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Keychange Charity Rose Lawn Care Home Outstanding

All reports

Inspection report

Date of Inspection: 19 February 2013
Date of Publication: 4 April 2013
Inspection Report published 4 April 2013 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 19 February 2013, 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 and talked with staff.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We spoke with six people living in the home, four relatives and we looked at four care plan files. People told us they were completely satisfied with all aspects of the care they received. Comments included "I can’t praise them anymore than I do, it’s lovely, A1. They look after me lovely”. One person told us that “the girls are wonderful, I don’t have to worry about anything, they get the GP and sort me out.”

The service had completely reviewed their care records system since our last inspection. All staff we spoke to told us that they had had training in the new system and that named staff had been allocated the responsibility for ensuring that named care plans were completed and up to date. The senior staff meeting minutes showed that this had been a priority and allocation of tasks now included time for completing care records and discussion about the quality of care records was included in staff meeting agendas. One senior staff member had taken on the role of support for staff using the new system and they said that “it was much better, I’m glad my input helped”. We also saw that shift patterns had been changed to enable a more effective verbal handover so that staff could be sure that they knew what to do to meet people’s needs.

We spoke with staff who told us they thought the care plans provided them with the information they needed to support people. When we spoke with staff they knew how to meet these people’s needs. We saw that each care plan we looked at was completed, easy to understand and very detailed. Topics included; memory, communication, emotional needs, personal care and health monitoring such as weight, nutrition and skin care. For example, one plan detailed needs identified in the pre-assessment that had been transferred to the care plan. This showed how that need would be met, topics like memory loss, pain and foot care. There was clear information about health care needs such as diabetes. One plan showed how staff could be sure that it was safe to give the prescribed insulin dependent on the person’s blood result. All care plans were reviewed monthly by staff in a meaningful and person centred way, for example X is less frustrated due to…” This meant that changes in need were identified and acted upon.

For people who had needs that could be challenging for staff and others we saw clear behaviour plans which recognised and monitored any triggers so that staff could minimise this behaviour. Actions recorded were in line with information obtained from the person’s life history and was used to diffuse the persons aggressive behaviour. This ensured that people’s safety and wellbeing was maintained.

One care plan was very detailed about how to minimise behaviour that could be challenging to staff and another care plan had a detailed night plan but the quality of information was not always consistent. The registered manager said that they had started to review all the care plans to ensure that they had clear details as to what staff needed to do. Staff said there were good information sharing systems in the home. They said that detailed handovers between each shift ensured they were always given up to date information about any changes in people's care needs.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. For example, risk assessments had been carried out on areas of potential risk to people. These risk assessments included prevention of pressure sores, prevention of falls, and the risk of choking. These were audited and changed as necessary. For example, one care plan read “X is able to move more independently now that the furniture has been re-arranged”.

The home had sought specialist advice where necessary. For example the speech and language team had been consulted for one person for advice to prevent choking, and