This unannounced inspection took place on 13 and 14 December 2018. This was the first time the home had been inspected under this provider. At this inspection we found some breaches of regulations. You can see what action we asked the provider to take at the back of the full version of this report.

Rowley House Nursing Home is a ‘care 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. Rowley House Nursing Home can accommodate up to 35 people, based in one building. There were 24 people using the service at the time of our inspection, with one other person also living there who was in hospital.

There was no registered manager in post, although there was a manager who was in the process of applying to register with us. 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.

Quality assurance systems in place to monitor the service were not always effective at identifying concerns and prompt action was not always taken to ensure people’s care improved. Feedback sought from people and relatives was not always acted upon promptly. Feedback from other professionals was also not always acted upon quickly enough, so concerns identified continued to be an issue.

Medicines were not always managed safely and we could not be sure people were always getting them as prescribed. Risks were not always assessed and reviewed sufficiently to ensure lessons were learned. However, people felt safe and staff understood their safeguarding responsibilities. Staff were safely recruited to help keep people safe.

There was mixed feedback about staffing levels and the skills mix of staff had not always been considered. People were protected from possible infection by measures in place and the building was appropriately maintained.

People were not always supported to have maximum choice and control of their lives as the principles of the Mental Capacity Act 2005 were not always being followed, although staff did offer choices. Decisions made in people’s best interest were not always recorded. We could not be sure that all necessary Deprivation of Liberty Safeguarding (DoLS) referrals had been made as capacity assessments were not always undertaken or reviewed.

People did not always find the choice of food sufficient and felt the food needed improving. Staff received training and were supported in their role to care for people. People had access to other health professionals to help keep them well. The building was suitably adapted for the people living there and improvements to the décor were ongoing.

People found that staff were kind and caring and they were encouraged to be independent and to be involved in decisions about their care and support. People could personalise their bedrooms and there were no restrictions on visiting times for relatives.

People were not always sufficiently supported to partake in enough activities as staff were not always available. People and relatives felt that staff knew their preferences well, although further consideration of people’s protected characteristics would be beneficial. People felt able to complain and thought their feedback would be dealt with. Consideration had been given to people nearing the end of their life and arrangements made to ensure medicines were available so they would be pain-free.

People, relatives and staff were positive about the manager and felt the manager was approachable. Staff felt supported.