• Care Home
  • Care home

Rosebery House

Overall: Good read more about inspection ratings

2 Rosebery Avenue, Hampden Park, Eastbourne, East Sussex, BN22 9QA (01323) 501026

Provided and run by:
Spemple Limited

All Inspections

17 October 2022

During an inspection looking at part of the service

About the service

Rosebery House is a residential care home providing accommodation and personal care for up to 30 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 29 people using the service.

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

There were enough staff working to provide the care and support people needed. However, we made a recommendation that the provider reviews deployment of staff at peak times during the day.

People were protected from the risk of harm of abuse because staff knew what actions to take if they identified concerns. Staff received regular training and competency assessments which helped to ensure they had the knowledge and skills to look after people. The home was clean and tidy throughout with no unpleasant odours.

Staff knew people well and understood the risks associated with their support. Care plans and risk assessments provided guidance about risks. People received their medicines safely, when they needed them. Recruitment procedures ensured only suitable staff worked at the home.

The culture of the home was positive and staff worked hard to ensure people lived happy lives. The quality of the service was regularly monitored through audits, discussions and feedback surveys. Improvements were made where needed and there was an ongoing improvement program for the home. They worked well with other organisations. Visiting health and social care professionals spoke highly of the registered manager and staff.

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.

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

We undertook an infection prevention and control inspection (published 24 March 2022). This was a targeted inspection therefore we did not re-rate the service at this inspection.

The last rating for this service was requires improvement (published 28 July 2021). The provider completed an action plan after this inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider seek appropriate guidance in relation to the storage of prescribed topical creams. At this inspection we found topical creams were stored appropriately.

Why we inspected

We looked at infection prevention and control measures (IPC) 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.

The inspection was prompted in part due to concerns received about the care people received, this included continence care, staff training and IPC. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this report.

At our inspection, published 28 July 2021 a breach of legal requirements was found which related to IPC. At this focused inspection we also checked they had followed their action plan and to confirm they now met legal requirements

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

1 March 2022

During an inspection looking at part of the service

Rosebery House is a residential care home providing care and accommodation for up to 30 older people living with dementia or dementia type illness.

We found the following examples of good practice.

The provider was following current government guidance to ensure people were able to visit the home safely. There were safe and appropriate measures in place in relation to visiting at the home. This included temperature checks and lateral flow testing before visitors were admitted to the home. The provider had an allocated visiting room which was accessed at the rear of the building. People were able to use this for visiting or they could enter the home if they wished, once appropriate checks had been completed.

Families had been kept updated throughout the pandemic to ensure they were aware of visiting and testing requirements. Relatives had also been informed when an outbreak had occurred at the home.

People were being supported to go out and to attend appointments.

The home had designated housekeeping staff, with further cleaning tasks shared by care staff. Daily cleaning and cleaning of high touch areas was recorded.

A testing regime was in place for all staff in line with government guidance.

Staff had received training in relation to infection prevention and control and COVID-19. This had been supported with further staff meetings and information sharing as changes had occurred.

29 June 2021

During an inspection looking at part of the service

About the service

Rosebery House is a residential care home providing care and accommodation for up to 30 older people living with dementia or dementia type illness. There were 24 people living there at the time of the inspection.

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

The home had experienced a significant outbreak of COVID-19 during the pandemic. A number of staff including the registered manager and provider had been off sick, shielding or isolating. This had impacted on the service and although the home was now COVID-19 free, the registered manager and provider were still trying to catch up in relation to a number of quality assurance processes and documentation

Infection Prevention Control processes needed to be improved to ensure that staff were consistently following government guidance. Staff had not sought confirmation a visiting health professional had completed COVID-19 testing before entering the home. Another had been allowed to wait inside the home until they had their result rather than being asked to wait in the designated area outside until a negative result was confirmed. Although it was difficult to ensure people were socially distanced due to living with dementia, staff needed to mitigate risk as much as possible by supporting people and other staff to remain socially distanced when possible.

Some areas of documentation including care plans and risk assessments needed to be improved to ensure they consistently included relevant information about people. For example, triggers for anxiety and actions for staff to follow. Improvements were needed to ensure all risks were identified and assessments completed to demonstrate how risk was to be mitigated. For example, people who may not be able to socially distance and environmental risk assessments.

The registered manager was working with the provider and external health professionals to make improvements and ensure people received appropriate care. An action plan had been completed to identify which areas needed to be prioritised. We were told this was a ‘live’ document and further areas would be added once the essential improvements had been implemented. Newly implemented quality assurance systems needed time to become embedded into practice.

Staff giving medicines were appropriately trained and their competencies assessed to ensure medicines were given safely. People told us they received their medicines correctly. We have made a recommendation regarding medicines and the storage of topical creams.

Staff had received safeguarding training and knew what to do if they suspected anyone was at risk of abuse. Accidents and incidents were documented and referred to the local authority and CQC completed when required.

People and relatives told us they were happy with the care provided. We received positive feedback regarding staff and the registered manager. One told us, “They would rather be at home, but they now even says the girls are lovely, they have company with the staff, even if they are not able to talk to many of the other residents.” And, “The manager is very understanding and kind and has put me at ease.’

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 27 July 2019).

Why we inspected

This inspection was prompted by our previous Infection Prevention Control inspection in January 2021 and the last comprehensive inspection in July 2019. We were also prompted by our data insight which assesses potential risks at services, concerns received in relation to aspects of care provision and previous ratings. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. This enabled us to review the previous ratings. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

Enforcement:

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified a breach in relation to safe care and treatment.

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

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

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

21 January 2021

During an inspection looking at part of the service

Rosebery House is a residential care home providing care and accommodation for up to 30 older people living with dementia or dementia type illness. There were 23 people living there at the time of the inspection.

We found the following examples of good practice.

The home was currently closed to admissions and non-essential visitors. Measures had been implemented to ensure people and staff entering the home did so safely. This included temperatures being taken on arrival and personal protective equipment (PPE) being used.

People and staff had individual COVID-19 risk assessments completed where appropriate. This considered people’s associated risks, including long term and underlying health conditions and ethnicity.

The home had experienced a high number of positive COVID-19 people and staff. During the outbreak staff monitored people’s physical health and recorded this on a monitoring form, this included people’s temperatures and general symptoms.

10 July 2019

During a routine inspection

About the service

Rosebery House is a residential care home providing personal and nursing care to up to 30 older people. There were 22 people living there at the time of the inspection. Most people were living with dementia and needed additional assistance due to frailties of old age; such as support to move around the home safely. Some people had more complex needs, which included Parkinson’s disease and diabetes.

The manager had been responsible for the day to day management of the home for two months prior to the inspection. They had applied to register with CQC and their application was being progressed. During this time the provider had supported the manager and a number or improvements had been made since they started. For example, the layout of the furniture in the lounge had been changed so people could sit together in small groups if they wished and the decoration had been improved to brighten the room.

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

People and relatives were positive about the support provided at Rosebery House. People said the manager was very approachable and a relative told us the staff were excellent. Staff knew people very well, they treated them with kindness and respect and demonstrated a good understanding of people’s individual needs. People were assisted to access healthcare services when needed.

Risk assessments and management plans were included in the care plans and, there was guidance for staff to follow to reduce risk as much as possible. The provider had an ongoing training plan, with supervision and support for staff to ensure they were aware of their roles and responsibilities. People received their medicines when they needed them by staff who were trained to give them out safely. People were protected from the risks of harm, abuse or discrimination because staff had completed safeguarding training and knew what actions to take if they identified concerns.

There were enough staff working to provide the support people needed, at times of their choice. Recruitment procedures ensured only suitable staff worked at the home.

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.

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 16 November 2016).

Why we inspected - This was a planned inspection based on the previous rating.

Follow up: We will review the service in line with our methodology for 'Good' services.

1 August 2016

During a routine inspection

Rosebery House is registered with CQC to provide residential care for up to 30 older people. At the time of the inspection there were 27 people living at the home.

Rosebery House specialises in providing care for people with dementia and memory loss.

This was an unannounced inspection which took place on 28 July and 1 August 2016.

At the last inspection undertaken on the 1 and 2 June 2015 we asked the provider to make improvements in relation to the safe storage and administration of medicines, safe staffing levels in relation to evacuation procedures and peoples preferences and needs not being met. The provider sent us an action plan stating they would have addressed all of these concerns by August 2015. At this inspection we found the provider was meeting these regulations.

Rosebery House had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The manager was in day to day charge of the home, supported by a deputy manager. People spoke highly of the home and the way it was run. And staff told us that they felt supported.

Staff felt that training provided was effective and ensured they were able to provide the best care for people. Staff were encouraged to attend further training, with a number having achieved National Vocational Qualifications (NVQ) or similar. New staff received an induction and staff received regular supervision annual appraisals and had regular staff meetings. This meant that staff were supported to develop skills, knowledge and training.

Staff demonstrated an understanding around safeguarding and were able to tell us how they would report any suspected abuse. People were involved in day-to-day choices. All staff and management had a good knowledge and understanding of Mental Capacity Assessments (MCA) and Deprivation of Liberty Safeguards (DoLS). This meant that any decisions made had followed this process to ensure they were made in peoples best interest and supported by health professionals and Next of Kin (NoK).

Staff recruitment systems were in place and staffing levels were reviewed to ensure people’s needs could be met. A training programme was on going to ensure staff were appropriately trained to support people’s needs.

The home had a designated maintenance employee who was available at the home. Systems were in place to ensure emergency procedures were in place. And equipment and services were well maintained and checked regularly. There were systems in place to assess and monitor the service. This included auditing and feedback from people. All findings were analysed and used to make improvements to the day to day running of the home.

Staff provided care and support for people with kindness and patience. People’s dignity and privacy were respected and people were involved in decisions about how they received care and spent their time throughout the day.

Medicine administration, documentation and policies were in place. These followed best practice guidelines to ensure people received their medicines safely. Regular auditing and checks were carried out to ensure good standards were maintained.

People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave positive feedback about the food and the registered manager was developing photographs of meals to enable people to have a better understanding around meal choices available.

Referrals were made appropriately to outside agencies when required. For example GP visits, community mental health teams and community nurses. Notifications had been completed to inform CQC and other outside organisations when events occurred.

1 and 2 June 2015

During a routine inspection

Rosebery House is a residential home in Eastbourne, providing care for people with dementia. Rosebery House provides local authority and privately funded long term care and periods of respite. People’s care needs varied, some had complex dementia care needs that included behaviours that may challenge others. Other people’s needs were less complex and required care and support related to personal and social care needs. Some people were independently mobile and able to walk unaided or with the use of walking frames, whilst others used a wheelchair and were reliant on staff for all their personal care needs. The service is registered to provide care for up to 30 people. At the time of the inspection there were 22 people living at the service.

This was an unannounced inspection which took place on 1 and 2 June 2015.

Rosebery House had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Care plans had been written and reviewed regularly by the manager. These provided clear individualised care guidance for staff. However, daily charts and records had not been written to identify that care had taken place in accordance with people’s care plans.

Activities were provided on a daily basis by care staff, but these were not person specific. Staff told us they had not received any training to provide appropriate activities for people with dementia. Some staff felt uncomfortable being asked to facilitate activities. Others told us they wanted more training to ensure they were doing this well. There was a lack of accessible equipment for people to access throughout the day.

Quality assurance checks were completed regularly by the manager to ensure that the service provided good care and continued to improve. However some areas of auditing including completion of records and activities needed to be improved.

At lunch time one person was taken to the dining room and left sat alone for a long period of time before and after their meal. During the meal this person was assisted by three separate staff, this could be disorientating for a person with dementia and memory loss. People were offered a selection of snacks and drinks throughout the day with staff taking the time to assist people to encourage good nutrition and fluid intake. This was logged onto daily food and fluid charts used to assess people’s nutritional intake and highlight any concerns. Meals provided looked well-presented and appetising with people’s likes and dislikes documented to inform staff.

People’s weights were reviewed every month with referrals made to outside agencies when people had poor nutrition or had lost weight. People who required assistance at meal times had this provided in a dignified interactive way, with conversations taking place between staff and people throughout the meal time.

People living in the service told us they felt safe at Rosebery House and staff felt safe and supported working at the service. The manager was a visual presence at the service on a daily basis and had an ‘open door’ policy for staff, people living in the service and visitors. However we found some elements of medicines storage and administration were not always safe.

Staff had received safeguarding training and were able to demonstrate a good knowledge around recognising and reporting concerns appropriately. Safeguarding policies and procedures were in place and were up to date and appropriate. Safeguarding referrals were made to the local authority when required. The manager was open and transparent about previous safeguarding investigations and it was clear that learning had taken place with changes implemented in the response to investigation findings.

Staff knew people very well and were able to tell us about their individual needs. Environmental and individual risk assessments had been completed. There was an organisational recruitment policy and procedure to follow when recruiting new staff. This included an in house induction for new staff. Staff told us the manager was always around and available if they had any concerns. Staff felt able to speak to the manager and felt that they would be listened to and supported.

Equipment maintenance and servicing had taken place. With environmental and maintenance audits completed to ensure the building and equipment were maintained appropriately. This included contingency plans and procedures for evacuation, although the fire risk assessment was inaccurate and needed to be reviewed and updated.

Staff told us they knew people well and could respond appropriately when people became anxious or upset. When someone new moved into the service they took the time to get to know them and how they liked to be cared for. Information about people’s lives and background had been completed in care files to inform staff of people’s likes, dislikes and preferences.

A training schedule was in place which identified when staff attended training or when training was due. Staff felt supported by the manager and work colleagues .There was a programme for supervision and appraisals to take place, this included further ‘ad hoc’ meetings when required and policies and procedures were in place to support staff.

A number of staff including the manager had attended Deprivation of Liberty Safeguards (DoLS) training. We saw that DoLS applications had taken place when required. Care staff informed us how they gained consent from people, and displayed awareness around mental capacity, choice and restraint. Mental capacity assessments had been completed when appropriate.

People were seen sitting the lounge, dining area and their own rooms. During the inspection we saw many examples of positive communication and interaction between staff and people. Staff took the opportunity to introduce people and this led to a conversation. Staff demonstrated an obvious affection for people, and responded calmly and positively when they sat with people or passed them in the corridor. Staff showed a clear fondness for people and cared about their care and welfare. Responding in a calm manner, and providing support when people became anxious or distressed. People recognised staff and it was apparent in their body language they felt comfortable and trusted staff to look after them.

Staff told us they were part of a team, and felt that they all shared the same values to ensure people received the best care.

There were no current complaints investigations in progress. Past complaints had been dealt with following the organisations complaints procedure.

Staff spoke positively about the manager, the culture within the service and how they all worked together as a team to support each other.

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

24 September 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service. Not all of the people who lived at Rosebery House were able to communicate with us. We used Short Observational Framework for Inspection (SOFI). SOFI is a tool used when reviewing services for people who have conditions that mean they are not able to tell us about their experiences of living in the home. Those who could talk with us told us they were happy living at the home.

During our inspection we found that consent was sought before care was given. People were involved in choices and decisions throughout the day.

Care plans were personalised and documented the needs of people.

The home appeared clean and tidy. Appropriate infection control measures were in place.

A complaints policy was displayed in the reception area. Evidence was seen that comments and complaints were listened to and resolved in a timely and appropriate manner.

9 October 2012

During an inspection in response to concerns

Due to people's complex needs, many people were not able to tell us about their experiences. We used a number of different methods such as observation of care and reviewing of records to help us understand the experiences of people using the service.

People we were able to speak with who lived in the home told us they liked living at Rosebery House.

19 June 2012

During a routine inspection

People we spoke with who lived in the home told us they were happy living at Rosebery House. Relatives told us 'staff are quite caring, they are a good team' and 'staff seem very nice, they are always busy'. One visitor told us 'everything is labelled and yet items of clothing sometimes disappear, they return again a few days later, but you do wonder where they go'.

19 August 2011

During an inspection in response to concerns

One resident who was asked if she could do what she wanted to do when she wanted to,

replied that she could.

When asked about the care in the home one resident said ''I have no reason to complain.''

Feedback from residents who were asked about the food indicated a satisfaction with the

food provided.

One resident who was asked if she could do what she wanted to do when she wanted to,

replied that she could.

When asked about the care in the home one resident said ''I have no reason to complain.''

Feedback from residents who were asked about the food indicated a satisfaction with the

food provided.

8 July 2011

During an inspection in response to concerns

ue to the nature of dementia it was difficult to ascertain the views of all the residents. We were able to talk to two people and they stated that they were happy with the care received at the home.

Specific comments included ' 'The staff are wonderful.' 'We have no concerns.' 'It is lovely here.'