Rowan Cottage

Updated 10 April 2020

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.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Rowan Cottage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 did not have a manager registered with the Care Quality Commission. A registered manager is a person who is legally responsible for how the service is run and for the quality and safety of the care provided. It is a requirement of the provider’s registration that they have a registered manager. The previous registered manager left the service in November 2019 and a new manager was appointed on 3 February 2020. The new manager who will be referred to as the manager throughout this report, had previously been the deputy manager at the service for three years. The manager had commenced the CQC process to become the registered manager of Rowan Cottage.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including notifications received from the provider. The law requires providers to send us notifications about certain events that happen during the running of a service. We sought feedback from the local authority and professionals who work with the service. We reviewed the provider’s website. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people who used the service about their experience of the care provided. We spoke with 14 members of staff, including the registered manager, deputy manager, assistant manager, assistant regional director, two senior support workers, three support workers, the activities coordinator, an apprentice support worker, two night time support workers and a member of bank staff.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at six staff files in relation to recruitment and staff supervision and a variety of records regarding the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records and documents which detailed successful outcomes achieved by people. We spoke with six health and social care professionals who visit the home and seven relatives of people who use the service.

Updated 10 April 2020

About the service

Rowan Cottage is a residential care home without nursing situated in Burghfield, Berkshire, providing care and accommodation for up to nine people with a learning disability, autistic spectrum disorder or mental health needs. It is a bungalow with an annexe and an enclosed garden. At the time of the inspection there were nine people living at the service, eight in the main house and one in the self-contained ground floor annexe.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service

Support and care provided by staff was extremely personalised. Keyworkers went the extra mile to find out about people’s life histories, to ensure they had as much information as possible to inform the care planning process. Excellent consistency and continuity of care provided by a stable staff team has had a major impact on people’s quality of life. Visiting professionals consistently told us that the service was focused on providing person-centred care and support, which achieved exceptional outcomes for people. Staff were particularly skilful in supporting people to maintain relationships which were important to them and their emotional wellbeing.

Arrangements for social activities, education and work, were innovative, varied, highly individualised and followed best practice guidance so people can live as full a life as possible. Staff were exceptional at developing bonds between people living in the home and supporting them to be mutually supportive of people in achieving their goals. Staff tenaciously supported people to achieve their ambitions and aspirations.

People and their relatives knew how to complain and were confident the registered manager and staff would listen and take appropriate action if they raised concerns. People’s mental health needs had been sensitively considered when exploring their end of life wishes.

People consistently told us they felt safe living in the home. Staff had completed required training and understood their responsibilities to safeguard people from discrimination, harm and abuse. Staff had identified risks to people and effectively implemented measures to ensure these were reduced and managed safely. People were supported by enough staff who knew them well and how to meet their changing needs. The provider completed thorough selection procedures to ensure staff were of suitable character to support people with mental health needs. People received their prescribed medicines safely, from staff who had completed the required training and had their competency to do so regularly assessed. People lived in a home which was clean, hygienic and well maintained.

People's needs were met by staff who had the necessary skills and knowledge to carry out their duties effectively. The manager operated a system of training, supervision, appraisal and competency assessments, which enabled staff to provide good quality care. Staff promoted people's health by supporting people to access health care services when required and by encouraging people to eat a healthy diet.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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.

Staff consistently treated people with kindness and compassion. People were supported to express their views and wishes about their needs, which were respected by staff. People's privacy and dignity were promoted by staff during the delivery of their care.

The registered manager effectively operated quality assurance and governance systems to drive continuous improvement in the service. Staff worked well in collaboration with key organisations to ensure the safe and effective delivery of people’s care.

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

Rating at last inspection:

The last rating for this service was outstanding (report published 13 July 2017).

Why we inspected

This was a planned comprehensive 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.