Rose Villa Nursing Home

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 remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider 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.

People’s needs were assessed; however, information identified in risk assessments was not always reflected in the corresponding care plans. For example, individuals assessed as being at risk of falls did not have sufficient guidance recorded in their care plans to inform staff how to reduce the risk of falls or how best to support the person.

Staff did not always communicate effectively with people to confirm they were receiving the care they wished. One person told us they would like to go out more. The manager was present during this discussion and arranged for staff to support this person to the shops. Another person told us, "I'm not having a go, I just want them [staff] to listen to me."

The management team were prioritising reviews of people’s care plans; however, some plans still lacked essential details about individuals’ needs and preferences. For example, information about risks related to smoking and how people prefer to spend their time was not always included.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider did not always plan and deliver people’s care and treatment in partnership with them. Records showed that care plans contained basic information and did not consistently reflect people’s individual preferences, goals, or what mattered most to them in their daily lives.

We found examples where people's preferences and wishes, including cultural, social, or emotional needs, were not always recorded in detail. For example, when people shared preferences relating to their sexual orientation, staff appropriately acknowledged and supported these needs in day‑to‑day practice. However, this information was not clearly documented within care records, meaning staff did not have clear guidance on how to consistently respect and uphold these preferences.

This limited the provider’s and staff’s ability to ensure that care and treatment were truly person‑centred and tailored to each person.

Staff did not consistently follow individuals planned care, and records did not always show that required care had been delivered. For example, one person needed to be repositioned every two hours to reduce the risk of pressure damage, but the records did not always demonstrate that these positional changes had taken place.

The provider did not always work well across teams and services to support people.

Records did not always demonstrate effective partnership working. Documentation showed that timely referrals to relevant health professionals were not always made when needs were identified. Records did not always fully reflect people’s current needs and recommendations from health professionals were not always reflected to ensure effective follow up action was taken.

Staff did not always work well together as a team. Some staff felt there were challenges where family members worked together, and some staff were resistant to change. Comments from staff included, "There is enough staff the problem is family work together. They [staff] don’t always work fairly when they are working with family members" and "Staff need to work together a bit more. Some staff won't work with other staff such as agency or new staff."

The manager was aware of the concerns relating to the staff team and was addressing this through allocations and staff rotas.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were not always supported in a way that ensured their social needs were met. Several people told us they did not feel staff listened to them or engaged with them in a meaningful or person‑centred way. One person told us, "Staff argue with me, I don’t feel like I can tell them what I want sometimes."

Staff did not consistently explore people’s wishes or ask effective questions to understand how they wanted to spend their time. One person told us, “I don’t get to go out, there’s no one to take me.” When asked whether they would like to go out, the person responded, “Yes, I would like to go to the shops to buy some biscuits.” The manager was present during this discussion and said they would arrange this. Staff supported the person to go to the shop later in the afternoon.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

People’s care was not consistently monitored or delivered in line with their risk assessments or the guidance provided by healthcare professionals. Staff did not always complete monitoring records to demonstrate that people had received appropriate support with behaviours or repositioning. This issue had been identified at our previous assessment, and although additional checks had since been introduced, these measures had not sustained improvement.

People’s care plans did not contain enough guidance to direct staff in monitoring people's distressed behaviours and lacked instruction on how staff should document these. Staff rarely recorded incidents of distress on behaviour charts. One person was prescribed medicines to help manage their behaviours; however, they did not receive this when they became distressed nor was their behaviour monitored.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were supported to make informed choices about their care. Records confirmed that consent was obtained, and when individuals lacked capacity, decisions were made in accordance with the Mental Capacity Act 2005 (MCA). Staff had received MCA training and completed the necessary assessments for care-related decisions, including capacity assessments and best‑interest decision documentation.

During our assessment site visits, we observed staff offering people choices.