7 July 2023
During an inspection looking at part of the service
Rodney House Care Home is a residential care home providing accommodation and personal care for up to 57 people in one adapted building. Rodney House predominantly cares for people who require support with their mental health and or have a physical disability. At the time of our inspection 47 people were living at the home.
People’s experience of using this service and what we found
The provider had failed to ensure a safety monitoring and management approach had been effective across the whole service.
We had previously highlighted concerns with the management of people’s medicines at the home and these concerns remained. We had also raised concerns regarding the home’s environment, including cleanliness and hygiene in certain areas, and some of these concerns also remained.
The provider and home manager were responsive to our concerns raised during this inspection. They took appropriate action and put plans in place to quickly resolve the concerns highlighted.
Since our last inspection, there was an ongoing program in place to help ensure that all staff had the required skills and competencies to support people well and safely.
We made a recommendation regarding the scope of the training provided.
People spoke positively about the home; one person told us “I’m really happy with this place.” Another person said. “It’s all good here.” People described staff as “kind” and “respectful”; one person told us, “The staff are really decent people, they make me forget I’m in a care home.” Staff spoke positively about people and supporting them to achieve good outcomes.
Assessing and managing risk in relation to people’s care planning was improved. There was a new care planning system in place. The new care planning system focused on people’s decisions, preferences and what they are able to do for themselves; along with identifying the areas of their lives in which they need some support.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
There were enough staff deployed at the home to meet people’s needs within a reasonable time.
Steps had been taken to help protect people from the risk of abuse.
A number of other audits had been effective at the home, and these had contributed to areas of improvement that we had seen. For example, audits on response to safeguarding concerns and the use of as required (PRN) medication.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 07 December 2022) and there were breaches of regulation.
At this inspection we found the provider remained in breach of regulations. This service remains in Special Measures and has been in Special Measures since December 2022.
Why we inspected
We undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Enforcement and Recommendations
At this inspection we have identified breaches in relation to safe care and treatment; the ongoing assessment of risks, safe management of medicines, maintaining a safe environment and effective governance of the home.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures
The overall rating for this service is ‘Requires improvement’. However, the service remains in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.