences and interests. The provider regularly sought feedback and the opinion of people using the service using a variety of methods. People knew how they could make a complaint and the provider’s complaints process was clearly displayed for people to refer to.

All of the people and staff we spoke were very complimentary about the quality of leadership within the service. The registered manager and deputy manager undertook regular audits to reduce any risks to people and ensure that standards were maintained. Feedback was actively sought and acted upon from people.

We spoke with three people living at the home and with one staff member. People we spoke with were very happy living at the home and one person we spoke with said, “This home is bar far the best”.

We saw that people were involved in making choices about what they wanted to do and what they ate and drank.

We found that people's needs were appropriately assessed and planned to ensure that care received was safe and appropriate. However, we found that the fire exit at the rear of the home was not sufficiently cleared to allow easy access in case of an emergency evacuation.

The service took steps to prevent abuse by ensuring that staff recognised the signs of abuse, understood safeguarding processes and whistle blowing procedures.

We found that staff received appropriate training and supervision to develop their skills and competency in meeting the needs of the people they supported.

The home monitored the quality of service that people received through regular reviews. It improved the service by taking account of comments and complaints and regularly assessing service through audits.

There were four people living at the home when we visited. We spoke with three people. One person said, ''I like it here'' and a relative said “They have got some wonderful staff”.

We saw that people were involved in making choices about what they wanted to do and where they wanted to go. Pone person we spoke with said, “I bough my Christmas presents, staff came with me to see if I was okay”.

We found that people's needs were appropriately assessed and planned to ensure that care received was safe and appropriate. People told us they were happy with the care they received. One person told us, "We’re looked after excellent, staff are brilliant”.

Staff knew how to safeguard people from harm and felt confident that if they had to report any abuse, action would be taken to protect people.

We saw that people’s health and welfare needs were met by competent staff that had appropriate supervision and training.

There was a system to monitor the quality of service people received through regular reviews and audits.

We spoke with people who told us that they were involved in their care. We heard from people that the registered manager had gone through their care plans with them and that they were well looked after.

One person told us that they “get the right care” and that there were resident meetings to discuss what they liked and disliked. We were also told by people that they “feel listened to”.

We looked at the visitors’ book for the service which had positive comments from other people who had visited. We saw comments that said the home was “clean” and that it “felt like home”.

We saw that questionnaires had been filled in and people told us that staff either explained the questions or they could complete them alone. The feedback was positive from the questionnaires and people said that the menu choice was good.

We saw that people were well presented, clean and looked content at the time of our visit.

People said that they “couldn’t find a better establishment than this” and that it was the “best home I’ve been in”.

People told us about the things that they like and said that they have choices open to them. People also told us that they suggest the menus and staff ask them what they would like for meals.

One person told us that they could go out in their wheelchair and staff will help them to go to shops of their choice.

People told us that there were different activities available to them and that they could go out on the bus or taxi which the staff arranged. One person told us that “staff are very good and staff will go with you day or night to outings”.

We heard from people that the holidays are very well planned and that they had been to a holiday camp in Minehead. The choice of the holiday was made at a residents’ meeting where people put different ideas forward.

People told us that they “feel safe” and if they had any issues they would “tell staff”. One person also told us that the Deputy Manager was “very good at making things ok”.