Rosewood Lodge Residential Home

Rosewood Lodge Residential Home is a care home providing personal care for up to 20 people, some of whom may be living with dementia. At the time of our inspection, 15 people were using the service.

We found the following examples of good practice.

¿ Safety measures were in place to protect people. People and visitors were monitored for symptoms of COVID-19. All visitors were supervised to ensure they followed infection control guidelines and wore appropriate personal protective equipment (PPE).

¿ People were supported to maintain their relationships with family, friends and religious groups through phone and video calls. The service had a visiting area for use when visits were permitted. A booking system was in place to ensure the area could be appropriately cleaned between use. Processes were in place to enable relatives to visit people at the end of their lives.

¿ Staff maintained social distancing where possible. They wore appropriate PPE when supporting with personal care or when in close contact with people. Furniture had been rearranged to support safe social distancing and risk assessments were in place for people who were unable to follow guidance.

¿ Processes were in place to support the safe admission of people into the service which followed best practice guidance.

¿ Staff were trained in using PPE, although some PPE fitted poorly. The registered manager promptly addressed this. Designated areas were available for staff to put on and remove PPE.

¿ Regular testing of people who used the service and staff was completed in line with current guidance. Clear procedures were in place to support people to isolate.

¿ The service was tidy and cleaned regularly to minimise the risk of people catching or spreading COVID-19. Some items of furniture could not be easily cleaned, though appropriate replacements were being purchased.

Further information is in the detailed findings below.

Rosewood Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as 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 is registered to accommodate 20 older people, some of whom may be living with dementia. There are two floors with the first floor having access via stairs or a passenger lift. There were 18 people living at the home at the time of the inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People living at Rosewood Lodge were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and the who to report this to if abuse was suspected.

Risks were appropriately assessed and mitigated to ensure people were safe. People received their medicines safely.

Staffing levels were sufficient to provide safe care to people. Recruitment checks had ensured they were suitable to work with people using this service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received care and support from a staff team that was provided with continual learning that enabled them to carry out their role effectively. Staff told us they felt supported and happy in their work.

People and their relatives described the staff as kind and caring. People's privacy, dignity and independence was respected.

People were supported and encouraged to have a varied diet which met their needs. People had a choice of food and drink at each meal time.

People's care plans were detailed and staff were aware of people's needs.

Staff spoke positively about the provider and registered manager and felt supported.

People knew how to raise any concerns they had and were confident these would be responded to. There were systems in place to seek people’s views about their care, and the management of the home.

The provider had systems to monitor the quality and safety of the service provided.

Further information is in the detailed findings below.

This inspection was carried out on 11 February 2016 and was unannounced. The service was last inspected in January 2014 and the service was found to be compliant in all of the standards apart from requirements relating to workers. This was followed up in March 2014 and the service was found to be compliant.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager in post who was registered with the Care Quality Commission (CQC). 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.

We found that staff had a good knowledge of how to keep people safe from harm and there were enough staff to meet people's assessed needs. Staff had been employed following appropriate recruitment and selection processes and we found that the recording and administration of medicines was being managed appropriately in the service.

We found assessments of risk had been completed for each person and plans had been put in place to minimise risk. The home was clean, tidy and free from odour and effective cleaning schedules were in place.

We saw that staff completed an induction process and they had received a wide range of training, which covered courses the home deemed essential, such as, safeguarding, moving and handling and infection control and also home specific training such as dementia awareness, dignity and end of life.

The registered manager understood the Deprivation of Liberty Safeguards (DoLS) and we found that the Mental Capacity Act 2005 (MCA) guidelines had been followed. The home did not use restraint, but the registered manager understood the process to ensure that any restraint was lawful.

People's nutritional needs were met. People told us they enjoyed the food and that they had enough to eat and drink. We saw people enjoyed a good choice of food and drink and were provided with snacks and refreshments throughout the day.

People told us they were well cared for and we saw people were supported to maintain good health and had access to services from healthcare professionals.

We found that staff were knowledgeable about the people they cared for and saw they interacted positively with people living in the home. People were able to make choices and decisions regarding their care. Staff were aware of the end of life process for people living in the home, recorded their views and wishes and held reflective debriefings following a person’s death.

People had their health and social care needs assessed and care and support was planned and delivered in line with their individual care needs. Care plans were individualised to include preferences, likes and dislikes and contained detailed information about how each person should be supported.

People were offered a variety of different activities for people to be involved in. People were also supported to go out of the home to access facilities in the local community.

People's comments and complaints were responded to appropriately and there were systems in place to seek feedback from people and their relatives about the service provided. We saw that any comments, suggestions or complaints were appropriately actioned.

We found the registered provider had audits in place to check that the systems at the home were being followed and people were receiving appropriate care and support.

When we contacted the manager on 24 March 2014 they told us that they had not recruited a new member of staff since the inspection in January and did not have any plans to do so. We therefore asked the manager to send us copies of the updated recruitment documentation so that we could determine whether they had made the necessary improvements to ensure that people living at the home were protected from the risk of harm.

The documentation we saw had been reviewed and updated and provided checklists to ensure that all safety checks were in place prior to people commencing work at the home. The induction programme had also been updated to ensure that people received thorough training when they were new in post.

People told us that they were happy with the care they received. They described staff as being 'Lovely' and 'Helpful' and said that there was always someone to talk to if they had any concerns. We saw that staff assisted people appropriately; they did not hurry people and spent time talking with them. We observed that they responded to call bells promptly. The systems in place at the home to ensure that medication was stored, administered and recorded were robust.

People were happy with the meals they received. We saw that a three course meal was served at lunch time and people told us that there was a choice of meal provided at lunch time and at tea time. The cook described how people's special dietary requirements were met.

There were sufficient numbers of staff on duty to meet people's assessed needs but we were concerned that the recruitment process for one person at the home had not been robust. This could have placed people who lived at the home at risk of harm.

Quality monitoring of the service included meetings for people who lived at the home and the use of satisfaction surveys. This gave people the opportunity to comment on the care provided. Quality audits had been undertaken by the manager and there was evidence that equipment and premises had been maintained in a safe condition.