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Roseleigh Care Home Requires improvement

We are carrying out a review of quality at Roseleigh Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 2 October 2018

This inspection started on 24 July 2018 and was unannounced. This meant the provider and staff did not know we would be visiting. A second day of inspection took place on 22 August 2018, and was announced.

The service was last inspected in May and June 2017 and was rated requires improvement. At that inspection we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to governance and management processes. We took action by requiring the provider to send us action plans setting out how they would improve the service.

When we returned for this inspection we found that the provider was still in breach of this regulation. We also identified additional breaches of regulation in relation to medicine management, person-centred care and premises and equipment.

This is the third time the service has been rated as Requires Improvement.

Roseleigh Care Home 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. Roseleigh Care Home accommodates up to 50 people across two separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with a dementia. At the time of our inspection 40 people were using the service.

There was a registered manager in place. 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. At the time of our inspection the registered manager was on planned long-term leave. The deputy manager had been acting as manager since the beginning of July 2018.

Medicines were not always managed safely. The premises were not always clean, suitable for the purpose for which they were being used or adapted for the comfort and convenience of people living at the service. Records of decisions made under the Mental Capacity Act 2005 or in people’s best interests were not effectively recorded. People did not always receive person-centred support. Care plans sometimes contained limited information and were not always person-centred. The provider’s quality assurance and governance processes were not always effective.

Plans were in place to support people in emergency situations. Risks arising out of people’s health and care needs were assessed and plans put in place to reduce the chances of them occurring. Accidents and incidents were monitored to see if improvements could be made to keep people safe. People were safeguarded from abuse. Staffing levels were monitored to ensure enough staff were deployed to support people safely. The provider’s recruitment processes minimised the risk of unsuitable staff being employed.

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 were supported with food and nutrition. People were supported to access external professionals to monitor and promote their health. Staff were supported with training, supervisions and appraisals.

People spoke positively about the support they received, describing staff as caring and kind. Relatives also described the support people received as caring. People were usually treated with dignity and respect. People told us staff supported them to maintain their independence. Policies and procedures were in place to support people to access advocacy services where needed.

People were supported to access activities they enjoyed. Policies and procedures were in place to investigate and respond to complaints. At the time of our

Inspection areas

Safe

Requires improvement

Updated 2 October 2018

The service was not always safe.

Medicines were not managed safely.

The premises were not always clean or suitable for their purpose.

Staffing levels were sufficient to provide safe support.

Emergency plans were in place.

Effective

Requires improvement

Updated 2 October 2018

The service was not always effective.

Records of decisions made under the Mental Capacity Act 2005 or in people’s best interests were not effectively recorded.

People did not always receive person-centred support.

The premises had not been adapted for the comfort and convenience of people living there.

Caring

Requires improvement

Updated 2 October 2018

The service was not always caring.

People did not always receive person-centred support.

People and their relatives spoke positively about the care and support they received.

Procedures were in place to support people to access advocacy services where appropriate.

Responsive

Requires improvement

Updated 2 October 2018

The service was not always responsive.

Care plans were not always person-centred.

People were supported to access activities they enjoyed.

Policies and procedures were in place to investigate and respond to complaints.

Well-led

Requires improvement

Updated 2 October 2018

The service was not always well-led.

The provider’s quality assurance and governance processes were not always effective.

Feedback was sought from people using the service and their relatives and was acted on.

The service had community links with local agencies and groups for the benefit of people living there.