Romford Nursing Care Centre

Updated 12 November 2021

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 Care Act 2014.

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

The inspection was carried out by one inspector, a nurse specialist advisor 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

Romford care 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we already held about this service. This included details of its registration, previous inspection reports and any notifications of significant incidents the provider had sent us. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service and twelve relatives about their experience of the care provided. We spoke with 13 members of staff including four care staff, a maintenance worker, one domestic staff, the chef, two nurses, the clinical lead, the dementia experience lead for the provider, the registered manager and a director for the provider. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included seven people’s care records and multiple medicines records. We looked at seven staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at staff rotas and information the provider sent us around health care.

Updated 12 November 2021

About the service

Romford Nursing Care Centre is a residential care home which was providing personal and nursing care to 47 people at the time of the inspection. Most people living at the service were older people, some of whom had dementia. The service can support up to 114 people in one adapted building over three floors. At the time of our inspection three of five units were in use, of these working units, two were nursing units.

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

Medicines were mostly managed in a safe way. We have made a recommendation to follow best practice so wording in some medicine protocols was clearer. People’s risks were assessed and monitored. Staffing levels had improved since our last inspection and the provider was actively engaging in recruitment. Recruitment processes were robust. There were systems in place to safeguard people from abuse. The service followed national guidance and infection prevention and control. Lessons were learned when things went wrong as there were processes in place to learn from incidents which had occurred.

Staff had received training and supervision to support them in their roles. People were supported with nutrition and hydration to ensure balanced diets. The provider had adapted the building to ensure it met people’s needs. People’s needs were assessed before the commencement of care so the provider was assured they could meet those needs. Staff communicated with other agencies to ensure people received good care. 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 and relatives were involved in completing care plans.

People and relatives thought staff were caring. People were supported to express their views. People’s privacy and dignity were respected, and their independence promoted.

The provider responded to people’s complaints appropriately. People’s communication needs were met. People were supported to undertake suitable activities they could enjoy. People’s care was planned to meet their needs. The service sought to record people’s end of life wishes.

Staff understood their roles and the registered manager fulfilled regulatory requirements. There were quality assurance systems in place which supported the provider to improve the care and support people received. People, relatives and staff thought highly of the management. The registered manager understood duty of candour and acted appropriately where required. The service worked with other agencies to the benefit of people using the service. People, relatives and staff were able to engage with the provider and be involved with decisions that affected the outcomes of the service.

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 requires improvement (published 27 September 2019) and there were multiple breaches of regulation. The provider was issued warning notices for regulation 12, Safe care and treatment and also for regulation 17, Good governance.

Further breaches of regulation were found in relation to regulation 18, Staffing and regulation 14, Nutrition and hydration at a targeted inspection in 2020. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.