Rowans Residential Home is a ‘care home’ that provides accommodation for a maximum of nine adults, of all ages, with a range of health care needs and physical disabilities. At the time of the inspection there were nine people living at the service. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rowans provides accommodation over two floors. Some bedrooms are on the ground floor where communal areas are also present. The remaining bedrooms are on the first floor which is accessed by chair lifts. Staff continuously monitor people if they remain in their rooms to ensure people’s needs are met at all times. People are able to access garden area. The home is near to St Agnes which people visit regularly.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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. Rowans have been owned by the provider for many years and it is a family run business.

We carried out this announced inspection on 24 February 2018. At the last inspection, in October 2015, the service was rated Good. At this inspection we found the service remained Good.

On the day of the inspection there was a calm, relaxed and friendly atmosphere in the service. We observed that staff interacted with people in a caring and compassionate manner. We spoke with all the people at the service to gain their views of the service. They all told us they were happy with the care they received and believed it was a safe environment. Comments from people included, “All the staff are wonderful”, “it’s lovely here”, “I feel very lucky to be here.”

Staff ensured people kept in touch with family and friends. Relatives we spoke with told us they were “delighted” with the care that their family members received. Comments included “It’s a lovely atmosphere; it’s a real family here.” Relatives told us they were always made welcome and were able to visit at any time.

Staff said they were proud to work at Rowans and told us “This is our extended family” and “We [staff] love working with the residents and relatives and we work well as a team.”

People were protected from abuse and harm because staff understood their safeguarding responsibilities and were able to assess and mitigate any individual risk to a person’s safety. People said they felt safe at Rowans, and relatives echoed this view.

The service was warm, comfortable and appeared clean with no unpleasant odours. The service was well maintained. People were pleased with their private bedrooms and had decorated them to reflect their preferences and tastes. People were treated with kindness, compassion and respect.

The service had suitable arrangements for the storage and disposal of medicines. Medicines were administered by staff who had been trained and assessed as competent to manage medicines. The manager had contacted the pharmacist as there had been difficulties with the service receiving some people’s prescribed medicines in a timely manner. The manager had liaised with the GP to ensure that medicines that were delayed in being sent to them were available to administer for people. Whilst there had been a difficulty with gaining some medicines it had not impacted on the health of people using the service.

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Rowans. Staff were prompt at recognising if a person’s health needs had changed and sought appropriate medical advice promptly. One perso

We spoke with five people who used the service at the time of our inspection regarding their experiences of the care and treatment provided to them. All of the people we spoke with told us their experience had been positive and we judged that people were treated as individuals and received person centred care and support. Comments made by people we spoke with included; “I have nothing but praise for this home” and one person remarked that staff were, “Absolutely lovely and very kind”.

We found there were suitable arrangements in place for obtaining, and acting in accordance with, the consent of people who lived at The Rowans Residential Care Home in relation to the care and treatment provided for them.

We found the nutritional needs of people were met and that there was a choice of food provided that was of a good quality.

Medications were managed safely and staff ensured people received their medication in a timely way and as per their prescriptions.

The home had an effective complaints system which identified, handled and responded appropriately to complaints and comments made by people who used the service.

All three of the people that we spoke with were happy and complementary about the service they recieved. Their comments included, “you couldn’t have any better care” and “it’s very very good here.” We also spoke with two relatives who were also complementary and said, “they fall over themselves to help” and “nothing is too much trouble”.

People’s privacy, dignity and independence were respected and they experienced care and support that met their needs and protected their rights.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

This unannounced inspection of Rowans Residential Care Home was conducted by one inspector on 29 October 2015. The service provides accommodation and personal care for up to nine people who do not require nursing care. At the time of this inspection there were nine people living at the service.

The service had a registered manager but on the day of our inspection they were unavailable. 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.

The service was previously inspected in December 2013 at which time we found they had fully complied with the requirements of the regulations.

People told us they were safe and well cared for at Rowans Residential Care Home. We saw people were relaxed and comfortable in the service. People readily approached staff when they wished to be supported and staff respected people’s privacy and dignity. People told us, “all the staff are really good”, “I am well looked after” and “[the staff] are lovely, good as gold, no faults at all.” While people’s relatives commented, “my relative is well looked after we have no complaints.”

Professionals were complimentary of the service and the high standard of care and support it provided. Comments from professionals included; “I think it’s a good home”, “It’s lovely and friendly. I was trying to get [my relative] in here but there was no room” and, “if I was searching for a place for a relative I would wait for a place here.”

We found there were sufficient staff available to meet people’s care needs and professionals commented, “They seem to have enough staff.” People told us, “If I press the bell they come straight away, I am never kept waiting.” We observed that call bells were consistently positioned within people’s reach and that staff responded promptly to people’s requests for care or support.

The service had a very stable staff team and no new staff member had been employed since our previous inspection in December 2013. Staff records demonstrated all staff had received regular training updates and appropriate supervision. Staff told us, “the supervisions are good but we are such a small home we can work things out together.”

The service was well led by the provider who lived next door. Staff were well motivated and focused on ensuring people needs were met. Staff told us “[The provider] is lovely” and one person told the provider “you are useful aren’t you.”

People’s care plans had not been regularly updated to ensure they accurately reflected people’s current care needs. Although these documents required improvement this had not adversely impacted on the quality of care that people received. Staff demonstrated throughout our inspection a detailed understanding of people’s individuals care needs.

Staff knew people well and quickly recognised any changes to their health or care needs. Prompt referrals were made to relevant healthcare services by staff to ensure the wellbeing of the people they supported. One person told us, “the dentist came here yesterday as I lost a filling in my tooth” while professionals commented, “they do follow advice and will let us know if it doesn’t work.”

The provider and staff understood the requirements of the Mental Capacity Act 2005 (MCA). Staff consistently respected peoples’ choices and there were appropriate systems in place to ensure that if the service needed to make decisions on someone’s behalf they were made in the person’s best interests.

Activities within the service were predominantly provided on a one to one basis as most people chose to spend time in their rooms. Staff regretted the declined in group activities within the home but had respected people decisions. Staff comments about activities included; “We have a singer once a month and people will come down for that, it’s a good social event”, “and, “we try to come up with new ideas but people don’t want to and that is their choice to make”. People told us they enjoyed the regular religious services and musical events but confirmed they now preferred to spend more time in their own rooms.

The provider valued people’s feedback and was in the process of conducting an annual survey at the time of our inspection. Initial responses had been complimentary and we found the service had not received any complaints since our last inspection.