Rosehill House Residential Home

Rosehill House residential Home is a care home without nursing registered to provide accommodation and care for up to 30 people. People living at the service are older people, some of whom may be living with dementia. At the time of our inspection there were 27 people using the service.

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

We last inspected the service in November 2022. At that time, we had concerns regarding the management of medicines and Rosehill House Residential Home was rated Requires Improvement. We identified checks and monitoring that had not always been completed.

At the previous inspection we found the management of medicines was not always safe. We previously found that records were accessible but not always up to date. Audits had not picked up that medicine’s records were not always accurate. Medicines administration records (MAR) were now stored securely, records were now maintained, and no gaps were found in MAR. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

The environment was safe and there was equipment available to support staff in providing safe care and support. Health and safety checks of the environment and equipment were in place.

People told us they were happy with the care they received, and people said they felt safe living there. Comment from one person was, “Yes I am safe here.” People looked relaxed, happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service. A relative told us, “If they are happy- then I’m happy.” While a professional commented, “It’s a well-respected care home within the GP practice” while another professional said, “I can honestly say that this is one of the best.”

The service used a computerised care planning system that enabled the staff to add information straight away via handheld devices. Records were accessible and up to date. The management and staff knew people well and worked together to help ensure people received a good service.

Staff were recruited safely in sufficient numbers to ensure people’s needs were met. There was time for people to have social interaction. There was not a designated activities staff member currently, however the registered manager hoped to recruit one soon. Currently staff planned and carried out activities. Staff knew how to keep people safe from harm.

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 were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. One visiting professional said, “The registered manager and the staff will also contact us in a timely manner.”

Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. People’s communication needs were identified, and where they wanted, people had end of life wishes explored and recorded.

Staff told us the registered manager was available and assisted them. They went onto say how they were approachable and listened when any concerns or ideas were raised. A staff member said, “Very happy working here.”

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 25 February 2022).

Why we inspected

We carried out this inspection to follow up on the breaches of regulation from the previous inspection.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosehill House Residential Home on our website at www.cqc.org.uk

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.

Rosehill House Residential Home is a care home that provides accommodation and personal care for up to 30 adults some who are living with dementia. At the time of the inspection 28 people were living at the service.

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

People and their relatives told us they were happy with the care they received, and people said they felt safe living there. A relative said; “She, my relative, tells me it’s like a 5 staff hotel.” One professional said; “Staff are brilliant- all very good.” People looked happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service. One person said; “I’m happy with the care I receive.”

People were supported by a service that was well managed. Records were accessible and up to date. However, audits had not picked up that medicine’s records were not always accurate. The management and staff knew people well and worked together to help ensure people received a good 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 were supported by staff who completed an induction, training and were supervised. Staff were recruited safely in sufficient numbers to ensure people’s needs were met. There was time for people to have social interaction and activities with staff. Staff knew how to keep people safe from harm. However, some staff were absent from work at the time of the inspection. Staff were covering shifts so they were not short of staff.

The environment was safe and improvements were being made. People had access to equipment where needed.

Staff received appropriate training and support including fire safety and mental health training to enable them to carry out their role safely.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. One professional said the service was very good at contacting them appropriately.

Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. People’s communication needs were identified, and where they wanted, people had end of life wishes explored and recorded.

People were involved in menu planning and staff encouraged them to eat a well-balanced diet and make healthy eating choices. Special diets were catered for. One person said; “I’m pleased with the new cook, they do diabetic cakes which are lovely.”

Staff told us the registered manager of the service worked alongside them to cover shifts when other staff had been off work. They went onto say the registered manager was approachable and listened when any concerns or ideas were raised.

People and their families were provided with information about how to make a complaint and details of the complaint’s procedure were displayed at 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

The last rating for this service was good (published 21 December 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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 intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

Rosehill House is situated in Par, near the town of St Austell. It is an older style property with an extension. Accommodation is offered on two floors, which are connected by a shaft lift and stairs. There is a range of aids and adaptations in place to meet the needs of people living there. There were people living at the service who were living with dementia and were independently mobile. On the ground floor there are two lounges and a dining area. The majority of bedrooms are for single occupancy, some have en-suite facilities and others share bathroom facilities. There was a garden which people could use.

This unannounced comprehensive inspection took place on 1 December 2018. At the last inspection, in January 2016 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. People told us they were happy with the care they received and believed it was a safe environment. One commented, “It’s been amazing here, staff are great, food is great, I have received so much support”. Relatives and health and social care professionals echoed this view.

We spent time in the communal areas of the service. Staff were kind and respectful in their approach. They knew people well and had an understanding of their needs and preferences. People were treated with kindness, compassion and respect. A visitor commented, “No matter when I come, I’m always welcomed, the staff are always smiling, it’s always clean, and my friend is just so well cared for here.”

The service was comfortable and appeared clean. People’s bedrooms were personalised to reflect their individual tastes.

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.

Some people were at risk of becoming distressed or confused which could lead to behaviour which might challenge staff and cause anxiety to other people. Care records contained information for staff on how to avoid this and what to do when incidents occurred.

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.

Accidents and incidents that took place in the service were recorded by staff in people’s records. Such events were audited by the manager. This meant that any patterns or trends would be recognised, addressed and the risk of re-occurrence was reduced.

Information about people’s care would be shared at daily handovers to ensure consistency of care practice could then be maintained. This meant that there were clearly defined expectations for staff to complete during each shift.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards (DoLS) were understood and applied correctly.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy. People told us, “I have needed to alter the buttons on my clothes as the food is so good here”.

Some people commented they enjoyed the activities provided by the service. Other people told us they chose not to join the activities provided but pursued their own interests such as reading, needlework and going out with family. Staff supported people to keep in touch with family and friends.

Staff were supported by a system of induction training, supervision and appraisals. 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 told us they enjoyed working at Rosehill house and that they worked well as a team. All staff stated they felt supported and were able to approach the registered manager and assistant manager if they had any issues.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. Audits were also in place to monitor the standards of the care provided.

We carried out this inspection on 25 January 2017. At the last inspection, in November 2014, the service was rated Good. At this inspection we found the service remained Good.

People who were able to talk to us about their view of the service told us they were happy with the care they received and believed it was a safe environment. People and their relatives commented, “It’s fine here, I am very happy” and “We are very happy with the home.”

Where people were unable to tell us about their experiences we observed they were relaxed and at ease with staff. People had good and meaningful relationships with staff and staff interacted with people in a caring and respectful manner. Comments from people about staff included, “Staff are lovely” and “Staff are good.” A healthcare professional said, “Staff have good communication skills.”

People were able to take part in a range of activities of their choice. Where people stayed in their rooms, either through their choice or because they were cared for in bed, staff spent one-to-one time with them. This helped to prevent them from becoming socially isolated and promoted their emotional well-being.

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse. Staff ensured people kept in touch with family and friends. Relatives told us they were always made welcome and were able to visit at any time.

Safe arrangements were in place for the storing and administration of medicines. People were supported to take their medicines at the right time by staff who had been appropriately trained.

Staff supported people to access to healthcare services such as occupational therapists, GPs, community nurses and chiropodists. Comments from healthcare professionals included, “Staff work well with us, they always follow any instructions we give”, “The home is quick to report any concerns about people’s health needs” and “The monitoring of people who are cared for in bed is very good and the incidents of pressure sores are extremely low.”

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Rosehill House. Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. Details of how people wished to be supported were personalised to the individual and provided clear information to enable staff to provide appropriate and effective support. Any risks in relation to people’s care and support were identified and appropriately managed.

There was a wide range of meals on offer and staff were knowledgeable about people’s likes, dislikes and dietary needs. People told they enjoyed their meals. People and their relatives said, “The meals are excellent”, “The food is lovely” and “Mum enjoys the food.”

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to apply the principles of the MCA in the way they cared for people.

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. Comments from staff included, “I absolutely love working here”, “This is the best home I have worked in” and “We are a great staff team. For all of us this isn’t a job, it’s just like looking after someone in our own family.”

People and relatives all described the management of the home as open and approachable. One relative told us, “We are very happy with the home. We looked around other homes and thought this was the best one.” People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

We were also told that the Safeguarding policy had been updated. A flow chart to indicate the reporting process, should abuse occur, was on display in the home. Staff confirmed they had knowledge of this.

During our observations we saw staff help two people to mobilise. We also saw staff conversed with people when they were delivering personal care. We saw people talked to each other in the lounge areas.

We witnessed staff interactions with people which were positive. People told us staff answered call bells promptly. One person said the staff were 'polite and friendly'. Another person said,'I am very happy here, no complaints'. People told us the food was good and they were offered choices. We were told visitors were welcome. One person said, 'I can go to bed when I want, if I wanted to go out someone would take me'. Another person told us they were involved in the planning of their care.

We heard care workers ask people what they would like to do and they gave them ideas if people could not make a choice.

People who used the service told us and we observed that they were enable to make choices on how they spent their day. Care plan documentation identified people's preferences and through our observations we saw that staff were aware of these.

People who lived at Rosehill House told us that staff were kind and helpful. People told us that they were pleased with the care that they received from the staff. Staff told us that they liked to work at Rosehill House.

The training and supervision provided to staff was not up to date. Some staff members had not received sufficient training at Rosehill House to ensure that people who used the service continued to receive a quality care service.

We observed that all areas of the home were clean, hygienic and odour free.