Rosebank Care Home

Effective systems were in place to ensure visitors to the service followed government guidelines for wearing Personal Protective Equipment (PPE). Facilities were available for visitors to sanitise their hands and put on PPE. Screening questions and a temperature check were standard requirements for all visitors.

Staff supervised all essential visitors to ensure social distancing and infection control guidelines were followed.

All staff were trained in safe IPC practices. We observed staff wearing appropriate PPE and sufficient supplies were available.

A regular programme of testing for COVID-19 was in place for staff and people who lived in the service. There had been a good uptake of residents receiving the COVID-19 vaccine.

The environment was clean and hygienic. Enhanced cleaning took place daily.

People were supported to maintain contact with their relatives in different ways including window visits and video calls.

Staff knew how to respond to an outbreak of infection to ensure the safety of people and staff. Immediately followng the inspection the service updated their emergency continuity plan to include this procedure.

Rosebank Care Home is a residential care home providing personal and nursing care to 20 people living with dementia at the time of the inspection. The service can support up to 26 people. Rosebank Care Home is a large detached two-storey house set in its own grounds.

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

During this inspection we found improvements in regard to medication however additional improvements were needed and so we have made recommendations in regards to medication. We also made additional recommendations in regards to care documentation and mealtimes.

Care plans and risk assessments were in place that reflected the needs of people, however we identified that some information held in care plans was not always reflected in other not always reflected in other documentation. We discussed this at the time of our inspection with the registered manager who assured us this would be actioned accordingly

We observed care being delivered in the home and saw that this was done in a caring and patient manner. We saw that people were comfortable in the presence of staff and positive relationships had developed between people receiving support, relatives and care staff. Visitors told us staff were kind and treated their relatives with dignity and respect.

Staff were recruited safely and received regular training, received supervisions, attended staff meetings and had regular competency checks. Staff we spoke to said that they felt well supported. The registered manager had implemented a number of new processes following discussions with staff.

The activities co-ordinator had recently left, however the registered manager assured us that the staff were continuing with the activities and was in the process of recruiting another activities co-ordinator.

Complaints, accidents and incidents were managed appropriately and referrals were made to other professionals in a timely manner when people living in the home were in need.

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 - The last rating for this service was requires improvement (published 03 November 2016). There was also an inspection on 21 November 2017 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

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.

Rosebank Care Home is a 26 bedded home providing residential care to older people with a variety of support needs including those with dementia. It is located in its own grounds in a residential area, close to Sheffield city centre. At the time of our inspection 24 people were using the service, many of whom were living with dementia.

There was a registered manager in place. 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 were safely supported to access their medicines. However medicines were not always securely stored and there was a discrepancy in the count for one person’s medicines.

Risks to people arising from their health and support needs or the premises were not always assessed and plans were not always in place to minimise them.

A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.

Staff understood safeguarding issues, and felt confident to raise any concerns they had in order to keep people safe.

The service monitored people’s levels of dependency and used this to assess staffing levels. A number of recruitment checks were carried out before staff were employed to ensure they were suitable. The service was in the process of recruiting new staff.

Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training.

Staff received support through regular supervisions and appraisals. Staff felt confident to raise any issues or support needs they had at these.

Staff had completed a range of training that enabled them to meet people’s assessed needs effectively.

The registered manager and staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) training. At the time of inspection one person who used the service was subject to a DoLS authorisation. Care plans contained evidence of MCA assessments and consent. We have made a recommendation around MCA and DoLS.

The service worked closely with external professionals to support and maintain people’s health. Staff knew how to make referrals to external professionals where additional support was needed. Care plans contained evidence of the involvement of GPs, nurse practitioners, district nurses and other professionals.

The interactions between people and staff were cheerful and supportive. Staff were kind and respectful; we saw that they were aware of how to respect people’s privacy and dignity. People and their relatives spoke highly of the care they received.

Procedures were in place to support people to access advocacy services should the need arise.

Care plans were person centred and provided a lot of personal information that was relevant to that person. However care plans did not always capture people’s needs. We have made a recommendation regarding care plans.

People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People told us they enjoyed the food although were not offered a choice. The cook did not fully understand how to fortify people’s meals and the picture menus did not match what food was on offer that day.

The service was in the process of employing a new activities co-ordinator. At the time of the inspection staff were arranging activities. People were happy with the activities on offer.

The service had a clear complaints policy that was applied when issues arose. People and their relatives knew how to raise any issues they had.

Staff were able to describe the culture and values of the service, and felt supported by the registered manager in delivering them.

The registered manager was a visible presence at the service, and was actively involved in monitoring standards and promoting good practice. Feedback was sought from people and their relatives to assist in this. The service had some good links with the community.

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

We checked files and records, and spoke with staff. We found that the provider did not have appropriate arrangements in place for gaining people's consent to care and support. Subsequent to the inspection, the registered manager provided us with copies of forms that the provider used in relation to gaining consent or reaching best interest decisions. However, we did not see any of these in use on the day of the inspection.

People were cared for in a clean, hygienic environment. We carried out a visual inspection of the premises, and found that areas we checked were cleaned to a high standard.

The recruitment process each staff member had gone through showed that their suitability, skills and competencies had been assessed. Each staff member had been subject to reference checks and identity checks prior to appointment.

People's personal records, staff records and other records relevant to the management of the home were accurate and fit for purpose.