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Keychange Charity Rose Lawn Care Home Outstanding

All reports

Inspection report

Date of Inspection: 23, 27 May 2014
Date of Publication: 21 June 2014
Inspection Report published 21 June 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 23 May 2014 and 27 May 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information given to us by the provider.

Our judgement

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

At our last inspection 28 October 2013 and 5 November 2013 we made a judgement that care and treatment at Roselawn was not consistently delivered in a way that was intended to ensure people's safety and welfare.

During this inspection we followed up previous concerns to check improvements had been made. We found improvements had been made. We saw records showing the incidents of falls at the home had dramatically reduced. The home had implemented new falls guidance assessment documentation. The document had a system to identify the level of concern immediately following a fall and a clear protocol advising staff of actions they needed to take. The staff completed a post falls review monitoring document for up to 48 hours after the accident. The deputy manager told us they felt the reduction in falls at the home was due to increased staffing levels and staff training. We asked care staff why they felt the levels of falls had decreased at the home. They told us it was due to their better understanding, checking the environment for falls risks, recognising changes in people’s health and the new protocol in place. This meant the home had systems in place to ensure people’s safety and welfare were met.

We saw that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at the care records for five people living at the home to find out how their health and personal care needs had been assessed and how the service planned to meet those needs. Each person had a care folder that contained risk assessments which included people’s mobility needs, falling risks, skin integrity and nutritional status. They had been reviewed and updated regularly by the designated senior care staff.

We saw the care plans were detailed, individualised and took into account the information gathered by the risk assessments and people’s level of ability and understanding. The care plans included how to meet people’s personal hygiene needs, communication, mobility, nutrition and continence needs. The plans gave staff clear guidance. Examples included guidance for staff to support somebody to use the toilet. Staff were instructed to explain the procedure to the person, give them time to understand the request and accept the procedure. It concluded by saying the person would be more likely to comply with the request.

We spoke with three district nurses supporting people at the home. They told us that they had seen improvements at the home over the past few months. They told us staff had been very enthusiastic about increasing their knowledge about administration of medication and that the home had been proactive with regard to some concerns raised. They told us there had been a few communication concerns between the home and district nurse team regarding the homes management of catheter care and understanding of tissue viability. In response they had allocated the home a designated nurse to improve the working relationship and communication between the services.

We observed staff assisting and interacting with people during our visit. We found staff were kind, were patient, reassuring and engaged in cheerful discussions. People told us they were happy at the home. Comments included, “I am very comfortable here, looked after well”, “It’s like being at home”. “They (staff) will do anything if I ask” and “We are very well cared for”.

There were opportunities for people to be engaged in activities. We saw there was an activities and events sheet for May 2014 on the homes notice board. Events included a clothes sale, music and movement and shopping. The deputy manager told us that church services were held at the home on alternate Sundays and Tuesdays and there was a weekly religious discussion group. At our first visit we saw that people were being supported by the designated activity person to go shopping. On the second day of our visit we saw that a person was encouraged to play the p