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Rosewood Lodge Requires improvement


Inspection carried out on 30 August 2016

During a routine inspection

The inspection took place on the 30 and 31 August 2016 and was unannounced. At the last inspection in December 2013 the provider was found to be meeting all of the standards inspected.

Rosewood Lodge residential home provides care and accommodation for up to 20 people. On the days of the inspection 19 people were living at the home. The home was over three floors, with access to all floors either via stairs or the lift. Some bedrooms had an en-suite toilet. There were shared bathrooms, shower facilities and toilets throughout the home. Communal areas included two lounges, one dining area, a front garden and courtyard and hair dressers room.

The service had a registered manager at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are registered persons. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People did not always have up to date risk assessments and guidelines that identified how staff should support them with their specific care needs. Where one person was at risk of choking we found staff were not following the support plan so the person received safe care and treatment. Those people at risk did not always have records completed that confirmed what care and support staff had provided relating to their skin care and modified diets.

People felt safe and all but two people had a personal evacuation plans that identified what support they should require in an emergency. Fire checks were undertaken regularly but the building had no fire plan so staff were able to tell the area which would need evacuating in an emergency situation.

People had their medicines administered safely by staff who had received training. People who required their blood sugar levels monitoring did not have their checks undertaken with test equipment that had been calibrated in line with the manufactures guidelines.

People were supported by staff who were happy in the home and who felt supported by the manager. Staff had received regular supervision and training and staff meetings were an opportunity for staff to raise any changes or concerns. Staff had adequate checks completed prior to working with vulnerable people.

People and relatives were happy with the care they received and felt staff were kind and caring. One person who was supported with their lunch did not receive their meal in an inclusive, supportive manner. There was a lack of engagement and one to one support to provide this person with a positive meal experience. People were supported to maintain relationships with people who were important to them.

People’s consent to care and treatment was obtained and care plans reflected if people had capacity to make their own decisions. People were involved in their care planning and referrals were made to health care professionals when required.

The environment was not always enabling a dignified environment for people living at Rosewood Lodge. People had access to activities and people told us they enjoyed the meals.

People, relative’s, health professionals and staff views were sought. People and relatives felt able to raise any concerns and there was a complaints policy in place. The provider had quality assurance systems in place that monitored the quality and safety of the service and identified areas for improvement, although some areas of concern had not been identified prior to this inspection.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 19 December 2013

During a routine inspection

We spoke to three people that use the service at Rosewood Lodge, and all stated that they were happy with the care and attention they received from the staff. Some of these people have a degree of dementia care needs, so their communication with us was varied.

We looked at three care plans in detail and saw that people had signed consent forms in their care plans and the care documentation was written using the expressed words of the people using the service where possible.

We observed staff speaking with people who used the service and saw that they spoke to the people at eye level and offered assistance to them before carrying out tasks.

We spoke to a district nurse visiting the home who told us that the staff working at Rosewood Lodge were quick to highlight changes in care needs of the people living there. They also told us that the staff responded promptly to their advice and provided a high standard of care.

Inspection carried out on 1 February 2013

During a routine inspection

During our visit we spoke with five people who used the service and two people who had relatives who used the service. People who spoke with us said they could choose how to spend their day. One person described the home as “it was the home’s loving and caring atmosphere which persuaded me to stay.”

We saw there was information for people in the reception area of the home so that people were aware of the activities available.

One visitor told us they had always been welcomed in the home and staff members were always polite and caring. They told us the “the staff are very good, you couldn’t wish for a better place.”

People we spoke with told us they were happy and safe at Rosewood Lodge. One person commenting on the home told us, “I cannot think of anywhere better than here.”

The staff we spoke with had a very clear understanding of the care needs of people who lived in the home. We saw people were treated with respect and dignity, for example, staff were observed to make good eye contact and used touch to reassure people.

Staff told us they were aware of the home’s policies on recognising and reporting abuse and would not hesitate to report any concerns to the manager.

We observed the atmosphere and general ambiance of the home to be friendly, calm and relaxed.

During an inspection to make sure that the improvements required had been made

The purpose of this review was to check that improvements had been made to achieve compliance with this outcome. We did not involve the people living in the home

Inspection carried out on 17, 18 May 2011

During a routine inspection

People told us the staff are very respectful and helpful, encourage them to do what they can for themselves, and remind them what to do if they are forgetful. They are able to participate in a range of different activities. However, we were told by the staff that the majority of people in the home decline any entertainment as they are not interested.

We saw staff speaking to the people in the home and observed how they treated them in a calm reassuring manner and were aware of those people with dementia care needs.

One person who lived in the home told us “my future daughter in-law can visit at any time. She came yesterday and nobody bothers. We can stay in the lounge or go to my room. We are free to go any where we want”.

We saw staff speaking to the people in the home and observed how they treated them in a calm reassuring manner and were aware of those people with dementia care needs.

We saw that staff do receive mandatory training and are competent to do their job, but we noted that there are some gaps in training that the manager and staff have received which would help them to further understand and respect the cultural, social values and beliefs of people they support and enable them to challenge anti- discriminatory behaviour. This training would also help them to ensure people’s best interests and to recognise when people are being deprived of their liberty and what to do about it.

We spoke to an advocate of a person who lives in the home who told us ‘I cannot be more pleased with care provided to the person I visit. They look better than they have done for years’. We were told how the home had supported this person to make choices and decisions about their care, including moving to a different room to help them feel less isolated and nearer to he People who use the service are encouraged to be involved in decisions about their care and support and are encouraged to express their views. There are no records in peoples care plans to show that they, or their representatives, have been involved in their care planning.

People are supported to have coordinated care from other care professionals and services, but we found there had been a significant delay in the service referring one person to health care professionals when their needs had changed.

One visitor told us that they had lived in the home three years ago and they now come in to eat lunch at the home twice a week, as they enjoy the food and the company. This person was very complimentary about the home. They said the staff would do anything for you.

One visitor told us that there was always enough staff on duty when they visited. They said there were usually four or five staff.

People receive appropriate attention and treatment but they cannot be completely confident that important events that affect their welfare, health and safety are reported to the Care Quality Commission.

The people who live in the home, a visitor and the staff that we met and talked with at Rosewood were complimentary about the staff and the manager

One person spoken with said “the girls are brilliant and the manager, but we do not see her much”.