Our inspection of Rowland House took place on the 30 April 2018 and was unannounced.

Rowland House Care Home is registered to provide care, support and accommodation for up to seven people who have an acquired brain injury. At the time of our visit there were seven people living at the home. 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.

At the time of our visit a registered manager was present and 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.

We found that there was no over view or system of recording and monitoring all of the incidents and accidents. We also found that when certain events occured, the provider had failed to notify CQC where necessary. You can see what action we told the provider to take at the back of the full version of the report.

Relatives told us they felt their family member was safe living at the service. Staff had received training in relation to safeguarding and were able to describe the types of abuse and processes to be followed when reporting suspected or actual abuse. Risks to people were assessed and considered consistently.

There were sufficient staff present to safely meet people's needs. We observed staff being consistently present with each person throughout the day. We also saw that safe and correct checks had been completed in the recruitment process for all of the staff.

Staff were seen to check the medicine administration record (MAR) to check what medicine was required at what particular time. When medicine was given to people, staff explained what it was and made sure they had a drink, or other fluid to make it easy to swallow. People were protected against the risk of the spread of infections. The home environment was clean with no malodours.

Peoples’ needs and choices were assessed to make their care, treatment and support as effective as possible. In two care plans we saw clear and detailed pre admission assessments which assessed the care required for people. People’s relatives were very positive about the food at this service. We observed that people’s nutritional ad hydration needs were being met.

All staff had been trained in areas relevant to their role which was in line with the Care Certificate. The Care Certificate is an identified set of standards that health and social care workers adhere to in their daily working life. All staff were supported with frequent supervision by the manager.

We saw evidence of people being supported to access healthcare professionals when needed. The home had a gym in the basement which was frequently used by people and occupational therapists (OTs). The environment was suitably adapted for the people living there.

Where there were restrictions in place, staff had followed the legal requirements to make sure this was done in the person's best interests. Staff consistently sought consent from people. Staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made for people in the least restrictive way.

Relatives told us that they felt staff treated their family member with kindness, respect and compassion. Staff promoted people’ privacy, dignity and independence. Peoples independence was promoted.

Where there had been complaints made there had been clear action taken to address the concerns.

There were plans in place for person centred end of life care in each care plan. We saw one care plan which had a detailed booklet specifying the steps, contacts and relevant facts to one person and thei

This inspection took place on the 1 March 2016 and was unannounced.

Rowland House Care Home is registered to provide care, support and accommodation for up to seven people who have an acquired brain injury. At the time of our visit there were seven people living at the home.

At the time of our visit a registered manager was 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. At the time of our visit the registered manager was on annual leave, however a senior member of staff assisted us with our inspection. We had a telephone conversation with the registered manager following the inspection.

Not all records at the home had been accurately maintained. We found there were gaps in the recordings of medication people had received and the daily recording of the temperatures where medicines were stored. However, these issues had been identified in the quality assurance monitoring as were being addressed by the registered manager.

People told us they felt safe living at the service. Staff had received training in relation to safeguarding and were able to describe the types of abuse and processes to be followed when reporting suspected or actual abuse.

Staff had received training and regular supervisions that helped them to perform their duties. New staff received a full induction to the service which included training.

Where there were restrictions in place, staff had followed the legal requirements to make sure this was done in the person’s best interests. Staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made for people in the least restrictive way.

People and relatives we spoke with were positive about the care provided and their consent was sought. People were positive about the caring nature of the home and all the people we spoke to consistently said that they liked the home. People told us that staff treated them with respect and attended to their personal care needs in private.

People’s care and health needs were assessed and they were able to access all healthcare professionals as and when they required.

People’s nutritional needs had been assessed and people were supported by staff to eat and drink as and when required. The menus provided a choice of meals and people were able to choose a meal that was different to the menu choices. People and their relatives were complimentary about the food provided.

Documentation that enabled staff to support people and to record the care and treatment they had received was up to date and regularly reviewed. People had signed their care plans and were involved in writing and reviewing their plans of care. People’s preferences, likes and dislikes were recorded and staff were knowledgeable about the care needs of people.

Relatives, partners and friends were encouraged to visit and people were supported to go out with their visitors.

Staff showed kindness and compassion and people’s privacy and dignity were upheld. People were able to spend time on their own in their bedrooms and their personal care needs were attended to in private.

There were enough staff to ensure that people could undertake their activities and to meet the assessed needs of people. Staff encouraged people to be independent and to do things for themselves, such as cooking and doing their own laundry.

People and relatives told us they thought the home was well run and they were able to have open discussions with staff. People told us they were able to raise concerns and make complaints if they needed to.

Staff were knowledgeable about the values and visions of the service and worked in line with these. Staff were also aw

During our inspection we spoke with the registered manager, one person who used the service and a member of staff. People told us that the service was always clean and tidy and their bedroom was cleaned every day.

During our inspection we spoke with five people who used the service, one relative, four members of staff and the registered manager.

People who used the service told us they were happy living at the service. People told us they had a care plan and this was discussed with them. One person told us, “I look at my care plan with my key worker every month.”

People told us they made decisions for themselves but staff helped them if they found things difficult to understand. One person told us, “Staff helped me to understand why I had to attend a hospital appointment for my toe.”

People told us that the food was always good and they chose the menu every week. One person told us, “I cook my own meal once a week.” Another person told us, “I make soup for everyone on a Monday.” People also told us that the home was always clean, tidy and never had any smells.

We found the service was non-compliant with one of the six outcomes we looked at.

People who used the service told us that they made choices every day that included choosing their bedtimes, the food they would like to eat and the clothes they wanted to wear. We saw staff supporting people to plan their activities, for example, a member of staff supported one person to access their E Mails so they could communicate with the cinema museum to make the necessary arrangements. One person told us, “We do activities every day.” People told us that staff looked after them well and that they were happy living at the home. They stated that if they ever felt unsafe at the service they would talk to their key worker. One person told us, “I would talk to the manager.” They told us that the staff always listened to what they had to say and would do as they asked them. People who used the service told us that they had a care plan and they had seen them. One person told us, “My key worker goes through my care plan with me every month.”

We saw two care plans that were person centred and provided information for staff on how the person liked their assessed needs to be attended to.

Staff were knowledgeable about safeguarding adults and we saw that they had received training in regard safeguarding adults.

We saw records of supervision and appraisals. This demonstrated that staff were able to discuss their performance with the manager and identify training and development needs.