Archived: The Rock

Updated 14 May 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection consisted of one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type: The Rock is a care home. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. The manager was also the registered provider. A registered person is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: The first day of the inspection was unannounced. Inspection site visit activity started on 20 March 2019 and ended on 21 March 2019.

What we did: We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse. We sought feedback from the local authority safeguarding adults team, the quality team, community nurses and other professionals who work with the service. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection we spoke with six people and two relatives to ask about their experience of the care provided. We spoke with four members of care staff, the management team which included; the business manager, home supervisor and the registered manager who was also the registered provider.

We reviewed a range of records. This included four people's care and medicine records. We also looked at three staff files around staff recruitment, various records in relation to training and supervision of staff, records relating to the management of the service and a variety of policies and procedures developed and implemented by the provider.

Updated 14 May 2019

About the service: The Rock is a residential care home that provides personal care to 14 older people, some of whom were living with dementia.

People’s experience of using this service:

People told us they felt safe; however, we found people were not always protected from risks associated with their environment, medicines management and potential risks to people's health and welfare had not always been assessed.

People were not always protected by safe recruitment processes. The provider had not always obtained the necessary pre-employment checks before new staff started working at the service.

Systems and processes to monitor the service had either not been established or operated effectively to assess, monitor and mitigate the risks to people's health, safety and welfare. The provider’s quality assurance processes did not identify the issues we found at this inspection. These included concerns with the safety of the environment, risk management, recruitment and medicines management.

There was a risk that people's rights were not protected because staff did not always act in accordance with the Mental Capacity Act 2005 (MCA). Where people's capacity was in question MCA assessments were not always taking place and best interests decision processes had not always been followed.

Improvements were needed to ensure the service met the needs of people living with dementia. There was a lack of signage to help people living with dementia find their way around the home. People's bedrooms were not easily identifiable with nothing displayed on their doors. We made a recommendation to the provider about this.

People were supported by staff who had completed a range of training to meet their needs. Staff told us they felt well supported by the management team. The management team monitored staffs’ practice through regular observation but did not have a system of formal supervision meetings. We made a recommendation about this.

People received personalised care from staff who knew them well and understood how to meet their needs. Care plans contained information about individual preferences and what was important to people such as interests and activities. However, during the inspection we observed people were not engaged in meaningful activity and there was no information displayed within the home about activities on offer. We made a recommendation to the provider to review their activity provision at the service.

People and their relatives felt staff were kind, friendly, and attentive to their needs. We observed warm interactions and people were treated with kindness and care by staff. One person said, “I feel like one of the family. I am one of the family!” Another person said, “Staff look after us ever so well.”

People's privacy and dignity was respected, and their independence promoted.

People had access to healthcare professionals when required and were supported to maintain good healthcare. Health professionals we spoke with told us they were happy with the quality of care and engagement from the service.

Rating at last inspection: At the last inspection the service was rated Good (report published 18 October 2016).

Why we inspected: This was a planned inspection based on previous rating.

Enforcement: During this inspection we found four breaches of regulation. Action we told provider to take can be seen at the end of full report.

Follow up: We will carry out ongoing monitoring of the service and check the improvements have been made at our next inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk