• Care Home
  • Care home

Rowans Residential Care Home

Overall: Good read more about inspection ratings

31 Goonown, St Agnes, Cornwall, TR5 0UY (01872) 552147

Provided and run by:
Mr & Mrs I J Hirsch

All Inspections

25 February 2023

During an inspection looking at part of the service

About the service

Rowans Residential Care Home is a residential care home providing personal care to up to 9 people. Some people were living with dementia. At the time of our inspection there were 8 people using the service.

People’s experience of using this service and what we found

People were protected from the risk of abuse and avoidable harm. People told us that they felt secure in the service and risks in relation to people's care were identified and managed to keep them safe. A relative told us, “We are overwhelmed with the kindness shown to [person’s name]. It is just like a home from home”.

There were enough staff to meet people's needs and ensure their safety.

Appropriate recruitment procedures ensured prospective staff were suitable to work in the service. 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.

People’s medicines were administered and managed safely. We looked at infection prevention and control and were assured the provider was protecting people, staff and visitors from the risk of infection.

The environment had equipment available to support staff when delivering care and support. Health and safety checks of the environment and equipment were in place. Systems were in place to support people in the event of an emergency.

The manager-maintained oversight of complaints, accidents and incidents and safeguarding concerns. The manager and staff engaged well with health and social care professionals.

The systems in place to monitor the quality of care within the service were effective. The manager promoted a positive person-centred culture and fully understood their responsibilities as a manager.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good published 20 March 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

10 February 2022

During an inspection looking at part of the service

The Rowans Residential Care Home is a service which provides care and support for up to 9 predominantly older people. People living at The Rowans Residential Care Home had physical health needs and mental frailty some with a diagnosis of dementia. At the time of this inspection there were 9 people living at the service.

We found the following examples of good practice.

The manager was communicating with people, staff and family members regularly to make sure everyone had an understanding of procedures and precautions being taken, and how to keep people safe. The manager worked with the care staff and housekeeping team to ensure infection prevention and control measures were followed.

The service was following current guidance in relation to visiting care homes. The service had identified a number of designated essential care givers. This is a person who can provide companionship, but also additional care and support. They can visit more often and during periods of COVID-19 outbreak. The manager told us if people were in receipt of end of life care visitors were not restricted. Visits to other people were arranged by appointment and took place in people’s rooms rather than communal areas.

The service had a committed staff team to ensure people received care and support in a safe and hygienic environment. People were supported in the service in accordance with national guidance. The staff team supported people and their relatives to understand the policies and procedures surrounding protection against COVID-19.

Additional cleaning protocols were in place to ensure all high touch points were regularly sanitised. We saw evidence of additional cleaning schedules and audits which showed additional systems had been added to increase infection control procedures during COVID-19 pandemic.

Personal protective equipment (PPE) was available to all staff and visitors. Staff and people living at the service were regularly tested for COVID-19.

All staff had received the necessary vaccinations to work in the care sector. The manager kept staff updated on any changes to guidance and all staff had received training in COVID-19 and infection control procedures.

We spoke with two people at the service. They told us they were satisfied with the way they received care and support. Comments included, “Just love it here,” “Spotless. The staff are on the ball,” “It’s so homey and the staff are lovely” and “Yes, All the staff wear their masks all the time. I feel very safe.”

24 February 2018

During a routine inspection

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 person told us “I have good and bad days. Yesterday was a bad day and I stayed in bed and staff looked after me.” Relatives told us the service always kept them informed of any changes to people’s health and when healthcare appointments had been made.

Care plans were well organised and contained personalised information about the individual person’s needs and wishes. Care planning was reviewed regularly and whenever people’s needs changed. People’s care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they wanted. Risks in relation to people’s care and support were assessed and planned for to minimise the risk of harm.

People told us they were able to take part in a range of group and individual activities. Care records showed that people took part in a range of activities. We saw people undertaking individual activities such as reading books, socialising, listening to music and watching TV.

People told us the food was “Great.” Staff supported people to maintain a balanced diet in line with their dietary needs and preferences. Where people needed assistance with eating and drinking staff provided support appropriate to meet each individual person’s assessed needs.

Staff were recruited in a safe way. There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes.

Staff were supported by a system of induction training, one-to-one supervision and appraisals. The induction and on-going training of staff ensured they were effective in their role. Staff knew how to ensure each person was supported as an individual in a way that did not discriminate against them. People’s legal rights were understood and upheld.

Management and some staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). They demonstrated their understanding of these principles in the way they cared for people. Staff believed that everyone at the service had the right to make their own decisions and respected them. The manager told us currently the people they supported had capacity to make decisions about their health and welfare and this was constantly reviewed. The manager knew the process to follow if a person’s level of capacity changed so that the service would act in accordance with legal requirements.

There was a management structure in the service which provided clear lines of responsibility and accountability. Staff had a positive attitude and the management team provided strong leadership and led by example.

People and relatives all described the management of the service as open and approachable. People and their relatives told us if they had any concerns, or comments about the service that they could approach the provider, manager or staff “without hesitation.”

People were asked for their views on the service regularly. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

29/10/2015

During a routine inspection

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.

14 December 2013

During a routine inspection

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.

21 February 2013

During a routine inspection

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.