Rookery House

Updated 26 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector.

Service and service type

Rookery House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Rookery House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, a new manager had recently been appointed to the post. They had not yet submitted their application to register at the time of the inspection.

Notice of inspection

This inspection was unannounced.

We visited the service on 12 and 18 June 2023. We reviewed documents remotely and spoke with staff, relatives and professionals. We met with the manager and regional manager remotely and gave feedback on our findings at the end of the inspection process on 21 June 2023.

What we did before inspection

We reviewed information we had received about the service since the date they were registered. We sought feedback from the local authority, Healthwatch England and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We are improving how we hear people’s experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool and an observation tool called ‘SOFI’. For this inspection, the symbol based tool was not appropriate. The inspector used some speech, Makaton and observations to try and seek people’s views. These were conducted over 2 unannounced visits, one of them out of hours on a Sunday.

We read people’s care and communication plans and spoke with 6 members of staff including the manager, regional manager and 4 support staff. We spoke with 1 relative and 2 professionals to gain their views. We reviewed 2 staff recruitment records including their supervision and induction records. We reviewed various audits and other quality assurance documents and policies.

Updated 26 July 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Rookery House is a residential care home providing personal care to 1 person at the time of the inspection. The service can support up to 1 person.

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

Right Support:

The service did not always give people care and support in a safe, well-maintained environment that met their sensory and physical needs.

People were supported to pursue some interests but did not have goals in place that identified future aspirations and guided staff about how to support them in a consistent way. Staff did not always communicate with people in ways that fully met their needs.

Staff supported people to make decisions following best practice in decision-making. The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

People were supported to have maximum choice and control of their lives and most staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff enabled people to access specialist health and social care support in the community. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care:

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

The service had enough appropriately skilled staff to meet people’s needs. Staff had training on how to recognise and report abuse and they knew how to apply it and who to report any concerns to.

Staff had not yet received training in the persons preferred communication method. Clear systems of communication were required to support people to further develop their methods of communicating and ensure they were able to better express their views.

People’s care, treatment and support plans reflected their current needs and this promoted their wellbeing and enjoyment of life. People could choose how to spend their time and pursue interests. Staff assessed risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

Staff and managers did not effectively evaluate the quality of support provided to people in relation to how they spent their time and what skills they had achieved. Relevant information about progress and outcomes was not recorded.

People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Staff placed people’s wishes, needs and rights at the heart of everything they did and knew people well.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. People and those important to them were involved in planning their care.

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

Rating at last inspection

This service was registered with us on 25 August 2021 and this is the first inspection.

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.

Enforcement

We have identified breaches in relation to safety, the environment, effective audits and staff supervision and support at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.