Archived: Roseland Care Home

At the time of our inspection, the home was providing care for eight people. We used a number of different methods to help us understand the experiences of people who used the service, because people using the service had complex needs which meant they were not able to tell us their experiences.

We observed the care provided and the interaction between staff and people who used the service. We also spoke with three care staff and the provider. We also spoke to the relatives of people who used the service.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People who used the service had support plans and risk assessments which helped to ensure their safety and welfare.

Records had been stored which allowed them to be located quickly and accessible during the inspection.

People were protected from the risk of infection because appropriate guidance had been followed.

There were recruitment and selection procedures in place and appropriate checks had been undertaken before staff began work. Staff were trained in areas of relevance to their job roles and demonstrated knowledge of people's individual needs.

We found the home did not have effective safeguarding, whistle blowing and Deprivation of Liberty Safeguards (DoLs) policies and guidance in place. When speaking to staff, they were unable to provide examples of what constituted abuse and how they could identify abuse. They were not aware of action to take and how to report allegations or incidents of abuse to the relevant authorities.

CQC monitors the operation of the DoLs which applies to care homes. While no applications have been submitted, appropriate policies and procedures were not in place. When speaking with staff we found they did not have an understanding of the Mental Capacity Act (MCA) 2005 and the DoLs and how it applied to the people they were providing care and support to on a daily basis.

Is the service effective?

We looked at three care plans and saw that people's needs had been assessed and care and treatment were planned and delivered in line with their individual care plan.

Is the service caring?

One relative told us their relative 'looks well and is reasonably happy. The staff are pleasant and polite'.

People's likes and dislikes had been noted and staff were encouraged to prompt people to enable people to be independent in areas it was possible.

One relative told us 'The home has improved and the current keyworker is brilliant. My [relative] is talking a bit more and eating by themselves. They seem well looked after'.

Is the service responsive?

People's health and medical needs were assessed and we viewed records demonstrating that they were supported and provided access to health and medical services when necessary.

Is the service well-led?

At the time of our inspection, there was no registered manager in place at the service.

During our inspection, the provider told us the previous registered manager at the home had left. The provider was in the process of recruiting a new registered manager for the home and was currently overseeing the management of the home until a new manager had been recruited

Our inspection of 13 June 2013, also found the provider non-compliant with regulation 23 (Regulation 23(1)(a)) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The provider did not have suitable arrangements in place to ensure staff received appropriate training to enable them to safely deliver care and treatment.

In this inspection, we also looked at three other regulations we had planned to check.

We checked to see if people receiving care were safe and if their health and welfare needs were met by staff who were fit and appropriately qualified. We found the provider followed a suitable recruitment process, including all of the necessary checks.

The provider did not have systems to manage and monitor the prevention and control of infection. This meant the health of people who used the service were put at risk.

All care records and records associated with the management of the service were kept securely in the manager's office. However some policies and procedures could not be located in a timely manner when needed and were not updated to reflect current changes.

Staff were not properly trained, supervised and appraised to ensure they were well supported to provide care and treatment to people.

People were supported to have adequate nutrition and hydration. Appropriate guidance was followed where there was any risk of poor nutrition or difficulty in swallowing. We saw that people at risk of losing weight were regularly monitored and food was cut into manageable sizes for those at risk of choking.

People were protected from abuse or risk of abuse because staff knew how to recognise and respond to the signs of abuse.

We were concerned that staff were not fully supported to acquire further skills and qualifications relevant to their work.