Rosehill House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The service had introduced an online care planning system since our last inspection.

Although care plans were generally person centred and included information about people’s social and communication preferences, some lacked information about people’s health needs and how staff should manage these.

People and relatives had been involved in care planning and reviews.

The service ensured care, treatment and support was delivered in line with legislation and current evidence-based good practice and standards.

Staff supported people to have enough to eat and drink to prevent malnutrition or dehydration. One person told us, “The food is good and there is plenty of choice.” One staff member told us, “People have enough to drink, and there are always jugs of liquid available. People have a choice of cold and hot drinks. There are plenty of meal options available.”

Care plans included people’s safe swallowing guidelines and we observed staff following them while supporting people to eat. We saw evidence of staff having made a referral to the speech and language therapy team (SALT) when 1 person was experiencing swallowing difficulties.

The service worked well across teams and services to support people.

Staff worked together well and held daily handover meetings to ensure updates about people’s care were shared across the staff team. One person told us, “Communication here right now is the best I have ever seen.”

Staff were proactive in working with other services when multidisciplinary involvement was required. One professional visiting the service told us, “Communication with the home is excellent and the management are on the ball. They are proactive at seeking advice.”

The registered manager told us, “We recently attended a meeting with a health professional about how ward rounds were going and agreed to streamline our referral process to ensure referrals could be prioritised more effectively. This has led to people being seen more quickly when needed.”

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

We saw evidence the service sought support from healthcare professionals when they identified people could benefit from this. When people were unwell, records showed that staff facilitated access to the GP or other health partners quickly. One visiting professional told us, “Following a referral for somebody experiencing weight loss, the home provided us with a detailed weight history and completed food diaries so their nutritional needs could be analysed.”

We observed various health professionals visiting people over the course of our onsite inspection and records showed staff following up actions or acting on recommendations.

We discussed with the registered manager the need to ensure care plans and risk assessments were updated in a timely way following a change to their support following involvement from health professionals.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

There were systems in place to monitor people’s needs such as food diaries, weight charts, bowel charts and repositioning charts. Staff used these effectively to identify when involvement from healthcare professionals was needed. One staff member told us, “Some people require support to be turned regularly. If I see issues with people's skin, I tell a senior carer who then refers on to health professionals. I record what I have seen, and photographs are taken where required.”

We discussed with the service the need to ensure where drinks required thickening due to the risk of choking or meals required fortifying to promote people’s weight gain, this information was clearly written in people’s daily notes or food diaries.

The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Although improvements had been made in how the service obtained people’s consent and with their understanding of the principles of the Mental Capacity Act 2005 (MCA), further improvements were required to ensure this was applied for all relevant decisions and that the relevant people were involved in best interest decisions. For example, we found mental capacity assessments and best interest decisions were not undertaken for people who shared rooms. Although family members had been involved in best interest decisions, their names had not always been recorded in the decision-making records.

Staff told us they respected people and gained consent before providing care. One staff member told us, “I always gain consent from people, for example, by asking if they would like a shower. I try to encourage [people] as much as possible but always respect their wishes.”

The service had now obtained an up-to-date record of where people had lasting powers of attorney in place.